Shoulder Pain

Adhesive capsulitis is initially an extremely painful shoulder condition, often starting without injury. It demonstrates phases commonly starting with severe pain which then as it eases is replaced with severe stiffness and difficulty moving the shoulder. This time scale can be different in each patient and can last up to 2 years. Treatment of frozen shoulder involves therapies to improve range of motion with stretching and exercises alongside lifestyle advice.

The 4 main muscles and tendons that move the shoulder are collectively known as the rotator cuff. This cuff lies under the acromion (a bony extension of the shoulder blade). The space between the cuff and the acromion contains the subacromial bursa. The primary function of these four muscles is in to hold the top of the arm central in the shoulder socket, allowing for smooth “roll, slide and glide” on the shoulder joint in the socket when the arms move during activity.

If one or more of these muscles is weak or not activating sufficiently then the shoulder can’t be held central in the socket allowing it to travel upwards. This narrows the space “impinging” on the rotator cuff or sub acromial bursa. The cuff and bursa become inflamed and painful.

Treatment of impingement syndrome and the consequent inflammation or tendinopathy involves locating the causative factor as well as reducing pain and stiffness. If the cause of the problem is not found, quite often the symptoms remain or return at a later date. Once determined, the cause of the problem can be corrected with manual therapy, acupuncture, taping and a graded exercise program.