Why consult?

Shoulder pain

Information to help you understand your symptoms and who to consult for prevention or treatment.

Shoulder pain interferes a lot with your everyday activities because your shoulder is involved in most upper body movements. Different healthcare professionals can help you relieve these pains and restore your shoulder’s normal functioning.

Douleurs à l’épaule

Why do you have shoulder pain?

Shoulder pain can be caused by a sudden injury such as a blow, a fall, or an awkward move. It can also occur over time due to repetitive movements or maintaining an improper posture, for example.

Your shoulder has not just one, but three joints (glenohumeral, acromioclavicular and sternoclavicular), which enable it to perform a wide variety of movements in several directions, but which also make it more vulnerable to injury.

What are the primary causes of shoulder pain?

There are a large number of diagnoses associated with shoulder pain, including tendinitis, tendinosis, bursitis, capsulitis, dislocation, impingement syndrome, sprain, fracture, etc. Consulting a physiotherapist will help you fully understand the structures affected and the means to take in order to promote their healing.

What are the symptoms of shoulder tendonitis?

The main symptom associated with tendinitis or tendinosis of the shoulder, two types of tendinopathy, is the presence of pain. This pain is often localized on the top or side of your shoulder, mainly when your arm is raised above your head.

Tendinopathy is irritation, inflammation or tearing of a tendon (the structure that connects muscle to bone). In the shoulder, it is most often a tendinopathy of the rotator cuff, a group of four muscles that serve to both mobilize and stabilize the shoulder.

How can you tell if you have a rotator cuff tear?

The rotator cuff is a group of four muscles, the supraspinatus, the infraspinatus, the teres minor and the subscapularis, located around the scapula which serve to mobilize and stabilize the shoulder. The tendons of these muscles attach to the upper part of the humerus, the upper arm bone, to the side and front of the shoulder. When one or more of these tendons are irritated or torn, it is called rotator cuff tendinopathy.

A rotator cuff tear can be caused by a sudden injury, but most of the time it occurs normally with aging. It is common to observe a partial tear of one or more of the tendons of these muscles with a magnetic resonance imaging test (MRI) without there necessarily being pain. Pain is the best indicator of a shoulder problem. It is usually located on the top or side of your shoulder, mainly when your arm is raised above your head.

What is bursitis?

Subacromial bursitis is inflammation of the bursa, a small fluid-filled pad located on top of the shoulder joint. It is often caused by doing repetitive movements with your arm raised.

Warm, diffuse pain in the shoulder, which may be constant and wake you up at night, is a typical symptom of subacromial bursitis. All shoulder movements can be painful, especially overhead movements.

What causes capsulitis?

Capsulitis is damage to the envelope, called the capsule, which covers the shoulder joint. The exact cause cannot always be identified. Sometimes it occurs due to a pre-existing condition in the shoulder, such as bursitis, tendinitis, dislocation, fracture, or prolonged immobilization of the joint after surgery.

At first, the pain caused by capsulitis is usually sharp and diffuse in the shoulder. It can extend to the side of the arm, sometimes to the hand, and manifest themselves both at rest and in motion, day and night. Most of the time, all movements of the shoulder are limited and painful. You might feel more stiffness in the morning.

After a few months, the pain decreases to give way to a predominant stiffness in arm’s rotation and elevation movements.

How do you know if you have a dislocation?

A violent impact to your shoulder can cause a dislocation, i.e. a loss of contact between the bones of the joint.

The dislocation often creates a marked sensation of a “dislocated” shoulder accompanied by visible deformity, significant pain and an inability to move the shoulder.

After suffering a dislocation, the shoulder’s stability at rest is permanently affected, but stability in motion can be restored with specific exercises recommended by a medical professional.

How is shoulder pain treated?

Expert advice: Regulate your movements

Try to identify the movements that increase the pain. During the first 2 days, modify them or avoid doing them in order to limit your pain. Afterwards, it is important to start moving your shoulder again and resume your activities, as movement is the best way to promote healing. It is normal to feel a little pain, but make sure it does not increase significantly during or after the movement.

Which professional should you consult?

Different professionals often work together to maximize results. If in doubt, we recommend that you first consult a physiotherapist so that they can assess your needs and the treatments required for the specific condition of your shoulder. If necessary, they will recommend other professional(s) to consult in order to optimize your rehabilitation.

Why consult a physiotherapist?

After a thorough assessment of your shoulder, a physiotherapist will explain which structures are affected and offer you a treatment plan based on your goals Different options can be considered such as exercises specific to your condition, joint mobilizations, muscle relaxation techniques, etc. Your physiotherapist will also give you advice on how to relieve pain and get back to your activities.

Why consult an occupational therapist?

An occupational therapist will assess the impact of your shoulder condition on your usual abilities such as working, doing household chores and hobbies. Their treatments, which can take the form of strengthening exercises or simulations of work tasks, for example, will help you maximize your autonomy at each stage of your recovery.

Why consult an osteopath?

Using various manual techniques, an osteopath will treat mobility restrictions that can affect all the structures of your body (bones, muscles, ligaments, viscera, etc.) related to your shoulder. Better Improved mobility enables the body to recover better and decreases pain.

Why consult a massage therapist?

A massage therapist will work mainly to release tension in the superficial and deep tissues that affect your shoulder to help you reduce pain and move more freely. Their treatments will also help increase blood circulation to promote better recovery.

Why consult an acupuncturist?

Through various techniques and using therapeutic tools such as needles and suction cups an acupuncturist will work to reduce pain, stress, muscle tension and inflammation that can occur following a shoulder injury.

Why consult a kinesiologist?

A kinesiologist will teach you how to do adapted exercises, based on their evaluation of your ability to move your shoulder and your physical condition, so that you can resume your activities.