How a Brighton Physiotherapist Can Help With Shoulder Pain

If you are looking for a physio in Brighton to help with shoulder pain then we can help.  Shoulder pain can affect up to 1 in 3 people at some time. But how does physio help with shoulder pain? What does a physio do and how successful is it?

Shoulder Pain

The shoulder is one of the most complex joints in the body. Unlike the hip joint which has a deep socket for the ball of the thigh bone to sit in the upper arm bone, the humerus, sits in a shallow cup. Ligaments tie the bones together. The cup is deepened by a rim of cartilage but this itself can tear and cause pain. The shoulder and chest muscles wrap around the shoulder joint to hold the bones in place as well as move the bones themselves. It is this complexity and the competing goals of flexibility and stability that make the shoulder joint a target for injury.

Physiotherapy Examination

With so many possible structures to go wrong in the shoulder, the first thing our physios do is examine and probe the tissues, testing ranges of movement and looking for restrictions  and weaknesses. Simple tests often show up where the problem is but sometimes x-rays are needed which are carried out at Sundial or we refer for MRI or ultrasound scans.

Brighton Physiotherapists

Our physios are some of the best in Brighton and are experts at diagnosing shoulder problems. Once a firm diagnosis is made then treatment can start. The treatment for shoulder problems is a partnership between you and the your physio. You may be given exercises to gently mobilise stiff joints as well the physio carrying out precise mobilisation procedures here. You may also be given muscle strengthening exercises which can work wonders at getting to the root cause of the problem as well reducing the pain signals from the injury.

Brighton Physiotherapists Secret Weapon

Our secret weapon in the treatment of shoulder injuries is our Thor laser. It is one of the few units in the whole of Sussex. Laser is remarkably effective in reducing pain and inflammation and also at  improving  healing. Studies have shown laser to be more effective than many other treatments for shoulder pain including ultrasound.

Our physios work with other practitioners where needed to bring about the quickest benefits. Sometimes bringing one of our chiropractors to work alongside can improve the outcome of treatment especially where spinal joint problems are playing a part in the shoulder dysfunction and pain.

So if you have pain in the shoulder and would like to get rid of it make an appointment to see one of the physiotherapists at our Brighton clinics. To download a free physiotherapy check certificate go here.

References

Comparison of the effects of low energy laser and ultrasound in treatment of shoulder myofascial pain syndrome: a randomized single-blinded clinical trial.

Rayegani S, Bahrami M, Samadi B, Sedighipour L, Mokhtarirad M, Eliaspoor D.

Eur J Phys Rehabil Med. 2011 Sep;47(3):381-9.

The Sacro-iliac Joint Revisited

261705_c681173cbd278f7bdcc90a9a598da505_largeI mostly agree with Adam Meakin about SIJ diagnosis but disagree with some points.

Static palpation is indeed of limited value, probably because of variations in anatomy and poor correlation of supposed findings with pain, dysfunction or pathology. The bone out place theory has not been taught at chiropractic colleges in Europe for 30 years and I don’t use static palpation of bony landmarks for diagnosis at all.

I do however use movement palpation as described in the Gillet test in the references Adam Meakin quotes. Despite poor inter examiner reliability studies I believe motion palpation has a role. Some motion palpation studies have shown better inter-examiner reliability when the design of the study is improved. Although of the cervical spine it shows improved reliability with a different study design. Having palpated an SIJ an estimated 50,000 times over the last 27 years I believe I have built up some skill in assessing these small movements.

As with the other orthopaedic tests Meakin cites for SI examination however, no one test is diagnostic. Motion palpation, taken in combination with the clinical picture, other tests and clinical experience can be helpful in reaching a working diagnosis. Using the correlation of many tests is an approach common to diagnosing many msk conditions.

In addition to motion palpation and orthopaedic tests I find joint line tenderness to be helpful to assist in reaching a conclusion. In addition, prone springing on either side of the SIJ will often reveal decreased give on the hypomobile side as well as tenderness. Some studies have demonstrated altered muscle activity in the presence of SI pain and I often find weakness on testing of rectus femoris, hamstrings or glut max for instance. This may be an effect of arthogenic inhibition but studies have mostly looked at hip and knee pathology in this regard so that is my personal theory to explain some of my clinical findings.