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Shoulder Pain/Rotator Cuff Disorders

Definition
Supraspinatus calcification, tedinopathy, impingement, bursitis, and rotator cuff disorders all present with the following similar symptoms:

  • Pain on elevation of arm above shoulder level
  • Pain when lying on the affected shoulder
  • Night pain
  • Stiffness, catching or weakness in the shoulder
  • Loss of range of motion in shoulder

Many rotator cuff disorders are associated with pinching of the tendons/bursa within the shoulder joint. Your Advantage Healthcare and Physiotherapy physiotherapist will be able to assist you in accurately diagnosing your shoulder pain.

Management

Physiotherapy Management
Physiotherapy treatment for patients with this condition is vital to hasten the healing process and ensure an optimal outcome.
Specific exercises are required to retrain and correct the muscle activation in your shoulder to prevent recurrence of symptoms.

Medical Management
If physiotherapy treatment alone is not sufficient to resolve all symptoms, your physiotherapist will refer you on for further investigation.

Frozen Shoulder (Adhesive Capsulitis)

Definition
Adhesive capsulitis, or frozen shoulder, is defined as inflammation, scarring and thickening of the capsule that surrounds the shoulder joint. It usually consists of 3 different stages, each of which presents with different symptoms: the painful stage, the adhesive (frozen) stage and the thawing stage.

Mechanism of Injury
The reason for the development of adhesive capsulitis is unknown. It is most prevalent in middle aged people, particularly women.

The known risk factors are:

  • Cervical disc disease of the neck
  • Diabetes
  • Shoulder injury or shoulder surgery
  • Open heart surgery
  • Hyperthyroidism

Signs and Symptoms
A frozen shoulder has three phases each with different symptoms:

  • Freezing – characterised by pain around the shoulder initially, followed by a progressive loss of range of movement. Known as the red phase due to the capsule colour.
  • Frozen – minimal pain, with no further loss or regain of range. Known as the pink phase due to the capsule colour.
  • Thawing – gradual return of range of movement, some weakness due to disuse of the shoulder. Known as the white phase due to the capsule colour.

Management

Physiotherapy Management
After a thorough physical examination, your Advantage Healthcare physiotherapist will offer you a range of different treatment options to help manage the pain and increase your range of movement.

Medical Management
Adhesive capsulitis usually resolves on its own over the course of a few months or years. Despite this, it is often recommended that you have physiotherapy treatment to obtain a better outcome and regain functional capacity faster.

Depending on the severity you may be sent for further investigations, such as MRI to confirm the diagnosis. If your pain is still unbearable and your range of movement is restricted, you will be referred to a specialist who may help you via injection therapy.

What to Avoid
Avoid any sports or activities that aggravate the symptoms.

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