Ask the Expert - Ice and injuries
In this issue’s Physiotherapy Corner local experts at Boathouse Physiotherapy focus on the topic of Shoulder Pain.
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Shoulder Pain – what is the best treatment?
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It’s a familiar story: you’ve gone to lift something out of a high cabinet, maybe tried to put your arm into your coat and then you get a sharp stabbing pain. It is short lived, terribly intense, and as time progresses the frequency of this sharp pain increases. Then you find lying on that shoulder, or the even the pain free shoulder is painful.
You see your GP, you’re told it’s ‘impingement’ and off to the physio you go. Possibly expecting a painful 30 minutes of twisting, stretching and generally being told you’re too weak here, too tight there and don’t even get us started on posture!
Thankfully, the reality is quite different these days, well maybe not the part about being told you’re too weak or tight. Although we do pride ourselves in cushioning this news in the language of diplomacy.
What is impingement?
It’s an older term that seeks to describe compression of a tendon between the top of the arm bone. The reality is a bit more complex and, as we now know, can even include the body creating new cartilage around the base of the tendon.
So what is the best treatment and how long should I do it for?
Firstly, if pain is intractable, if it is interfering with sleep, work, family life you must get pain under control. This may well be a steroid injection in the first instance to calm things down.
Then exercise has been shown to be effective, very effective. But it must be done religiously. And I don’t mean once a week on a Sunday.
A team from Denmark published a paper outlining the very best treatment for ‘impingement’ pain:
In a group of 3306 patients, 43% did not complete the recommended minimum duration of 12 weeks of rehabilitation.
Exercise significantly improved symptoms in all patients, and this fits well with the current guidelines where exercise therapy is considered to be the first line of treatment in subacromial pain syndrome.
While all exercises were effective, strengthening exercises had the best clinical outcomes, followed by mobility exercises, and lastly by posture/scapula exercises.
So there you have it. You must, must, must complete 3 months of exercise. This won’t be daily, maybe 2-3 time per week for 15 mins, but it must be done. This will improve you shoulder pain if you have impingement symptoms.
If the story of shoulder pain sounds familiar then please get in touch with us at Boathouse Physiotherapy via 0118 976 7189.
The Boathouse Surgery, Whitchurch Road
Pangbourne, RG8 7DP T. 01189767189
You see your GP, you’re told it’s ‘impingement’ and off to the physio you go. Possibly expecting a painful 30 minutes of twisting, stretching and generally being told you’re too weak here, too tight there and don’t even get us started on posture!
Thankfully, the reality is quite different these days, well maybe not the part about being told you’re too weak or tight. Although we do pride ourselves in cushioning this news in the language of diplomacy.
What is impingement?
It’s an older term that seeks to describe compression of a tendon between the top of the arm bone. The reality is a bit more complex and, as we now know, can even include the body creating new cartilage around the base of the tendon.
So what is the best treatment and how long should I do it for?
Firstly, if pain is intractable, if it is interfering with sleep, work, family life you must get pain under control. This may well be a steroid injection in the first instance to calm things down.
Then exercise has been shown to be effective, very effective. But it must be done religiously. And I don’t mean once a week on a Sunday.
A team from Denmark published a paper outlining the very best treatment for ‘impingement’ pain:
In a group of 3306 patients, 43% did not complete the recommended minimum duration of 12 weeks of rehabilitation.
Exercise significantly improved symptoms in all patients, and this fits well with the current guidelines where exercise therapy is considered to be the first line of treatment in subacromial pain syndrome.
While all exercises were effective, strengthening exercises had the best clinical outcomes, followed by mobility exercises, and lastly by posture/scapula exercises.
So there you have it. You must, must, must complete 3 months of exercise. This won’t be daily, maybe 2-3 time per week for 15 mins, but it must be done. This will improve you shoulder pain if you have impingement symptoms.
If the story of shoulder pain sounds familiar then please get in touch with us at Boathouse Physiotherapy via 0118 976 7189.
The Boathouse Surgery, Whitchurch Road
Pangbourne, RG8 7DP T. 01189767189