Shoulder pain can be extremely debilitating. Think about instances where you don’t use your arms. Not that many, right? Shoulder pain is a common complaint frequently related to overuse or overload. Terms you may have heard are frozen shoulder, impingement, rotator cuff syndrome, biceps or suprapinatus tendinopathy and even instability. Some terms are outdated but still get thrown around without thought. Poor information can cause great fear to the person suffering with the pain. It is best to seek professional help for an accurate diagnosis and an in-depth care plan. However, you can start here by becoming educated and empowered.
1.Trust the process.
Don’t look for a quick fix or believe there is a miracle cure like a quick cortisone shot. If your shoulder pain is not due to a traumatic event or sports injury, trust and know that the body is very clever at healing itself. Shoulder pain has a very good natural history of slowly getting better over time when you treat it with respect, modify movement and gently exercise. Nature has a better long-term outcome than cortisone and the body is trying to tell you something, don’t shut it up.
2.If it irritates your shoulder pain, don’t do it.
Sounds simple enough, yet every day I see patients that keep poking the bear, hoping to get different results. Sometimes it is a simple movement like reaching for the seat belt but often people find weird and wonderful positions that provoke the pain. Stop.
Rather find a way to modify the movement in such a way that it takes pressure off and helps reduce pain. If you need help, a physio is trained in helping you modify movement.
3.Your best posture is your next posture.
Many people are aware that the neck and back can get sore from hours of sitting in one position. Did you know the shoulders also suffer? How do you remedy that? More and more research is pointing toward movement being the answer to postural pain and not necessarily sitting in the perfect posture. Simply put, variety is the spice of life. Move often and adopt a plethora of postures during the day, especially positions that alleviate your shoulder pain. In many cases, the pain-free position mimics the old “perfect posture” positions, but if maintained for hours, even perfect becomes uncomfortable. Move.
4.Don’t sleep on the sore shoulder.
The reason we say this is that lying on it all night is a very heavy load. A sore shoulder is one that doesn’t have capacity to handle load. I realise that this is easier said than done because we have all have sleeping habits. It may be that you can only fall asleep lying on the sore shoulder but the converse is that you can’t fall asleep due to the pain or your sleep gets disrupted. Try to develop a new habit of either sleeping on the opposite shoulder whilst hugging a pillow or on your back with the shoulders supported. See our earlier blog on sleeping positions. A supported shoulder will feel more comfortable and is one way of unloading it.
5.Never underestimate the other factors.
The question: “Why did it hurt today when it didn’t hurt yesterday with the same activity?”. The simple answer is that there exists a relationship between your body’s capacity to handle load and that capacity being reduced by factors you wouldn’t dream would have an impact. Factors such as lack of sleep, overindulging in food or alcohol, lost strength, high amounts of stress or anxiety, a cold or tummy bug, hormonal changes, change in medication, to name a few. Perform a ‘normal’ activity when the system is overloaded by another factor(s), the ‘normal’ activity becomes what we call relative overload. Pain follows.
Therefore, it won’t simply help to adjust the activity. You may need to consider waiting until your body has recovered from the cold, or learn to meditate to help with stress or reduce the amount of alcohol you consume. Each situation and person is influenced by different factors. Figure out which could be yours and find a way to manage them better.
6.Exercise at the level your shoulder can handle, then slowly progress.
By now you have hopefully found which movements cause pain and how to adapt those movements. You have also found the external factors that play a role and understood the basics of load capacity. Whether weakness is one of those factors or not, beginning to increase the body’s capacity to handle relative load is an important consideration. The best way to do this is with a variety of shoulder exercises that slowly increase the strength over time and with minimal pain.
Isometric exercises are a great place to start, do not place a large amount of strain on the body, yet if practiced regularly (a few repetitions multiple times during the day), can build up the tolerance to load, increase muscle strength and reduce pain enough to progress to the next group of exercises. If isometrics are too easy, then start with lighter weights or pure body weight exercises, graded in such a way to slowly add more load and complexity as the shoulder allows.
Graded or progressive exercises and movement adaptations can be quite tricky. Consulting with a physiotherapist will make the process easier and in turn translate into better results. Give us a call today and we can help guide you.
Although this advice and information is based on sound knowledge it is still followed at your own risk. I cannot take any responsibility for injuries or health conditions that may arise as a result of my advice. Videos and advice are generalised and cannot replace the individualised advice provided after a medical assessment by your local healthcare professional.