Physiotherapy Portal

How to fix your own shoulder pain

Posted by Stuart Fossella on Wednesday, March 01, 2017

8 Quick Tips to decide if your problem is your Neck or your Shoulder

 Boy Lifting Arm

Ok here’s one to help you out if you are suffering from ‘Shoulder Pain’.

We see this all of the time and it’s no fault of the patients when they come to us complaining of ‘Shoulder Pain’. They will point to the area between the base of the neck and the actual Shoulder joint - Check out the picture on our homepage (lady in blue vest) if you can't picture where I am talking about.

Now it would be easy for the non-therapist to think and feel that this problem was related to the shoulder, why wouldn't you?

The thing is…this ‘Shoulder Pain’ is more than likely actually originating from the NECK!

You see the region the hand has been placed on is so near to the junction of the neck it's untrue. Sitting right in this area are the muscles of the back of the neck and the joints of the spine themselves. The picture on the homepage actually shows the ladies hand covering the joints of the neck.

So how can you tell if it's your Neck or your shoulder that's the actual cause of your troubles?

8 Quick ways to decide of your problem is coming from your neck or your shoulder:

Check out this list to help you decide what is what.

1) Do you feel your pain when you move your head either: up, down or when looking over the shoulder?

  • If the answer is yes the problem is probably coming from your Neck.

2) Do you feel your pain if you shrug your shoulders to the ceiling?

  • If the answer is yes the problem is probably coming from your Neck.

3) Do you feel the pain in that region when you are trying to sleep?

  • If the answer is yes the problem is probably coming from your Neck.

4) Would you consider yourself to have a generally stiff neck at the moment?

  • If the answer is yes the problem is probably coming from your Neck.

And now for some quick questions that might help to decide if your problem actually originates from the Shoulder:

5) Do you have pain in the region when you lift your arm overhead, as in getting dressed or reaching?

  • If the answer is yes the problem is probably coming from your Shoulder.

6) Do you have pain in the Shoulder in lying on that side at night?

  • If the answer is yes the problem is probably coming from your Shoulder.

7) Do you have difficulty in carrying bags down at your side?

  • If the answer is yes the problem is probably coming from your Shoulder.

8) Is your Shoulder stiff when reaching overhead or in tucking your clothes in around the back?

  • If the answer is yes the problem is probably coming from your Shoulder.

So there it is, your quick guide to deciding if your trouble comes from the Neck or the Shoulder.

Sounds quite simple, and as a quick screening tool the above can be quite helpful. Of course, its not a given, and to complicate things, you could have a combined Neck and Shoulder problem, or the Neck could be causing the shoulder problem!

But that's why we are here, so Bring us your problems :-)

You know where we are - and we’d love to help you out if we can.

If a colleague, partner or friend may find this piece useful, we’d love it if you passed it on to them to read.

The Team at Straight Back

Pilates and Physiotherapy

Posted by Sarah Fossella on Thursday, July 21, 2016


Francesca is trained in Pilates

Because she's Hard-CORE

Not everyone can hop under the Squat Rack for there rehab, we know that and Francesca knows that. It's why she uses Pilates with her Physio treatments.

If you’re suffering with aches and pains from injuries to your back, neck or shoulder, or just wanting to avoid them, then Physio & Pilates is a useful place to start.

Pilates is now widely regarded as one the best ways to tone up weak muscles and give support to your back, neck and shoulder joints.

If you would like to ask Francesca anything about how Pilates can help then call on 01242 802365 / 07940 102905


Email Francesca directly on:




Copyright © Straight Back Physio

Commuting - Im Lucky - I know...

Posted by Stuart Fossella on Wednesday, June 08, 2016


My Neck Pain, Her Back Pain - Our Back Pain Report

Commuting over the bank holiday period got me thinking…Deadly I know.

So, a trip back down to Brighton to see the family resulted in the obligatory bank holiday nightmare traffic. I thought I was being clever coming back to Cheltenham on the Tuesday am.

Well it wasn't to be…

It was raining cats and dogs down South after a great weekends weather, and this caused an almighty build up of traffic all the way along the M23, M25 and M4 - deep joy.

Well a 2.5 hr car journey suddenly became +4 hrs - which set off a few days worth of neck pain for me and some low back pain for Sarah.

What’s going on then?

Well…unaccustomed activity can lead to the onset of pain and dysfunction as we stress joints and muscles in ways in which we usually don't in a day to day basis - we have mentioned this in relation to sport in some of our other Blog posts (have a look at some of the other useful bits of info we've created here)

Find the Injury Info here

In the same way that ‘diving’ straight into a hectic sports routine has the potential to cause damage to joints and muscles, so does sitting for the equivalent of half a working day (the exact opposite of sport = Inactivity).

Some of you may have read in the press recently that sitting can be as bad for your health as smoking!!

Seems to be a bit of an exaggeration you might think?

But check out this BBC piece to shed a little more light on whats mentioned.

BBC News Piece Here - Sitting as bad for you as smoking

Motion is lotion...

Lotion to our joints that is -

The spine is made up of 33 bones that have a total of 76 joints.

That's 76 joints that can and should move freely - sitting for extended periods of time allows these to seize somewhat, not in a permanent way, but in a way that can go on to cause pain and discomfort. Just like what Sarah and I felt in the car last week.

Combine inactivity with an unusual pillow and mattress for 3-4 nights and hey presto - I got myself a ‘bad’ back or neck.

Sure its not going to last forever, but it can last a few weeks or months if you are unlucky.

So get active, keep active, and above all else...

If Back or Neck pain is troubling you get some help!

PS…A really good place to start if you do have Back pain is to start some simple exercising, have a look at the exercises below.

These stretches may not be enough on their own (we’ve found through years of experience in treating back and neck pain that the hands on treatments in conjunction with exercise work best)...

So I had a dose of neck pain, but Im lucky - Why???

Because fortunately I have the knowledge to know how to help myself in exactly this kind of situation, and of course…

I can call upon my brilliant wife to give me Physio treatment on my neck (I only ever ask for this when she doesn't want to wring my neck :-)

Here's some exciting info for you. 

We've got this great new report for anyone suffering from BACK PAIN - COMING SOON

For more tips on easing back pain like this, here’s free special report with 7 top tips on how to avoid back pain…


Give us a Reply if you need any advice in the meantime.


Incoming: Neck Pain

Posted by Francesca Carpenter on Thursday, May 19, 2016

Lady using phone

My Inbox Reads: Text Neck

While out for a coffee at the weekend, I had a good old look around, as you do, and its safe to say 90% of people there were engrossed in some form of technology - phones, laptops, tablets, all sorts, be it while sat with their coffee or even while waiting for it to be prepared. 

As brilliant as technology is, its use does seem to continue to cause all sorts of aches and pains and although this isn’t a new thing it just continued to highlight to me the reason we as physios see so many people with neck pain. 

The idea of this ‘text neck’ phenomenon that was highlighted in the press perfectly illustrates the effects head position has on our necks.

Neck Posture

When looking at this, no wonder why we develop pain. As efficient as our bodies can be, it can only take so much load before something’s going to give.

We are all guilty of it, all finding ourselves in these positions at numerous points throughout the day, be it using the computer, reading or looking at our phones but it all can amount to the same thing – a pain in the neck!!

Often patients can’t recall a specific event that triggered their pain and in the majority of cases it is often just a ‘little niggle’ that creeps up on us until eventually the body can’t take anymore and that once ignored ‘niggle’ becomes more of a debilitating pain.


If you’re sat reading this now – have a quick think about your current position.

Are your ears way out in front of your shoulders? Are you slumped?

What’s your desk set up like? Below is an illustration of some quick basic tips you can adopt to optimise your position at work. Take a look and see if you need to consider making any changes.

Neck Posture

There are also a few basic exercises that can help with muscle tightness and joint mobility that are worth giving a go:

Lady using phone

We are only human therefore we will all find ourselves falling into bad postures. However, if we can increase our awareness of our body position in whatever we are doing then we can look to make the changes required.

You may not currently have pain but prevention is always better than cure!!

Bet that made you sit upright :-)

Let us know by leaving a comment if you did happen to be grabbing a coffee when you read this!

If you know anyone obsessed with their Tech but moans about a bad neck, show them this, it might just help.



Posted by Stuart Fossella on Thursday, November 22, 2012

the mechanism of whiplash


When people think of Whiplash they think of road traffic accidents. In reality whiplash is associated with sudden acceleration and deceleration or a ‘whipping’ motion. Of course this whipping action can also be caused by a sporting blow or tackle.

The whipping action causes trauma to soft tissues such as muscle, tendon, and ligaments. The force of the action can also sprain joints of the neck. Equally nerves can also be traumatised in an accident.

Physical examination may reveal a lack of head/neck movement, restricted because of muscular spasm and stiffness of the neck joints.

Check out the following link for a 3D image of the neck muscles Healthline

Clinical Signs

  • People often complain of pain and stiffness of the neck a day or two after an accident.
  • Muscular spasm can be noted in and around the neck.
  • Shoulder pain can may or may not be present.
  • If nerves have been damaged, symptoms may travel down the arm, including pins and needles or numbness.
  • Headaches are fairly common after an accident


  • In the early stages pain management is important. This can include the use of pain killers and anti-inflammatory medication.
  • Heat and ice can be useful to ease symptoms.
  • Taping techniques and Acupuncture can be useful to ease symptoms of pain.
  • Its important to keep mobile, but take relative rest so not to aggravate symptoms.
  • As time progresses, neck stretches, soft tissue massage and joint mobilising are important to regain full function and health of the damaged joints and tissues.

Osteo Arthritis (OA) of the neck

Posted by Stuart Fossella on Thursday, November 22, 2012

X-Ray displaying the effects osteoarthritis has on the neck

OA (Osteo Arthritis) of the neck

Also known as Cervical Spondylitis or Cervical degeneration this condition in its most simple form can be thought of as wear and tear, or wear and repair of the small joints in the neck. Arthritic changes occur naturally with age but can be found in younger people who have suffered previous trauma.

All of the joints throughout the body are lined with super smooth cartilage that allows free and smooth movement. When this starts to degenerate and ‘wear’ the body attempts to replace the lost cartilage with haphazard bony growths. If these bony growths ‘catch’, neck movement can become restricted and painful.

Check out the following link for a 3D image of the neck joints to imagine how bony growths would affect movement Healthline

Natural aging also means that the discs or spacers between joints may lose height. The bony growths and loss of disc height may irritate nerves and cause symptoms of pain, pins and needles and weakness down the arm.

Clinical Signs

  • Stiffness at the end or beginning of the day.
  • Pain and stiffness at the neck.
  • A loss of neck movement.
  • Headaches may be apparent.
  • +/- Upper limb symptoms including weakness, pins and needles or numbness.


  • Joint mobilisation or manipulation.
  • Muscle stretches and strengthening of postural muscles.
  • Acupuncture.
  • Soft tissue massage and release.
  • Advice and education regarding Independent management of symptoms including pacing strategies.
  • Heat or cold treatment.

Bulging Disc or trapped nerve

Posted by Stuart Fossella on Thursday, November 22, 2012

image of spinal vertebrae displaying disc bulge

Bulging Disc or Trapped Nerve

Between the spinal bones or vertebrae lay jelly like discs that act as shock absorbers and structures that act as spacers. These discs are gel like in make up and held together by an outer casing. If the outer casing becomes damaged or ‘fails’, the disc may end up ‘bulging’ rather than slipping.

Check out the following link for a 3D image of the discs sitting between the vertebrae and the nerves exiting the joints Healthline

If a disc bulge is large enough it may press on, and trap the nerve that lies closely to the disc, causing pain down the arm.

Causes of a disc bulge include:

  • General wear and tear from repetitive actions such as bending, twisting and lifting.
  • Sudden movements.
  • Or because of no apparent cause (‘creeps up’ on a sufferer).

Clinical Signs

  • Usually associated with severe one sided pain at the neck or arm and hand which may be made worse with neck movements or coughing, sneezing and straining.
  • If a nerve is trapped or irritated then it may cause someone to feel pain or ‘pins and needles’, down the arm to the hand (also known as referred pain).
  • A loss of skin sensation or loss of muscular strength may be noticed in the arm or hand.
  • If a bulge is large enough, symptoms may be felt in both arms.


  • Initial management of pain with adequate pain relief.
  • Ice treatment or the warmth of a hot pack.
  • TENS/other electrotherapy.
  • Neck traction.
  • Activity modification, postural advice, ergonomic assessment/modification.
  • A rehabilitation programme and Graded return to activity.

Wry Neck or Torticollis

Posted by Stuart Fossella on Wednesday, November 21, 2012

Wry Neck or Torticollis

The term Wry neck or Torticollis refers to a painful and stiff neck that is locked because of severe muscular spasm. Rather than the neck being ‘locked’ by a facet joint, stiff muscle is the main problem. The spasming of the neck muscle generally occurs because of repetitive twisting, bending or abnormal, unaccustomed sustained positioning of the head. Many sufferers report simply waking one day with the condition.

Check out the following link for a 3D image of the neck joints and soft tissues Healthline

An physical examination may reveal a lack of head/neck movement, limited because of acute spasm related to tight soft tissues, perhaps caused by the underlying muscle, tendon, fascia and ligaments.

Clinical Signs

  • Classically associated with a side bent and rotated head.
  • One sided pain.
  • Pain and stiffness of the neck or top of the shoulders.


  • Stretching techniques to reduce stiffness.
  • Soft tissue release and massage.
  • Acupuncture for pain relief.
  • Advice associated with posture modification.
  • Electrotherapy.
  • Kinesio Tape

Sprained Neck

Posted by Stuart Fossella on Wednesday, November 21, 2012

Sprained Neck

A ‘sprain’ by definition suggests damage to a ligament caused by over stretching. So a sprained neck is the term for a condition that is often brought about from sudden or unexpected neck movement. This can include can include slips, trips, falls or sports injuries. Pain may be delayed in its onset, so you may actually feel symptoms a day or so after an accident.

It is almost impossible to diagnose exact structures that may be causing pain, but diagnosis is taken from a detailed patient case history and the results of a physical examination.

Based upon a patients explanation of an injury we can begin to ‘paint a picture’ of the cause of neck pain which may include: Damage / sprain of the facet joints (the small joints in the neck which allow movement) or sprain to the ligaments of the neck.

Check out the following link for a 3D image of the neck joints and soft tissues Healthline

Clinical Signs

  • Pain may be one sided and become worse with movement.
  • Pain may be delayed in its onset.
  • May or may not be associated with muscle stiffness and spasm.
  • Pain may be felt into the arm.


  • Treatments may include reducing spasm and pain with hot or cold treatment, and the use of simple analgesia or anti-inflammatory medication.
  • Modifying activities to avoid aggravating symptoms further will generally be useful.
  • Soft tissue massage.
  • Kinesio taping.
  • Acupuncture.
  • Gentle exercise including stretching.
  • Gentle exercise including stretching.
  • Postural modification and core stability exercises.


Posted by Stuart Fossella on Tuesday, November 20, 2012

Image of a lady suffering with a headache


Headaches can be caused by a wide variety of problems but what we are considering here is those that originate from the neck region. These are very commonly caused by joint stiffness in the upper part of the neck or because of muscular tension, or more often than not, a combination of the two. So although you are suffering with a headache, the actual cause may be your neck!.

Check out the following link for a 3D image of the neck joints and soft tissues Healthline

A Cervicogenic headache (originating from the neck) is diagnosed based upon a patients description of symptoms and upon the findings of a detailed physical examination carried out by your Physiotherapist.

An examination may reveal a lack of head/neck movement, limited because of stiff joints. Acute areas of tenderness through the neck may be related to tight soft tissues, perhaps caused by the underlying muscle, tendon, fascia and ligaments.

Clinical Signs

  • A frontal or one-sided headache, or ache behind the eyes.
  • Headache made worse by postures held for an extended period of time.
  • Headache made worse by movement or certain specific activity.
  • Stiffness and tenderness in the neck causing a loss of movement.


  • Joint mobilising, +/- joint manipulation.
  • The release of tight soft tissues.
  • Acupuncture for pain relief.
  • Stretching and strengthening of postural muscles at the neck and upper back.

Contact us today, and see how Physiotherapy can help relieve headaches.

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