There are many areas of the body that can cause shoulder pain. The location of the pain is important in helping to determine where the pain is coming from. If your pain is below the point of your shoulder then the shoulder joint is possibly involved.
However, if the pain is on the neck side of the point of your shoulder then the cervical spine, thoracic spine, acromioclavicular and sternoclavicular joints do need to be excluded as possible causes.
The most important message when understanding pain in the shoulder is that the shoulder is best viewed as a complex of joints rather than one joint in isolation. Any of the areas I have mentioned above can result in pain in your shoulder or further down your arm.
The best approach is to have an assessment by your therapist to determine the cause of your pain. They will be able to direct you if you require scans or a specialist review.
Ever wondered if your shoulder pain requires an ultrasound to help with diagnosis? More often than not it doesn’t. Ultrasounds have been found to be useful in diagnosing full tears of the rotator cuff but less effective in diagnosing partial tears. However, ultrasounds are just as effective in detecting full tears compared to an MRI
A physio is trained to assess your shoulder thoroughly and is able to detect if a tear is present. If after a few treatments, your shoulder is not improving an ultrasound can then be useful in determining the severity of any tears and what further management is required.
Whiplash is an acceleration-deceleration mechanism of injury to the neck where there is associated rapid flexion/extension of the neck. It most commonly happens in motor vehicle accidents especially when there is no headrest or airbag present.
Whiplash can potentially affect bony, ligamentous, neurological and muscle structures.
The main symptoms can include neck pain and headaches. Other symptoms may include neurological symptoms, dizziness, tinnitus and visual disturbances.
The most recent and strongest supporting evidence for physiotherapy treatment of whiplash is early mobilisation and exercise programs. It is recommended not to wear a collar if there is no evidence of fractures or ligament tearing.
Prognosis is variable depending on the severity of the initial injury. However outcomes are generally positive.
Studies have shown that people who are positive about recovery and resume their normal activities earlier and as tolerated may recover faster than those who markedly alter or reduce their activity level for a period.
At Fountain Gate Physiotherapy we encourage and support patients to stay active and resume work as soon as possible.
90% of us will have some form of osteoarthritic or degenerative joint change by the time we turn 40. One of the most common joints affected is the knee and can result in a great deal of functional loss.
Common areas of pain in the knee are at the front of the knee, inner portion of the knee and the rear of the knee joint. Common aggravating factors for knee arthritis include difficulty squatting, ascend/descending stairs, and sitting for prolonged periods.
Treatment techniques that have been found to be useful in managing the pain include physiotherapy manual techniques, ice on acute swelling, heat for stiffness, paracetamol, NSAIDS, hydrotherapy, activity modification and weight-loss.
Below are some simple exercises to help strengthen areas to help these forms of arthritic knee pain.
Bridging – lying on your back on the floor with your knees bent up. Lift your bottom off the floor. Repeat 30 times. If you have pain in your lower back whilst doing this exercise then do not lift your bottom as far. If you find the exercise easy perform using one leg only with the other leg in the air.
Clamshell – lying on your side with your knees bent up. Keeping your feet together and make sure you do not move at your pelvis and stay on your side. Lift your upper knee towards the ceiling, like a book opening. Repeat 30 times.
Straight leg raise – lying on your back straighten your knee as hard as you can. Keeping your knee straight, lift your leg about 20cm or 10 inches. Repeat 30 times.
Mini squats – stand in front of a chair. Imagine you are sitting down and slowly lower yourself towards the chair. Only lower about 1/3 of the way and then return to straight. Repeat 30 times. This exercise is the most likely exercise to aggravate your pain. Only squat to a depth that is pain free. Do not go further than the first point of pain.
Calf raises – standing up, slowly lift your heels off the ground raising up onto your toes. Lower back to the ground. Repeat 30 times.
If you find the exercise is too easy, you can make it harder by increasing the number of repetitions.
If you have any form of giving way in your knee or swelling you should discuss with your doctor or health professional before beginning these exercises. If you have pain whilst performing or after completing the exercises then stop and consult your physiotherapist.