Shoulder Pain 101



In today’s society with the invention of computers and the increasing digitization of our world, we at Joint Reaction are seeing an increasingly staggering amount of shoulder/ neck issues. At present, an estimated astounding 60% of my clients are being seen for shoulder/neck related problems. The shoulder is an amazing joint and structure that is built with freedom of movement in mind. With this great amount of mobility however, the shoulder joint is susceptible to many external forces and factors, and stability is not one of its strengths. Furthermore, things like stress, posture and muscular imbalances affect this joint significantly. Quite simply, shoulder pain is not just shoulder pain. In this session we are going to talk about one of the most common types of shoulder pain: rotator cuff syndrome, otherwise known as shoulder impingement syndrome.

The shoulder is a structure of great praise in the anatomical hierarchy. It is one of the most important but most frequently injured structures in our bodies. It is in fact the 3rd most common muscular disorder in the orthopedic world. The incidence of shoulder pain peaks at roughly 3% of the population at any given time, and the highest prevalence being individuals between the ages of 42-47 years of age. Men are also more than 2 times more likely to develop this condition. One of the most common types of shoulder pain is called Rotator Cuff Syndrome .The “cuff” is made up of a group of muscles that collectively come from the shoulder blade area and then become tendinous slips that attach into the front of the top of the arm. It is often this great distance of travel and the passing through of many other structures that makes for numerous factors influencing shoulder pain.

Clinically, individuals that are suffering from Rotator Cuff Syndrome will present with the following:

  • 1. The individual frequently reports aching pain in the shoulder or referred pain along the outside upper arm.
  • 2. The pain worsens when the arm is lifted overhead, and at night (often called painful arc)
  • 3. Other symptoms may include weakness and reduced range of motion, and the onset of symptoms is often gradual.

The following is the severity classification of “Cuff” syndromes:

  • STAGE 1: swelling (edema) and/or bleeding (hemorrhage) occur. Stage 1 is frequently associated with an overuse injury. At this stage, the syndrome can either be reversed or it can progress.
  • STAGE 2: there is inflammation of the tendon (tendinitis) and development of scar tissue (fibrosis).
  • STAGE 3: frequently involves a tendon rupture or muscle tear, and often represents years of fibrosis and tendonitis.

As with many syndromes, there are risk factors that make people more susceptible to developing conditions, and those listed below are some factors that influence shoulder impingement.


  • 1. Workers that are required to repeated lift heavy objects overhead.
  • 2. Athletes who engage in sports such as swimming, tennis, weightlifting, and baseball, in which the arm is repeatedly raised over the head.
  • 3. Poor posture and tight neck muscles (disrupt the mechanics of the shoulder)
  • 4. Males as well as pre-menopausal women (hormonal changes can affect tissue health)
  • 5. Sedentary desk jobs (promotes poor posture and circulation obstruction)
  • 6. Significant one arm dominance

There is HOPE!!!

If you have the above symptoms and risk factors and have had them for longer than 1-2 weeks, there is a great likelihood that you have developed a “Cuff” problem. Don’t fret, there is hope. With the proper diagnosis and treatment from your local respected physiotherapist this type of condition can be completely reversed and improved tremendously. The length of time will vary but typically 8-12 sessions will suffice. Techniques such as ART, Graston and TDN (Trigger Point Dry Needling) are extremely effective in resolving this issue and diminishing the pain. This is of course in combination with an appropriate therapeutic exercise program. As a bonus we have included a few very simple and basic exercises that we use clinically at Joint Reaction, which may help to prevent you from developing the “Cuff Syndrome”. If you already have developed this problem please consult your physician or therapist before doing any rehab program. Use these exercises wisely, performing them several times daily to improve your shoulder health and prevent the dreaded Rotator Cuff Syndrome.

Neck Stretch #1
-Retract the head then tilt it to the shoulder opposite the pain
-Hold gently for 30 seconds 5 times in a row
-Repeat 3 times a day

Neck Stretch #2
-Turn head to shoulder opposite the pain, then drop the chin (AKA “smell the armpit”)
-Hold gently for 30 seconds 5 times in a row
-Repeat 3 times a day

Strengthen Upper Back
-Keep elbows tight to sides then squeeze shoulder blades together, trying not to elevate the shoulders
-Hold squeeze for 5 seconds 15 times, then repeat for a second set
-Repeat sets 2 times a day

To book your assessment call us now at (613) 425-5757.