Shoulder injuries how to assess, diagnose and treat: Healthfix Physiotherapy advice

Shoulder injuries how to assess, diagnose and treat: Healthfix Physiotherapy advice

  By Caitlan Skillicorn,  Senior Physiotherapist M. Physio & B. Ex. and Sport Sc.  

Your shoulder: what you need to know

  • Its the most unstable joint in the body (imagine a golf ball on a tea or a beach ball on dinner plate!)
  • Its the only upper body bony attachment where the sternum and clavicle meet
  • The muscles and ligaments are heavily relied on for stability due to the range of movement the joint can function in. The two groups involved in shoulder activation include:
  1. Stabilisers – Rotator cuff (supraspinatus, infraspinatus, subscapularis and teres minor)
  2. Movers – Deltoid, Pectoral muscles, serratus, lats, traps

How do Physiotherapist’s assess shoulder pain?

The subjective assessment will drive the objective assessment, this means that we delve into the cause of the pain first by getting a thorough history from you including:
  • Any history of trauma such as a fall
  • If there has been a sudden increase in training loads (gym, housework, renovations etc)
  • How long you have experienced pain for especially if it is low levels of pain for a long period of time
After reviewing this information, we then do a series of objective testing to see how your shoulder is moving and which movements elicit a pain response, these may include:
  • Active range of movements and repeated movements to see if any fatigue changes the movement pattern
  • Resisted movements
  • Special tests and manual muscle testing using a device
The purpose of these tests are to see what movements produce pain or limitations amongst the anatomy of your shoulder.  

How do Physiotherapist’s diagnose your shoulder complaint?

The three key areas physiotherapists use to diagnose shoulder injuries include:
  • Is it torn? (trauma or degenerative)
  • Is it stiff? (frozen shoulder, osteoarthritis, post-operative)
  • Is it irritable? (tendinopathy, bursitis etc)

When is it likely that your symptoms are not actually coming from your shoulder?

Often we find that clients symptoms are not directly related to their shoulder. The most common indications of this are if you experience:
  • Nerve related symptoms so things like pins and needles, numbness or burning sensation in your hands and fingers
  • If experience pain specifically in the upper trapeziues muscles
  • If you have restricted neck range of movement
  • If these are true then it is most likely that you

If you are unsure if you need to see a Physiotherapist

The most common complaint we see in active clients who are training in the gym is impingement which means the pain is triggered at the end of the range of movement or after 90 degrees of flexion. If this is you we recommend you change the angle of your movement and reduce the weight and volume (kgs and reps) and if symptoms don’t settle within a week then your best off to see a Physiotherapist for assessment and treatment.   Do you have a shoulder issue or are unsure about whether physiotherapy treatment will help your condition? To arrange to speak with one of our expert physiotherapists get in touch with us now!