Shoulder Pain Treatment in Wynnum

The shoulder is a complex, mobile joint with muscles, ligaments and tendons working together to maintain healthy movement and stability.

Assessment focused on identifying the source of pain, not just the location
Experienced physiotherapists with 10–20+ years in clinical practice
Management of instability, strains, tears and frozen shoulder
Clear explanation of what’s happening and what to do next
Progressive rehabilitation to restore movement and reduce recurrence

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No referral necessary

Why is shoulder pain so complex?

Shoulders are one of the most mobile joints in the body, it's a case of trading strength and stability for range of movement. Unlike the hip socket the shoulder does not rely on a deep socket for stability, the stability comes from ligaments, muscles and tendons instead. This anatomy allows for the extra movement, however when things go wrong a thorough physiotherapy assessment, diagnosis and treatment is required in order to help restore movement, instability or treat the pain.

What actually causes your shoulder pain?

Most shoulder pain isn't from a single traumatic injury. It builds up over weeks or months from posture, training load, sleep position, or a job that requires a lot of repetition. In other cases it may be something specific you can usually point to. You started bench pressing again, you slept funny, you fell on your arm, you picked up something heavy and felt a click or a grab.

The most common culprits we see in the clinic are listed below.

Bursitis

Bursitis is one of the most common causes of shoulder pain, the role of the bursa is to reduce friction and protect the tendon as it glides through the shoulder joint. Subacromial bursitis, which is inflammation of the bursa, often presents as discomfort on lifting your arm and may ache afterwards, it may also become sore when lying on that side. Often it is associated with tendinopathies, scapula dyskinesia (faulty scapular movement patterns) or a change in load.

Rotator cuff pain & tendinopathies

Rotator cuff tendinopathies can devlop over time through constant use and wear and tear accompanied by incomplete healing. Often combined with bursitis, rotator cuff dysfuction or pain can be limiting and due to the structure of the tendons (poor blood supply), can be ongoing and slow to heal. Often irritates on movements, first thing in the mornings, or after work.

Rotator cuff strains & tears

Acute overload of the rotator cuff can cause strains and tears to the rotator cuff. Partial tears and strains can be managed conservatively with physiotherapy, more advanced tears and ruptures may require some surgical intervention, followd by physiotherapy to rehabilitate the shoudler back to full function.

Subacromial impingement

Subacromial impingement refers to the mechanism of a catching or clicking pain on lifting your arm, often out to the side. This frequently leads to the development of a bursitis or predisposes to a strain or tear.

Shoulder dislocations/subluxations

The shoulder is one of the easiest joints to sublux or dislocate due to its design for optimum movement. Once a dislocation has occured, it's common to have more dislocations as often the initial dislocation has stretched the stabilising ligaments and joint capsule in the shoulder.

Muscular strength and stability needs to be trained to help compensate for this.

Frozen shoulder

In frozen shoulder the capsule around the shoulder thickens, contracts and adheres to itself, think gladwrap once itsfolder up on itself.

The main indicator of frozen shoulder is that your active movement is the same as your passive movement, in that if someone else lifts your arm they can't lift it any higher than you can lift it yourself.

Other causes of shoulder pain

Sometimes the pain felt in or around the shoulder isn't actually from the shoulder. The nerves that supply the shoulder come from the neck, and an irritated cervical disc or facet joint can refer pain into the shoulder, down the arm, and occasionally into the hand.

A major cause of shoulder pain is from either the thoracic spine, the surrounding muscles and the movement or control of the scapular.

The rhomboids, levator scapulae, serratus anterior and upper & lower trapezius all have to function together in order to give a stable platform for the rotator cuff and shoulder to function. When they don't it can lead to secondary impingement, leading to the development of the above conditions.

A need for a thorough assessment

Shoulder pain is one of those areas where guessing the diagnosis from symptoms alone gets you in trouble. Pain at the front of the shoulder could be biceps, rotator cuff, AC joint, or referred from the neck. Pain when you lift your arm could be bursitis, a cuff tear, frozen shoulder in its early stages, or a stiff thoracic spine making the shoulder compensate. The symptoms overlap a lot, and without accurate testing, treatments risk becoming generalised and less specific to the condition.

A good assessment starts with asking how it began, what you've tried, what makes it worse, what your work and sport demand of the shoulder, how it is affecting your sleep. That alone usually narrows things down to a couple of likely diagnoses before we put hands on you.

Then we test. How the shoulder moves actively and passively, how the shoulder blade tracks, how strong the cuff is in different positions, and which specific tests reproduce your pain. We check the neck and thoracic spine because they influence the shoulder constantly. If you're a lifter, we may assess your technique to work out what structures you may be overloading.

A thorough assessment is also where we pick up the things that need referring on, whether that's a scan, a GP review, or a specialist opinion. By the end of the first appointment you should know what we think is going on, why, what the plan looks like, and roughly how long it'll take.

Physiotherapy treatment techniques for shoulder pain

Shoulder pain is often multifaceted, and every case is different. Treatment should be tailored accordingly.

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Hands-on physiotherapy

Manual therapies including massage and mobilisations can be used in particularly stiff shoulders to help regain movement. They can also be useful in painful shoulders to help reduce the pain and restore pain-free movements. The physiotherapist will often combine these with home stretches and drills so you can continue to make improvements at home.

Exercise rehabilitation

Clinical rehabilitation and strengthening is particularly effective to strengthen the rotator cuff muscles, improve the strength of the scapular stabilisers and to build the resilience of the shoulder to help withstand future load or trauma. This can be done as part of your physiotherapy treatment or as part of a physiotherapy class. Often the physiotherapist will give you strengthening and stability exercises to continue with at home.

Load management and education

Load is a fundamental part of shoulder injuries and rehabilitation. A structured approach to returning to activity is important to support recovery and help identify why the pain has occurred or continues to occur.

Dry needling

Dry needling can be particularly useful to help reduce tight rotator cuff muscles and acupuncture may be useful in painful conditions such as frozen shoulder, where the shoulder is inflamed and angry.

Massage Therapy

Massage therapy can be useful alongside physiotherapy, by helping to release tight muscles and to help remove tension in surrounding joints or muscles. A remedial massage may be more focused on helping the surrounding structure that may be contributing to the pain.

Exercise physiology

Exercise physiology may be helpful for more complex or long-standing presentations, particularly where general conditioning, strength, or broader health factors are involved. It provides supervised, progressive exercise beyond the early rehabilitation phase.

When to see a physiotherapist for shoulder pain

Physiotherapy can help treat both acute and chronic shoulder conditions

You should book an appointment if:

You have irritated your shoulder on a movement.
Pain that is waking you at night or you are unable to sleep on that side.
Pain that is affecting your work, activities or training, or simple tasks such as putting on a seat belt.
Pain with clicking in the shoulder or catching on certain movements.
Shoulder pain that's started from a change in training, added new exercises ie benchpress or an increase in volume ie increased swimming distances.
Post-surgical shoulder shoulder rehabilitation.
Frozen shoulder where the pain is getting worse in every direction.
Shoulder pain in pregnancy or post-natal that's making feeding or carrying difficult.

Seek urgent medical care if you experience:

Sudden severe shoulder pain with chest pain, jaw pain, nausea or shortness of breath.
Shoulder pain with unexpected weight loss, night sweats, fever or a history of cancer.
You have had a recent fall and your shoulder looks deformed, you cannot move it at all or numbness or weakness into the arm or hand.
Sudden weakness into the hand with no pain.

If you’re unsure, it’s worth getting you shoulder assessed early as early physiotherapy can address the issues faster and prevent a more serious injury from developing.

Shoulder pain from the gym, bench press, and overhead work

Shoulder pain while bench pressing usually comes down to one of several things: your technique, the volume or change in volume in your training or a relatively weak rotator cuff muscles or scapular stabilisers.

A bar that's too high on the chest will cause the elbow to flare, and increased pressure on the front of the shoulders, scapulas that don't retraction also over load the shoulder and a decreased internal rotation can also place pressure on the shoulder and AC joints. A condition called osteolysis of the AC joint is common in weightlifters.

Volume is a large problem here. When making progress in the gym, it can be hard to slow down, stop chasing PBs (personal bests), or rotate in different exercises. While you may be getting stronger, often the stability muscles and tendons may take time to catch up, placing the shoulder at risk of injury. The same principle applies to yard work. If you have an office job and haven't been physical for a while, spending a whole day in the yard, pruning trees,
moving dirt, or overhead painting can be enough to create an issue.

If you're a CrossFitter, swimmer, thrower or overhead athlete, the same principles apply. We need to figure out how much load your shoulder can handle and reintroduce exercises as you are able to manage and rebuild your training volume.

Reviewed by Calum Fraser - Physiotherapist

Advantage Healthcare & Physiotherapy's goal is to provide the highest quality care possible to the Wynnum, Manly, Brisbane Bayside residents.