SHOULDER
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Shoulder pain is one of the most common musculoskeletal complaints and can affect daily activities, work, gym training, and sport. Symptoms may arise from muscles, tendons, joints, bursae, ligaments, or referred pain from the neck. Research suggests that shoulder pain is often multifactorial, involving a combination of tissue sensitivity, loading patterns, movement habits, and lifestyle factors (Lewis, 2015).
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The rotator cuff is a group of four muscles and tendons that help stabilise and move the shoulder. Rotator cuff injuries may involve tendon irritation, partial tears, or full-thickness tears and are common in overhead sports, repetitive occupations, and ageing populations. Research suggests rotator cuff-related shoulder pain is one of the most common causes of shoulder symptoms and often responds well to structured rehabilitation and progressive strengthening (Littlewood et al., 2013).
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Shoulder impingement refers to irritation of structures within the shoulder during movement, particularly overhead activities. Modern research suggests that shoulder pain is rarely caused by a single structure being "pinched" and is more commonly influenced by tendon loading, strength deficits, movement patterns, and tissue sensitivity (Lewis, 2015). Treatment often focuses on improving strength, shoulder control, and load tolerance.
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Frozen shoulder, also known as adhesive capsulitis, is characterised by progressive pain and stiffness that significantly limits shoulder movement. The condition typically progresses through three stages: the freezing phase, where pain gradually increases and shoulder movement becomes more restricted; the frozen phase, where pain may settle somewhat but significant stiffness and loss of motion remain; and the thawing phase, where shoulder mobility gradually improves over time. The condition commonly affects adults between 40 and 65 years of age and may occur without a clear cause. Research supports a combination of education, exercise rehabilitation, and in some cases hydrodilatation or medical intervention to assist recovery (Challoumas et al., 2020).
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Shoulder instability occurs when the shoulder joint becomes excessively mobile or repeatedly moves beyond its normal range. This may develop following a traumatic dislocation, repetitive overhead sport, or ligament laxity. Symptoms can include pain, weakness, clicking, apprehension, or recurrent dislocations. Rehabilitation often focuses on improving shoulder stability, strength, and movement control (Olds et al., 2015).
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Shoulder dislocations are a common injury that can occur during sport, exercise, or everyday activities. Early assessment and the right rehabilitation plan can help restore strength, stability, and confidence while reducing the risk of future dislocations. If you're experiencing shoulder instability or recovering from a dislocation, professional guidance can make all the difference.
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The labrum is a ring of cartilage that helps improve shoulder stability. Labral tears may occur following dislocations, repetitive overhead movements, throwing sports, or traumatic injuries. Symptoms can include pain, clicking, instability, weakness, and reduced sporting performance. Management depends on the severity of symptoms, functional limitations, and sporting demands.
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The acromioclavicular (AC) joint is located at the top of the shoulder where the collarbone meets the shoulder blade. AC joint sprains commonly occur following falls onto the shoulder, cycling accidents, football injuries, and contact sports. Symptoms often include localised pain, swelling, and discomfort during lifting or overhead activities. Rehabilitation aims to restore strength, function, and confidence with movement.
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The long head of the biceps tendon runs through the front of the shoulder and can become irritated due to repetitive lifting, throwing, gym training, or shoulder dysfunction. Symptoms often include pain at the front of the shoulder during lifting, reaching, or pressing movements. Treatment commonly focuses on load management, strengthening, and addressing contributing shoulder mechanics.
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Rotator cuff tears can occur following trauma or gradually over time as part of age-related tendon changes. Interestingly, research has shown that many rotator cuff tears are present in individuals without pain, highlighting the importance of correlating imaging findings with symptoms and function (Teunis et al., 2014). Management may involve rehabilitation, activity modification, or surgical referral when appropriate.
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Shoulder bursitis involves irritation of the bursa, a small fluid-filled structure that helps reduce friction between tissues. Bursitis often develops alongside rotator cuff-related shoulder pain and may contribute to pain during overhead movement, lifting, and sleeping on the affected side. Treatment focuses on improving shoulder function and reducing excessive tissue loading.
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Rehabilitation following shoulder surgery plays a critical role in restoring mobility, strength, and function. We regularly assist patients recovering from rotator cuff repairs, labral repairs, shoulder stabilisation surgery, and shoulder reconstructions. Research demonstrates that progressive rehabilitation is essential for achieving optimal outcomes following shoulder surgery (Longo et al., 2021).