Chronic Shoulder Pain: How to manage Bursitis, Rotator Cuff, Frozen Shoulder and more!

We’ve talked about acute shoulder injuries but what about those persistent shoulder problems that seem to hang around for ever?

Long term pain shoulder pain is managed similarly to acute shoulder pain, with a few key differences.

With acute shoulder pain we will often use the level of pain as a big indicator of how much is too much. The exercises we choose will often be pain free to prevent the shoulder from flaring up days after you exercise.

With longer standing pain our management is a little different.

Pain during exercise is actually ok to a point and
can actually be beneficial in reducing sensitivity in the structures of your shoulder.

The pain experienced in acute shoulder injury is often suitably protective so that we do not do further damage. This is different in long term shoulder dysfunction where we can often become OVER-protective and hyper sensitive to pain.

Correcting over-protective and maladaptive movement patterns in the shoulder (aka moving without pain!)

Often there is a pattern of movement that needs to be changed in order to get your shoulder moving more efficiently.

These are often movement patterns that your brain has adopted to try and reduce the likelihood of irritating the shoulder. This is beneficial in the beginning but can quickly become excessive as we progress through recovery. Think of it as like you are limping months after you injured your ankle – you sometimes need to relearn how to walk normally and recognise that the pain is no longer an indication of tissue damage.

The first thing we must do to address this is find what the most prevalent compensatory patterns are. Once this has been done then it is all about repetition and exercise to encourage a new movement pattern to take its place.

We will then progress to gradually loading  the shoulder with either bands or weights to build more robust patterns that you can rely on in your every day activities.

Strength training for shoulder pain

Generally most long term shoulder pain presentations will require some form of strengthening, especially if it has been a problem for a long time.

This is all well and good to say, but people often find it difficult to find exercises that are suitable for their current level of function and knowing how much pain is ok vs what is too much.

This is where we as physiotherapists can help you with determining what movement patterns are dysfunctional and how much to push your shoulder to stimulate recovery.

Not everyone needs to lift weights or use resistance bands. Everyone is different and your physiotherapist needs to tailor an exercise program to your individual needs.

Learn More About Our Shoulder Pain Service
Stay tuned on the blog for more about shoulders!

PS
If you didn’t get around to checking out my Free Shoulder Pain E-Book you can check it out here.
Written by Declan Price

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