Physiotherapy for Shoulder Pain

The shoulder, a complex and crucial part of human anatomy, is essential for countless daily activities, from reaching for a cup to swinging a tennis racket. This intricate joint system, comprising the rotator cuff, bursa, and glenoid labrum, enables a wide range of motion. However, its complexity also makes it susceptible to injuries and inflammatory conditions that can lead to pain, stiffness, and reduced quality of life. Understanding your shoulder’s anatomy and seeking timely physiotherapy for shoulder pain in Singapore can be crucial in preventing these issues from escalating and impacting your daily life.

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Table of Contents

Meet Our Physiotherapist for Shoulder Pain

What Is Shoulder Pain?

What Causes Shoulder Pain?

Shoulder Pain Symptoms

Diagnosing Shoulder Pain

Shoulder Pain Treatment in Singapore

How to Prevent Shoulder Pain 

What Are The Benefits Of Physiotherapy For Shoulder Pain?

Care Tips for Shoulder Pain

Frequently Asked Questions About Physiotherapy for Shoulder Pain

Learn More About Physiotherapy for Shoulder Pain

Meet Our Physiotherapist for Shoulder Pain

Ng Hong Kai, an experienced physiotherapist, has carefully reviewed the information on this page.

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Ng Hong Kai

Clinic Director and Chief Physiotherapist​​

  • Master of Clinical Physiotherapy (Musculoskeletal), Curtin University (Australia)
  • Master of Physiotherapy, University of Sydney (Australia)
  • Bachelor of Applied Science (Exercise & Sports Science), University of Sydney (Australia)
  • Member of the Australian College of Physiotherapists and Australian Physiotherapy Association
  • Fully registered with the Allied Health Professions Council, Singapore, and the Australian Health Practitioner Regulation Agency
  • GEMt Advanced Dry Needling Practitioner

Hong Kai has been practising musculoskeletal physiotherapy for more than a decade. He is the first Singaporean to achieve dual credentials as both an APA Titled Musculoskeletal Physiotherapist and a tertiary-trained Exercise Scientist.

Hong Kai's broad and extensive skill set allows him to create solutions that are simple, effective, and tailored to a client’s musculoskeletal needs. His belief in continuing education and self-improvement led him to complete his Master’s in Clinical Physiotherapy (Musculoskeletal), where he had the opportunity to participate in formal research into knee osteoarthritis under the supervision of world-renowned researcher and physiotherapist Prof. Peter O’Sullivan.

Hong Kai has experience treating a variety of musculoskeletal conditions, with a specific focus on addressing lower back, neck, shoulder, and knee pain.

What Is Shoulder Pain?

Shoulder pain can stem from various underlying causes, but two common culprits are shoulder impingement and instability. While both can lead to discomfort and limited mobility, understanding their key differences is crucial for appropriate treatment.

  • Shoulder Impingement: This condition occurs when the tendons of the rotator cuff become compressed or irritated as they pass through a narrow space beneath the shoulder blade. This often results from swelling or misalignment in the shoulder, leading to pain, especially during overhead movements.
  • Shoulder Instability: This refers to a feeling of looseness or a sense that the shoulder joint is slipping out of place. It can be caused by previous injuries, ligament laxity, or muscle weakness. Shoulder instability may lead to frequent pain and a sense of apprehension during movement.

While shoulder impingement is a specific condition, instability is often a symptom of an underlying issue. Both can significantly impact your daily life and activities, making it crucial to seek professional assessment and treatment, such as physiotherapy, to address the root cause and restore function.

What Causes Shoulder Pain?

The shoulder, a complex joint with many moving parts, can experience pain from various sources.  Common causes include:

1. Shoulder Bursitis

Shoulder bursitis occurs when the bursa — a small fluid-filled sac that acts as a cushion between your shoulder and arm — becomes inflamed. This condition can arise from overuse or injury to the shoulder, causing fluid accumulation, swelling, inflammation, and pain. Symptoms of shoulder bursitis include:

  • Pain in one or both shoulders.
  • Pain during arm movement.
  • A feeling of weakness in the arms.

Physiotherapy is vital for managing shoulder bursitis pain. In Singapore, physiotherapists employ techniques like dry needling, joint mobilisation, and soft tissue mobilisation to improve shoulder mobility, reduce muscle tension, and promote healing. They also prescribe targeted exercises to strengthen surrounding muscles, improve range of motion, and ensure stability. Furthermore, physiotherapists offer advice on proper body mechanics and ergonomic practices to prevent additional strain. These interventions collectively aim to reduce pain, restore function, and improve the quality of life for those with shoulder bursitis.

2. Shoulder Tendonitis

Shoulder tendonitis occurs when the tendons or the rotator cuff of your shoulders become thickened and inflamed due to overuse. This condition is commonly caused by repetitive shoulder motions or activities involving carrying heavy objects or raising your arms for extended periods. The inflammation leads to pain and dysfunction in the affected tendons.

athlete in singlet showing his shoulders

3. Shoulder Tendon Tears

Shoulder tendon tears involve tearing the tendon that connects the rotator cuff to the shoulder blade. This injury, often resulting from arm injuries, repetitive overhead movements, sudden forceful movements, or even simple tasks like sleeping in an awkward position, compromises the stability provided by the rotator cuff.

Physiotherapy is critical in managing shoulder tendon tears. Treatment includes manual therapy to improve joint mobility and promote healing, alongside prescribed exercises to strengthen muscles, increase range of motion, and stabilise the shoulder. Physiotherapists also educate patients on proper body mechanics, activity modifications, and gradually returning to functional activities, playing a key role in recovery, pain reduction, and restoration of shoulder function.

4. Shoulder Impingement

Shoulder impingement occurs when the rotator cuff and soft tissues are compressed between the humerus and the acromion, causing pain, inflammation, and reduced motion. Common causes include:

  • Arthritis
  • Overuse of the arm
  • Repetitive motions
  • Sleeping with an arm overhead
  • Trauma
  • Carrying heavy loads

Physiotherapy for shoulder impingement involves manual therapy to improve mobility and ease muscle tension. Exercises are prescribed to strengthen muscles, improve range of motion, and stabilise the shoulder. Education on proper body mechanics and ergonomics helps address causes, relieve pain, and aid recovery.

man suffering from pain on right shoulder

5. Shoulder Fracture

A shoulder fracture, often resulting from a fall onto an outstretched arm or sports trauma, involves breaks in the shoulder bones. Symptoms include:

  • Sharp pain disrupting sleep
  • Impaired arm function
  • Arm appearing out of position
  • Swelling and bruising
  • Inability to move the arm

Initial physiotherapy focuses on pain management techniques to reduce swelling. As recovery progresses, exercises are introduced to help with flexibility, strength, and range of motion. Manual therapy restores joint mechanics, and guidance on shoulder mechanics and activity modifications aids in recovery and functional return.

6. Arthritis

Arthritis causes inflammation, pain, and stiffness in joints. Osteoarthritis, the most common type, involves the breakdown of cartilage or bone around joints, leading to pain and inflammation. The shoulder is often affected due to its frequent movement and daily wear-and-tear, which restricts arm usage and mobility.

Physiotherapy is vital for managing arthritis in the shoulder. Physiotherapists prescribe exercises to enhance shoulder strength, flexibility, and range of motion. Manual therapy, such as joint mobilisation, restores function and reduces stiffness. Additionally, physiotherapists educate patients on activity modification, postural correction, and ergonomic practices to lessen joint strain. The goal is to improve function, alleviate pain, and enhance quality of life for those with shoulder arthritis.

man receiving treatment from a doctor for shoulder pain
Play Video about Explanation of What is Frozen Shoulder on YouTube by Hong Kai

7. Frozen Shoulder

Frozen shoulder, or adhesive capsulitis, occurs when the connective tissue surrounding the shoulder joint becomes inflamed, stiff, and painful, often leading to scar tissue and reduced mobility. Its exact cause is unknown, but risk factors include age (40-60), diabetes, and past shoulder injuries. Symptoms include:

  • Pain during arm movement
  • Stiff shoulder joints
  • Reduced range of motion
  • Arm weakness
  • Nighttime pain worsening

Treatment options include minimally invasive surgery to remove pain generators and non-surgical approaches like physio for frozen shoulder, injections, and medication.

Shoulder Pain Symptoms

Common symptoms and signs of shoulder injuries that may indicate a concern include:

  • Redness or warmth in the shoulder area
  • Persistent pain in the shoulder, neck, and back
  • Popping, clicking, or grinding sensations in the shoulder, particularly when moving the arm
  • Muscle weakness and stiffness
  • Restricted range of motion
  • Swelling in the shoulder joint or surrounding tissues
  • Tenderness to the touch in the affected area
  • Difficulty sleeping due to shoulder pain
  • Loss of strength or function, making it difficult to perform daily activities

Diagnosing Shoulder Pain

Diagnosing shoulder pain typically begins with a physical exam, where a physician assesses the location and severity of the pain and inquires about activities that exacerbate it and the duration of the symptoms.

To confirm a diagnosis, physicians may order the following tests, which help identify injuries or other issues within the shoulder joint:

  • X-ray: Utilises radiation to reveal images of shoulder dislocation, osteoarthritis, or bone fractures.
  • Magnetic Resonance Imaging (MRI) Scan: Employs radio waves and a magnet to create high-resolution images of the shoulder and surrounding structures.
  • Computerised Tomography (CT) Scan: Combines computer technology and X-rays to produce three-dimensional visuals of the shoulder.

Shoulder Pain Treatment in Singapore

If you experience persistent shoulder pain or discomfort, seeking expert advice is crucial. Once diagnosed and the cause of the shoulder pain is identified, your physician in Singapore may recommend the following common treatments:

  • Shoulder Surgery: Performed to stabilise the shoulder joint or repair torn rotator cuff tendons.
  • Physiotherapy: Focuses on strengthening shoulder muscles and improving flexibility. It also plays a vital role in post-surgery rehabilitation, helping to restore strength, mobility, and function to the shoulder.
  • Over-the-Counter Painkillers: Used to relieve mild shoulder pain.
  • RICE Therapy: Stands for Rest, Ice, Compression, and Elevation, aimed at relieving pain and minimising swelling and inflammation.
  • Corticosteroid Injection: Administered to reduce inflammation and alleviate pain caused by conditions such as arthritis and bursitis.

These treatment options are tailored to address the patient’s specific needs, ensuring effective recovery.

How to Prevent Shoulder Pain

  • Maintain good posture.
  • Use proper body mechanics when lifting or carrying heavy objects.
  • Avoid repetitive overhead motions.
  • Take regular breaks if your job requires you to keep your arms raised for long periods.
  • Engage in exercises that strengthen the muscles around your shoulder.

What Are The Benefits Of Physiotherapy For Shoulder Pain?

Physiotherapy is a safe choice for managing shoulder-related ailments. Experienced physiotherapists employ a variety of techniques, including manual therapy, dry needling, exercise prescription, and mobilisation methods, to address and manage shoulder pain.

Understanding the importance of resuming daily activities pain-free, physiotherapy specialists focus on creating personalised treatment plans tailored to each individual’s needs. These comprehensive services ensure patients receive optimal care designed to relieve pain and improve shoulder function effectively and safely. 

Beyond pain relief, physiotherapy offers a range of benefits. It can help improve your shoulder’s range of motion, strength, and stability, allowing you to perform daily tasks with greater ease. It also focuses on addressing the underlying causes of your pain, reducing the risk of future injuries and promoting long-term shoulder health.

Care Tips for Shoulder Pain

  • Embrace Shoulder Exercises: Incorporate gentle exercises into your routine to improve strength and flexibility. Start with low-intensity options like shoulder rolls and gradually progress as your pain subsides.
  • Prioritise Rest: If you’re injured or experiencing heightened pain, take a break from aggravating activities. Remember, gentle movement is still important to maintain range of motion.
  • Reduce Strain: Minimise activities that put excessive stress on your shoulder. This might involve adjusting your workspace, changing your sleep position, or modifying your exercise routine. Listen to your body and avoid pain triggers.
  • Perfect Your Posture: Maintaining good posture helps alleviate unnecessary pressure on your shoulder joint. Be mindful of your posture, especially when sitting for extended periods.
  • Utilise Cold Packs: For acute pain, apply cold packs to reduce swelling and provide temporary relief. Use them for short intervals with a protective layer between the ice and your skin.

Frequently Asked Questions About Physiotherapy for Shoulder Pain

You should consult a shoulder specialist if you experience persistent pain, decreased range of motion, or discomfort that interferes with your daily activities and sleep. Early diagnosis and treatment can prevent further complications and facilitate a quicker recovery.

Physiotherapy helps manage shoulder pain by employing targeted exercises, manual therapy, and various modalities to increase strength, enhance flexibility, and improve range of motion. Physiotherapists tailor treatment plans to individual needs, considering factors like the severity of pain, the underlying cause, and overall health. Recovery times vary, but physiotherapy aims to expedite the healing process and restore functionality.

While some physiotherapy exercises and treatments for shoulder pain may cause mild discomfort or soreness, the process should not be excessively painful. Physiotherapists work closely with patients to adjust treatment plans according to their comfort levels and pain thresholds, ensuring a manageable and effective approach to recovery.

While some physiotherapy exercises and treatments for shoulder pain may cause mild discomfort or soreness, the process should not be excessively painful. Physiotherapists work closely with patients to adjust treatment plans according to their comfort levels and pain thresholds, ensuring a manageable and effective approach to recovery.
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