So you are experiencing shoulder pain. I’m sad to say you are NOT alone. There are so many of our patients who experience shoulder pain on a daily basis. As a result they are left frustrated with trying to complete simple tasks. Brushing your hair, using your mouse, or even putting on your seat belt. So what could it be? Today we discuss Shoulder pain and the Rotator Cuff and Tendinopathy. 

What is Rotator cuff tendinopathy?

Firstly, the Rotator cuff is 4 small muscles that surround the shoulder, ensuring it is stable and able to move freely. Unfortunately, with muscle tightness, spasm, and poor biomechanics, these stability muscles can become the source of pain and inflammation. A tendinopathy occurs when there is a breakdown of the tendons within the shoulder. Think of your tendons being strained by repetitive over-use and over time these tendons undergo a lot of undue stress without adequate rest. Some inflammatory issues that occur are swelling between those tendons. The muscles get weaker and the tendons start signaling the body with a pain response! This leads to shoulder pain.

Shoulder Tendinopathy: What do the Rehabilitation guidelines say?

Our current gold standard rehabilitation guidelines consist of 12 weeks or more before considering any other invasive treatments!

These 12 weeks are focused on:

  • Specifically identifying which tendons are irritated or inflamed.
  • Reducing your pain
  • Improving your mobility 
  • Correcting your movement patterns
  • Building strength and stability in your muscles. 
  • Making you stronger than you were before the injury. 

Why do we do all this?

Outcomes show that when considering the cost of surgery, the associated time to take off work and return to social activities conservative management far out-weighs the benefit on both the patient and the health care system. 

Further to this is has been documented that at 2 years post-operative management versus conservative (physical therapy management) patients were NO better!

With this in mind, studies further demonstrated if patients had tears >1cm, if they were older than 65, had full-thickness tears, or any associated muscle atrophy they would respond better to an initial course of exercise therapy and evaluating change at 12 weeks or 3 months. If there was change then people were less likely to require and undergo surgical intervention.

In addition to this 12-week marker – if patients had change it showed there was less of a need to use of cortisone injections.

So what exercises should I do?
Your exercise plan will start depending on a few factors

  • Pain
  • Mobility
  • Strength
  • Movement control

Below are simple yet effective exercises that can to help ‘kick-start’ your shoulder rehabilitation. 

Sidelying External Rotation:

This is a basic, yet simple exercise to start firing the muscles at the back of the shoulder. Start by using a relatively lightweight to begin with to enure you can master the movement. A small towel under the elbow and ensure all the movement comes from the Shoulder. Aim to do about 2 x 15 repetitions. Any pain, STOP.  

Theraband Serratus Activation and Poster Shoulder Strengthening:

In the video above we see a great way to activate and “wake up” at the Shoulder stability muscles.

  •  Ensuring you have the tension on the band,
  • Setting your shoulders in their neutral down and back position.

Shoulder Stability and Endurance:

This is a great exercise to start start to fire and train the shoulder stability muscles.

  • Start on all fours with a straight neutral spine and Taking up the tension on the band, Fingers pointed forwards. 
  • Reaching forward to the 12 O’clock Position. Return. Reach towards the 9 o’clock position – return. Reach to 6 O’clock position and return. 
  • Maintain Tension on the band
  • Ensure shoulders do not ride up. 

If you’re having trouble completing any of the above exercises.Perhaps you would benefit from a more refined assessment from one of our Osteopaths. The Osteopaths at Equilibrium Sports and Spinal Clinic in Glen Iris are always happy to help you achieve your health and wellbeing goals. Let us guide you to a stronger body and stronger, healthier shoulders, minus the shoulder pain.

Any Questions?

Feel free to email us at .We are also more than happy to chat via our blue Drift Chat box in the bottom right-hand corner. 


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