Shoulder Pain Physiotherapy
Shoulder pain interferes with sleep, dressing and almost anything done above chest height. Getting it assessed early is less about a label and more about knowing what to keep loading, what to ease off, and which few signs mean seeing a doctor first.
Individual rehabilitation plan — shaped by the assessment, reviewed as you progress
We assess your situation first, explain what the assessment shows, and agree a suitable rehabilitation direction with you. WhatsApp us to book, or ask first.
The shoulder trades stability for range, and it depends on the rotator cuff, the shoulder blade and the upper back working together. Pain can come from the tendons, the joint capsule, the joint surfaces or the neck, and these sources overlap in how they feel. A description of symptoms cannot diagnose a shoulder — imaging findings such as tendon wear are also common in people with no pain at all, so what matters is the in-person examination read alongside your history and what you need the arm to do.
The usual story is pain reaching up or behind the back, difficulty lying on that side, and a shoulder that tires quickly with repeated overhead work. Weakness may be genuine loss of power or simply pain inhibiting the movement — those need different plans, which is why we test rather than assume. Other possible causes are worth keeping in mind: neck problems refer pain into the shoulder, and stiffness that limits movement in every direction can look similar to a tendon problem early on.
- Pain reaching overhead, out to the side or behind your back
- Difficulty sleeping on the affected side
- The arm tiring quickly with repeated lifting or overhead work
- Catching or a painful arc partway through raising the arm
- Loss of movement in every direction, not just one
We ask how it started — a fall, a heavy lift, a change in training, or nothing obvious — and how it affects sleep, dressing and work. We then measure movement in each direction, compare active and assisted range, test rotator cuff and shoulder-blade strength, and screen the neck because it commonly refers pain here. If the history suggests an injury, we check whether the arm is functioning well enough for rehabilitation to be the right first step.
- Your symptoms: where the pain sits, the movements that provoke it, and night pain
- Daily activities and function: dressing, washing hair, reaching shelves, carrying
- Work or sport demands, including overhead tasks, throwing or racquet use
- Sleep: which side you lie on and how often pain wakes you
- Load and injury history: falls, dislocations, training changes and previous episodes
- Movement: active, assisted and rotational range compared side to side
- Strength and control of the rotator cuff, shoulder blade and upper back
- Neurological and general screening: neck referral, sensation, muscle power, medical history and medicines
Shoulder rehabilitation is mostly about loading the tissue at a level it can handle and building up from there, so exercise is normally the backbone of the plan. Depending on the assessment, that may be paired with hands-on treatment, taping or acupuncture where you consent and they seem likely to help with comfort while you train. Your preferences and your work demands shape the order we do things in. There is no fixed routine, and if you do not respond as expected we reassess rather than push harder.
Keeping the shoulder gently moving usually beats resting it in a sling, which tends to stiffen things quickly. We agree what to change for now — how high you reach, how much you carry on that side, sleeping position — and what to keep. You will get a short exercise set, a rule of thumb for how sore is too sore, and a flare-up plan. Progress is reviewed at each visit against your own markers, and the load moves up or down accordingly.
For gradual-onset shoulder pain, a physiotherapy assessment is usually a sensible starting point. Arrange a prompt medical review first if the shoulder is hot, swollen and you feel feverish, if pain is severe and constant without an obvious cause, or if you have unexplained weight loss or a history of cancer. After an injury such as a fall onto the arm, a suspected fracture or dislocation needs urgent assessment before any rehabilitation. Go to an emergency department straight away for the situations listed below, and treat sudden shoulder or arm pain with chest tightness, sweating or breathlessness as a medical emergency rather than a musculoskeletal problem.
- A suspected fracture or dislocation after a fall or direct blow
- Obvious deformity, or the shoulder looking clearly out of shape compared with the other side
- Being unable to use the arm at all, or unable to hold it away from your body
- Numbness, altered sensation or a cold, pale hand after the injury
- Sudden shoulder or arm pain with chest tightness, sweating or breathlessness