This is something that bugs many in the health field - why do we treat shoulders so differently to many other joints? You might be wondering what I mean by this...I mean that when people come in with say, knee pain, we aim to reduce the pain, increase the movement and then gradually load the joint back up to better than pre-injury levels, or as I like to tell my patients - we calm shit down and then build shit back up.
So why don’t we do this with the shoulder?
The shoulder seems to be a voodoo for many therapists across all disciplines. I’ll admit that it can seem to be a complicated joint when you look at every single little thing that could go wrong. It can be overwhelming! Your shoulder moves in many different planes and is incredibly strong, whilst incredibly mobile!
I think that this may be the reason that it typically isn’t treated effectively and if you’re reading this then I can almost guarantee that you have, or have had, frustrating shoulder pain. So if you’d humour me for a few minutes, let me offer a solution to your pain.
Pain is Pain
Forget muscle pain or nerve pain or joint pain, it’s all pain and it all needs to be dealt with accordingly. We have so much amazing research now, which I won’t bore you with, that gives us the tools to help you decrease and be in control of your pain. Your perceptions about your pain will be far more important than ANY structural damage!
Don’t believe me? I wouldn’t either, who is this guy!?
A study in 2013 found NO DIFFERENCE in outcomes between patients given a sham clean out surgery of their knee compared to the real surgery. So what does this mean for you and your shoulder? It means that if you believe in the treatment you are receiving then your pain will decrease! That’s huge.
What About My Scans?
Throw them in the bin. Have a look at this fascinating graph below from Adam Meakins (The Sports Physio)
What this shows is that degeneration and pain are not interrelated! In fact, think of degeneration as you think of wrinkles and grey hairs - annoying, maybe; but painful? No!
So let’s put the scan away and focus on what really works...Movement and Strengthening!
Your Shoulder is Built to Move
It kills me when I hear people say, “Ohh I just can’t do that anymore, my shoulder can never get better - my Physio told me to change my lifestyle to avoid certain activities.” This is a nonsense and lazy approach to treating shoulders (99% of shoulders - can discuss frozen shoulders in another blog).
The truth is your shoulder CAN and SHOULD be able to go through the full range of movement and, by avoiding movements, you will develop more stiffness, pain and decrease movement further. Avoid all movements that hurt suddenly doesn’t seem like such great advice anymore does it?
You Can’t Go Wrong with Getting Strong - Adam Meakins
I love this part of rehab and you should too. This is where the magic happens. This is where you feel that great pain in your shoulder, the one you haven’t felt in so long; the feeling of the muscles working hard and getting stronger!
This is done so poorly with shoulders, we see small band rotations prescribed constantly but nothing that really challenges the shoulders muscles. And look, if you’re not challenging the muscles, how can you expect to increase strength and improve, right? It just makes sense! So let’s put the yellow theraband back in the box (practitioner band if they’re on a budget) and grab some weights. Let’s strengthen the rotator cuff and get you back to ALL shoulder movements.
Whether it be hanging the washing out or lifting heavy things overhead, you can and should be able to return to this!
If you would like me to call you to discuss your shoulder pain & how we may be able to offer your a solution then please fill in the contact form below. It is possible to do what you love again, pain free.