The weak painful shoulder
The weak painful shoulder is one that is described as painful and weak on special shoulder testing. This means when a chiropractor or physiotherapist uses resisted muscle tests of the shoulder to diagnose what the problem is, the muscles are recorded as weak and the patient describes associated pain when contracting the muscles during the test.
It must be noted here, that this is just the first step in diagnosing a weak and painful shoulder, there are a lot of false positives with shoulder testing. A full diagnostic battery (range of tests) must be performed and of the most important of these is looking for mechanical qualities of an injury such as directional preference, classification of the mechanical issue and evaluation of repeated shoulder treatment (movement) strategies.
The reason a chiropractor or physiotherapist must do all these tests and diagnostic protocols is because shoulders are complex and many conditions mimic each other, even after conducting special tests on them. This means you must seek treatment from a practitioner that knows the shoulder very well. Our chiropractors and physiotherapists at S3C are fine examples of this.
Causes of a weak and painful shoulder
A weak painful shoulder is almost always from a rotator cuff or bicep problem and/or a mechanically compromised shoulder joint. What does mechanically compromised mean? This means the shoulder joint complex may have a movement problem that causes pain and turns muscles off (simplified), even through there is actually nothing wrong with these structures from a pathological point of view. This is known as a derangement. These types of injury typically respond quickly to mechanical and specific treatments. Chiropractors and physiotherapists call rotator cuff problems rotator cuff tendinopathy or biceps tendinopathy (proximal).
While acute and chronic rotator cuff tears can cause a weak painful shoulder. However, a important point must be made. As we age most of us will get a rotator cuff tear that we:
- do not know about and
- does not inhibit or reduce our shoulder function.
It is all too easy to blame these tears but the reality is they may have nothing to do with your actual shoulder problems (its complex).
The most common cause of a weak and painful shoulder problem, rotator cuff tears, can occur by
- trauma, a large injury causing damage to shoulder structures
- repetitive stress, smaller injuries that are frequent and cause damage.
Symptoms of a weak and painful shoulder
Weakness and pain during shoulder movements are the classic symptoms of the problems that cause a weak painful shoulder. Getting the correct diagnosis on exactly what that condition is will speed up recovery. It is important to go to a chiropractor or physiotherapist with a clinical interest and vast experience in shoulder pain.
Treatment of the unstable painful shoulder
At Sydney Spine & Sports Centre (S3C) treating shoulder injuries is a large clinical focus at both our Balmain and Dee Why clinics. Non-surgical treatment of the weak painful shoulder is preferred, however with persistent weakness or pain our chiropractors and physiotherapists may need to send you for a surgical opinion, especially if the rotator cuff tear is large. Our chiropractors and physiotherapists in Balmain and Dee Why take an evidence-based approach to the treatment of shoulder pain and weakness. There is a large clinical focus on pain reduction and functional restoration through both hands on chiropractic and physiotherapy treatments and exercises to improve muscle qualities such as endurance, strength and power.