Have a sore shoulder that has been bugging you for weeks, months or even years? Does it hurt to raise above your head, or do you wake up to being incredibly stiff? You may have rotator cuff tendon problems (tendinopathy).

Chronic shoulder pain is not only a daily hassle but can eventually stop you doing the things that you love such as playing sport, picking up the grandkids or participating in gym classes with your friends. You’re trying to make an effort to improve your health, but that nagging shoulder is just constantly getting in the way.

Treatment / Management:

Currently, it could be considered logical to rest something when it gets sore and wait till the pain subsides. A standard coping mechanism would be to apply an ice pack to the affected area after a flare up hoping the pain will reduce. If the pain and stiffness continue a trip to the physiotherapist or even a surgical assessment may be the next step. What we know from current literature is surgery to improve nagging shoulder pain has a low rate of success and could create a host of new issues.

Sadly, taking a passive (rest and surgery) rather than active (corrective exercise) approach to this type of pathology will often only promote short term relief. Surgery and rest often result in weaker structures and not address the root cause of the problem which can result in dependency on healthcare professionals.

What we initially need to establish is that a tendinopathy is an overuse injury as a result of excess and/or incorrect loading of the tendon. Regarding shoulder tendinopathies, the cause of pain and irritation is often due to the supraspinatus tendon getting constantly jammed into the roof of the sub-acromial space during overhead movements.

The tendon can get inflamed by this irritation which causes increased pain and if not treated correctly leads to degeneration. During acute inflammation it is best to rest the tendon so not to increase the damage but soon after it is important to start strengthening the tissues. Unlike fractures, sprains or strains, a degenerated tendon responds best to load; eccentric (lowering phase) and isometric to be specific.  This is how it heals!

As Exercise Physiologists, we specialise in the management/treatment of chronic issues such this by taking on a holistic and proactive approach. Rather than just looking at the shoulder joint, we look at how other joints move in relation to it. Additionally, we factor in lifestyle influences (occupation), flexibility, posture and appreciate the complexity and uniqueness of each clients’ shoulder complaint as everyone’s anatomy is slightly different. We will also provide evidence-based education to clients about their injury helping them better understand what is going on and why they are doing specific exercises.

A true and effective treatment method is to address the cause of the problem which lies hugely how the shoulder joint (younger brother) moves in relation to the scapula (older brother). For the shoulder joint to work effectively and safely, it needs a strong older brother to help stabilise it! The scapula’s role is to help keep the humeral head depressed maintaining adequate sub-acromial space to prevent the supraspinatus tendon from rubbing and degenerating. Initial injury and poorly managed rehabilitation can result in compensation mechanics which will create faulty movement patterns creating a snowball effect to the injury. What we will do is address any shoulder mobility issues and correct poor movement patterns through movement sequencing and strengthening.

Come in and see one of ActiveOne Groups Exercise Physiologists to start taking control of your injury, improve your confidence in overhead movements and regain your independence! We will do a full movement analysis and design a specific exercise program for you and provide useful tips and tricks to take home and continue to use.

See below for some exercises we might prescribe for shoulder rehabilitation. Every shoulder is different and exercises need to be prescribed for individual’s needs. The exercise demonstrated here are only examples of exercises that may be used and might not be appropriate for your shoulder condition.

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