physiotherapy for Shoulder pain in Cheltenham

adhesive capsulitis

Also known as a frozen shoulder, adhesive capsulitis is when the shoulder loses a large range of movement and becomes very painful and stiff. The tissue surrounding the shoulder joint becomes inflamed and painful which prevents movement of the shoulder and, in some cases, prevents movement altogether.

The exact reason why a frozen shoulder develops is unknown. They tend to occur in the middle-aged or older people and are believed to result from irritation of the shoulder joint and its surrounding capsule. Irritation to the shoulder joint capsule causes an inflammatory response with the formation of adhesions, or small scars, between folds of the capsule.

Treatment may involve the use of anti-inflammatory drugs, stretching, strengthening and range of movement exercises. Occasionally, if these measures do not provide relief, referral for an injection into the shoulder joint may be appropriate. Other physiotherapy options include Postural Realignment, Ergonomic Assessment, Acupuncture, Taping and Soft Tissue Treatment.



Labral tear

A labral tear is a tear to the labrum which can occur as a result of trauma to the shoulder. The labrum is a ring of cartilage that surrounds the head of the humerus (upper arm bone) where it meets the shoulder. This is to make the ball and socket joint more stable and allows the shoulder to achieve a greater range of movement.

Physiotherapy can be a useful treatment and can prevent the need for surgery. There are three types of labral tears:

• SLAP Tear – This is a tear at the top of the labrum.
• Bankart Lesion – This is a tear at the front of the labrum.
• Reverse Bankart Tear – This is a tear at the back of the labrum.

Treatment can involve resting the shoulder, usually with the help of a sling, with movement gradually increased under a physiotherapist. Strengthening of the shoulder can then also be gradually increased and should focus on the muscles collectively called the rotator cuff. Strengthening the muscles around the shoulder blade and in the arm may also help to provide stability to your shoulder after a labrum tear.

Rotator cuff tear

The rotator cuff refers to a group of four small muscles that run from the shoulder blade to the top of the arm bone. They support and move the shoulder joint. A rotator cuff tear refers to a tear in one or more of these muscles. Physiotherapy can effectively treat rotator cuff tears.

A tear of the rotator cuff is usually felt as sudden sharp pain or ‘twinge’ in the shoulder. A person with minor tears may be able to continue with this pain with minimal hindrance. However, as the muscle cools down the pain often gradually worsens as bleeding and swelling around the injured muscle takes place. In severe tears, pain may be so significant that you are unable to continue participating. Other symptoms include reduced range of movement, stiffness, weakness, and joint clicking.

Initial treatment of a rotator cuff tear often involves activity modification, and the use of soft tissue treatment such as massage, stretching, and a series of specific, progressive strengthening exercises.

Other treatments include, Taping, Postural Realignment, Sports Injury Rehab, Ergonomic Assessment.



shoulder impingement

Impingement syndrome is when the tendons of the muscles in the shoulder become irritated and swollen as they pass through a narrow passage called the subacromial space. The first symptoms of impingement are mild. Therefore, many individuals do not seek treatment straight away. Symptoms gradually worsen over time. Initial symptoms include reduced range of movement, swelling/ inflammation,

stiffness, weakness, joint clicking, joint locking.

Impingement can be caused by overuse of the shoulder, especially repetitive overhead activities and lifting in the gymnasium or at work. Shoulder impingement can also be caused by muscle imbalance of the shoulder.

Surgery is not often performed unless physiotherapy has been completed. We may suggest relative rest and to avoid overhead activities. Treatment will focus on reducing pain, stretching any shortened muscle groups and strengthening weak muscle groups to allow return to normal activities as soon as possible. Treatments may include Manipulation / Mobilisation, Sports Injury Rehab, Exercise Programmes, Massage, or Postural Realignment.

winging scapula

A winging scapula occurs when there is a weakness or damage to one of the muscles attached to the scapula. The scapula (shoulder blade) is part of the shoulder and has several muscles that attach and stabilise the shoulder and help to move the arm. These muscles work in tandem with each other so if there is a problem with one of the muscles this causes a break in the rhythm of the scapula’s movement that can cause the scapula to ‘wing’, i.e. the scapula instead of being flat on the back, points outwards and away from the back.

There can be a number of causes for a winging scapula. These can include

Loss of function of a single muscle, General scapula stabilizer weakness, Shoulder instability, Shoulder pain, Damage to brachial plexus.

As there are various possible causes of a winging scapula, it is hard to list specific treatment. However treatment may involve Shoulder muscle imbalance correction exercises, Shoulder muscle strengthening exercises, Scapula setting exercises, Shoulder range of movement exercises, Long term management if the problem cannot be completely resolved.