Shoulder pain is common and can have many physical causes. Regardless of the cause and assuming there is no significant pathology, the following self-management tips may reduce the severity and frequency of shoulder pain.
1. Avoid movements or positions which significantly aggravate the pain. Generally, it is important to keep moving using movements that either reduce or have no effect on the pain; some discomfort is okay as long as it is manageable and eases shortly after moving.
2. Avoid repeatedly ‘testing’ the shoulder to see if it is still painful by moving or stretching the painful area in an overtly provocative way.
3. If very sore, use the shoulder within the ‘safe zone’. The safe zone is forwards and sidewards movements, keeping the elbow bent and below shoulder height. Moving within the safe zone minimises the stress on the rotator cuff and surrounding structures, shoulder capsule and muscles.
4. Try to get out for a 20-minute walk each day, not too fast, preferably outdoors. Allow the arms to swing generally in a relaxed way, lift your breast bone slightly and keep your chin gently tucked in.
5. It is essential to move from sitting for 2-3 minutes every hour, 10 minutes every two hours, and for a good half hour, preferably taking a walk, at lunchtime. This reduces the cumulative load on the shoulder girdle throughout the day.
6. If you have radiating (from the shoulder or neck) arm pain, try to move in ways that do not aggravate the pain or other symptoms, this may mean avoiding reaching upwards or outwards or downwards for a while. It usually helps to keep the elbow bent at the side when moving to avoid excess strain to the neural structures.
7. Those who move often get better quicker.... ’motion is lotion’. But be careful not to do the same activity over and over again, such as ironing or vacuum cleaning.
8. You may need to avoid certain sports which involve the neck, shoulder and upper back movement until pain severity has decreased along with improvements in mobility and strength to allow you to return to sport without the risk of aggravating the shoulder and delaying recovery.
These tips are usually best combined with physiotherapy treatment, which, if indicated, may include manual therapy, specific therapeutic exercises as well as medical acupuncture and dry needling.
In good health,
Lorraine Carroll MPhty, BScPhysio, BMAS
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