There are a variety of reasons your shoulder may be causing you pain. During our assessment, the focus is on WHY you have pain, rather than on the anatomical structure (i.e. disc, ligament, tendon, joint) involved. Once we know that answer, then we can find a solution.

Shoulder pain is typically more chronic so if we don't know the cause then we are only treating symptoms. That will not fix your pain permanently!

If the pain is acute (recent injury) from a specific incident then the therapist may be asking different questions to determine what treatment is required. The focus will be more on regaining range of motion and decreasing pain at the beginning.

For chronic shoulder pain, here are a few reasons you may be in pain but your therapist will be the one to assess your injury and create a treatment plan.

1) Postural dysfunction - Do you sit for long periods? Is your computer screen too small or too high/low for you? Are you reaching for your mouse? 

If the answer is Yes to any of these questions then it might be your posture which is creating the pain. Frequently we do not realize what position we are in at work or at home when we are doing our activities. 

We also need to remember to assess the neck when there is shoulder pain because frequently the pain is being sent to the shoulder from the neck.

2) Poor body mechanics - Are your arms out to the side or away from your body when lifting? Do you do a lot of overhead work? Do you do repetitive lifting/pushing/pulling for long periods? Do you do overhead sports?

If the answer is Yes to any of these questions then your body mechanics might be the cause of your pain! Frequently we overuse our upper body instead of using our whole body.

3) Muscle weakness - frequently a lack in strength in certain muscles, especially in the rotator cuff, will contribute to shoulder pain. The therapist will need to assess those muscles to see which ones are the problem.

4) Muscle tightness - if certain muscles are too tight then they are not able to move in the proper patterns. A muscle that is too tight or too stretched can be a problem!

Who can help you?

• Physiotherapist
• Massage Therapist
• Athletic Therapist

What might be involved in their treatment?

1. Assessment of movement and strength
2. Education - to teach you what is causing your pain and how to make it better as well as how to prevent it from returning in the future
3. Exercises - teaching you how to do the proper exercises to decrease your pain and improve your strength and/or mobility
4. Manual therapy - your therapist may need to release muscles or mobilize joints to improve their ability to move
5. Referral back to family doctor for imaging or to a specialist - if the therapist feels there is a need for an Xray, U/S or MRI then they will contact your family physician to discuss it. They may also suggest a specialist's referral if treatment is not progressing as it should. 

Tips for improving your pain:

1. The strength exercises should be pain-free - if they are not then it usually means you are using the wrong muscles to do the exercises

2. Pay attention to your shoulder position during the exercises - how many you do is not important but how you do it is essential!

3. Strengthening the correct muscles is the key to most shoulder injuries!

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