So I’ll admit that this is a bit of a click bait-y title, I do aim to do my best as a clinician to help you, the average person, suffering from shoulder pain, to understand how physios use their best skill to help manage and treat shoulder pain. In my humble opinion, I believe that the best skill and tool a physiotherapist has is their ability to perform a thorough, clinical assessment to diagnose your problem.
Obviously, the human body is complex, and this topic of shoulder pain is monstrously huge, and beyond the scope of a short blog piece. I try to keep everything as evidence based as possible and although there may be areas of unknown, I will provide a foundation and starting place for how one might best equip themselves to assess their own shoulders fairly thoroughly. This information will be helpful for you to question your own experience of shoulder pain and be immensely useful to present to a physiotherapist as I do not recommend you rely solely on your own assessment abilities if they are beyond your scope of knowledge.
Here are a few of the history of injury questions I ask my patients/clients presenting with shoulder pain and are questions you want to ask yourself and present to your physiotherapist, should you see one.
When did your shoulder pain start?
Try to be as specific as possible. Was it yesterday? Was it a 7 days ago? 6 months? 2 years ago? This information is important as it tells you how acute the injury has been and will dictate your approach.
How did this start?
Do you remember doing something that triggered your shoulder pain? Do you know the mechanism of the injury? Or did it appear insidiously, seemingly without cause that you can think of? This helps guide the diagnosis significantly.
Where and when does it hurt?
Is it a small area of pain or is it diffuse? Is it over the front of the shoulder? Along the side? Top of the shoulder? Or maybe even back of the shoulder? Or a combination of the above? Does it move? These are all helpful in identifying potential structural causes for your pain, (although the area of pain does not always dictate the structure/cause!). *
Does it hurt when your shoulder is at rest? Does it have a pattern? Does it hurt in the morning, afternoon, and during the evening? Understanding the character and nature of the pain is very useful in forming a diagnosis.
What aggravates the pain? What eases your pain?
Are there specific activities that cause your pain? Pain with raising your arm above your head? Or only if you are bench pressing 90% of your maximum ability? Your answer in comparison to your baseline function will be useful in telling you the severity of your limitations.
Information such as what has helped, or what eases your pain is important. If all you’ve tried is heat and ice, or that you’ve tried a focused, 6-12 week guided, progressive strength program, that tells your supervising clinician a lot.
Any other symptoms that are odd or unusual? Are you suffering from other health concerns?
This one is of significant importance and requires a lot more probing and just skims the surface. Further in depth questioning relating to external factors can help highlight potential contributing factors or rare and uncommon causes or drivers for your shoulder pain.
So, these are 5 key questions you want to be asking yourself when trying to piece together and make sense of your shoulder pain, and questions you should definitely be asked by your physiotherapist.
A good clinician will always ask much more, including questions such as what your hopes and goals are, and what key concerns you have, including what you might think are the potential causes for your pain.
As always, if you have shoulder pain and you’d like to have your shoulder assessed and managed by a Registered Physiotherapist, reach out to us at Vancity Physio.