Shoulder Pain: When Should I Be Worried?

The shoulder is a pretty remarkable piece of kit; it’s by far the most flexible joint in our body, capable of loading up in an almost infinite combination of movements. It’s also the fastest; a good thrower can make it turn at an acceleration of 6000-7000 degrees per second! All this performance doesn’t come without a few issues though, and shoulder injuries are some of the most common reasons people come to our clinic.

The most common pattern we see is called rotator cuff related pain, sometimes also called bursitis, impingement, subacromial syndrome or any combination of those. This is generally from a big spike in how much you’ve been using your shoulder. Think push up challenges during the COVID lockdowns, heavy loads of laundry, or doing lots of throwing after time off over winter. It’s a soft tissue injury, irritation or damage to the big 4 muscles which rotate your shoulder, and the network of other tissues around them.

Most of the time, this is pretty simple to manage. Early on, basic range of motion, grip strength and gentle loading exercises help to keep things steady. This is also where you might consider some pain relief, heat packs and making sure you’re getting plenty of good quality sleep and food.

*Example movement exercises courtesy of Physiotec - the program we use to provide patients with their individualised exercise programs.

If you find that after 5-7 days of this, the pain is sticking around and you’re still a bit weak or stiff, a good physiotherapist can point you in the right direction with more specific exercises targeted at your specific issues. If this sounds like you, you shouldn’t be worried at all. These injuries can be a bit stubborn and take a few months to settle completely, but it’s rare for them to stick around beyond that.

More serious shoulder injuries can be spotted by pain levels, strength levels and by big, fast, high impact stories. Normal rotator cuff pain will settle with rest, basic pain relief and heat. If you find that isn’t that case and your pain is throbbing when you’re at rest or trying to sleep, it’s a good idea to get checked out. If you get really weak after your injury, with or without pain, then that can also be a sign of some more substantial soft tissue damage. It’s actually not uncommon for more serious rotator cuff injuries to be pretty much pain free early on. If you can’t lift your shoulder above rib height in the first 48 hours, and you can’t support the weight of your own arm, that’s another reason to come in ASAP for some more tests.

Lastly, if you got injured by something big, heavy and/or fast, then there’s a higher chance of something serious happening. This is particularly true if you felt the joint “pop” in or out, or if you felt something move in the joint. You don’t necessarily need surgery if this is the case, but catching big injuries early on gives us a much better chance of getting you a good outcome.

The bottom line is to keep moving, do your basic rest and pain relief early on, and if there’s anything stubborn or suspicious from what I’ve mentioned above, then come in for a check up.

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