Shoulder pain - exercise and advice

How does the shoulder work?

The shoulder is the most mobile joint in the body.

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The main shoulder joint is a ball-and-socket joint, which allows a very wide range of movement. The joint is surrounded by a tough fibrous sleeve called the capsule, which helps to hold the joint together. A group of four muscles and their tendons make up the rotator cuff, which controls movement and also helps to hold the joint together.

There’s another smaller joint where the top of the shoulder blade meets the collarbone, the acromioclavicular joint.

What causes shoulder pain?

There are many causes of shoulder pain, but most cases will only affect a small area and are relatively short-lived. Shoulder pain may also be part of a general condition such as rheumatoid arthritis or osteoarthritis.

Shoulder pain isn’t always caused by a problem in the shoulder joint – problems in the neck can cause pain that’s felt over the shoulder blade or in the upper outer arm.

What can be done to help?

If your pain has a particular cause, like arthritis, treating that condition may help. Following the self-help tips and exercises here will also help, but if your pain isn’t improving after about 2 weeks then you should speak to your GP.

Medication

Painkillers such as paracetamol and ibuprofen may help and you should use them if you need to. It’s important that you take them regularly and at the recommended dose to help you control the pain and allow you to continue exercising. Don’t wait until your pain is severe before taking painkillers. You can also rub anti inflammatory cream directly onto the painful area.

You shouldn’t take ibuprofen or aspirin if you’re pregnant or have asthma, indigestion or an ulcer until you’ve spoken to your doctor or pharmacist. Medication can have side-effects so you should read the label carefully and check with your pharmacist if you have any queries.

Physiotherapy

If your shoulder pain is affecting your activity and is persisting, ask your GP about referral to a physiotherapist. Physiotherapy can help you to manage pain and improve your strength and flexibility. A physiotherapist can provide a variety of treatments, help you understand your problem and get you back to your normal activities.

Rest and exercise

Aim for a balance between rest and activity to prevent the shoulder from stiffening. Pace yourself to start with and try to do a bit more each day. Try to avoid movements that are most painful, especially those
that hold your arm away from your body and above shoulder height. It’s important to remain active, even if you have to limit how much you do.

Posture

Don’t sit leaning forwards with your arm held tightly by your side. This position can make the problem worse, especially if some of the pain is coming from your neck. When sitting, keep a pillow or cushion behind your lower back with your arm supported on a cushion on your lap.

Reducing the strain

When raising your arm or lifting objects, reduce the strain or pull on your shoulder by:

• keeping your elbow bent and in front of your body
• keeping your palm facing the ceiling.

To lower your arm, bend your elbow, bringing your hand closer to your body.

 

Simple exercises

Pendulum exercise

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• Let your other arm hang down and try to swing it gently backwards and forwards and in a circular motion.
• Repeat about 5 times.
• Try this 2–3 times a day.

Shoulder stretch

 

• Stand and raise your shoulders.
• Hold for 5 seconds.
• Squeeze your shoulder blades back and together and hold for 5 seconds.
• Pull your shoulder blades downward and hold for 5 seconds.
• Relax and repeat 10 times.

Door lean

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• Stand in a doorway with both arms on the wall slightly above your head.
• Slowly lean forward until you feel a stretch in the front of your shoulders.
• Hold for 15–30 seconds.
• Repeat 3 times.

This exercise isn’t suitable if you have a shoulder impingement.

Door press

 

a) Stand in a doorway with your elbow bent at a right angle and the back of your wrist against the door frame.

• Try to push your arm outwards against the door frame.
• Hold for 5 seconds.
• Do 3 sets of 10 repetitions on each side.

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b) Use your other arm and, still with your elbow at a right angle, push your palm towards the door frame.

• Hold for 5 seconds.
• Do 3 sets of 10 repetitions on each side.

Summary

• Most cases of shoulder pain aren’t caused by anything serious and will ease within 2 weeks.
• You can take painkillers to ease pain. Taking them before exercise can help you stay active without causing extra pain.
• Using an ice pack, learning how to protect your joints and being aware of your posture will help cases of shoulder pain.
• Try the exercises suggested here to help ease pain and prevent future symptoms.