Search the Herefordshire and Worcestershire Health and Care NHS Trust website
The rotator cuff is a group of muscles which help to control the movement of the shoulder's ball and socket joint.
People who work or do sports and/or hobbies that require putting their hands above shoulder height are the most likely candidates for rotator cuff problems. However, a shoulder injury, new or repetitive activity may also cause the condition to develop. Age also has an effect, with rotator cuff problems developing as you get older.
Minimising Risk of Shoulder Pain
Keeping yourself fit and active, and keeping your shoulder strong and flexible will help you minimise your risk of suffering from a range of shoulder problems, as well as helping with your rehabilitation if you do encounter them.
Frozen shoulder, or adhesive capsulitis, is the painful and gradual stiffening of the shoulder capsule (the tissue that surrounds the shoulder joint). Over time, this painful stiffening can lead to sleep disturbance and limits your ability to use your arm for day-to-day activities.
The exact cause of the condition is unknown. For some reason, your body has an over reactive response to a minor injury (or no injury at all) and tries to heal your shoulder capsule with scar tissue. It affects one in 20 people and is more common in women than men. Most cases of frozen shoulder happen between the ages of 40 and 60.
If you are suffering from frozen shoulder you should:
Maintain the movement and strength of your shoulder as much as possible.
Consult a physiotherapist for advice on exercise, pain management and to discuss whether any other treatments such as manual therapy or corticosteroid injection may be suitable for you.
Shoulder instability means that the shoulder can dislocate (be pulled out of joint) or sublux (moves more than it should do) during day-to-day activities. Both dislocation and subluxation can happen for a variety of reasons. How it happens affects the type of treatment you will receive.
The three main causes of shoulder instability are:
Traumatic dislocation – where the shoulder undergoes an injury with enough force to pull the shoulder out of joint (eg. a violent tackle in rugby, or a fall onto an outstretched hand)
Non-traumatic dislocation – this occurs with just minimal force, and can be due to factors such as abnormalities in the shoulder present from birth
Positional non-traumatic – the ability to dislocate your shoulder without any form of trauma. This is thought to be due to abnormal functioning of the shoulder muscles
Following a first-time dislocation, your arm may be put in a sling. Your doctor or physiotherapist will advise you on when to remove it to exercise.
Changes to your activity/rest: Making changes to the activities you do does not mean that you have to stop moving or stop using your shoulder altogether. Try to avoid activities that involve lifting your arm over your head or contact sports for the first three months after the dislocation.
Osteoarthritis of the shoulder is a low grade inflammatory condition of the joint, which although can be painful with activity, will respond well to exercise and strengthening, particularly in the early stages.
If you are suffering from osteoarthritis of the shoulder then you should:
- Consult a physiotherapist for advice on exercise to improve joint health and strength and to discuss methods of managing your pain
- Your GP or physiotherapist may give you an injection to settle the pain if severe, to allow you to fully engage with an exercise programme
Self refer into our service
It is important that you apply the advice and guidance provided above for around 8 weeks by which time we would expect you to notice improvement and in some cases complete recovery. If not, we have a team of trained physios who can help.
Think you need more urgent or emergency treatment? Follow the below guidance to see if you need to see someone quicker.
Physiotherapy Triage Red flag re-direction of patients to A&E/GP consultation
IMPORTANT 'Cauda Equina Syndrome’ although rare, can cause a permanent change to your bladder and/or bowel function, or foot strength.
IF you are suffering with low back pain and if you have any changes regarding the following since your pain started;
- Bladder or bowel function (i.e., Increasing difficulty when you try to urinate, increasing difficulty when you try to stop or control your flow of urine, loss of sensation when you pass urine, leaking urine or recent need to use pads, inabilityof knowing when your bladder is either full or empty, inability to stop bowel movement or leaking, loss of sensation when you pass a bowel motion)
- Loss of sensation/tingling around genitals, back passage, buttocks or inner thighs • Erectile or ejaculation problems or loss of sensation in genitals during sexual intercourse
- Loss of sensation/ tingling or numbness in both legs
- Weakness in foot (i.e. floppy foot or inability to lift front of foot when walking)
If YES call NHS 111 or go to A&E IMMEDIATELY
If you are suffering with low back pain and if you have any of the following;
- History of cancer
- Unexplained weight loss
- Feeling generally unwell/fever/lack of appetite
Please contact with your GP as soon as possible to discuss if other investigations are required rather than self-referring to physiotherapy.
You can also visit your GP for more information and advice on;
- Women's and men's health including pelvic floor and incontinence
- If you have had a series of falls and want to learn more to help avoid them
- If you have reduced mobility and require a stick or frame
- If you require neurological support for example if you have had a stroke or Parkinson's
- If you are housebound
- If you are under 16 years old