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Self help resources - Shoulder

Please self-refer to be assessed by a Physiotherapist if you:

  • Have had recent trauma to your shoulder and have a significant loss of movement/strength
  • Constant day & night shoulder pain that you cannot settle
  • You are off-sick and struggling to return to work due to your shoulder pain
  • Your symptoms are worsening and are not improving despite following advice below over the course of six weeks

What can I do to help?

Shoulder pain is common but can be self-managed really effectively following some simple advice and exercises.  If you are struggling with your pain, the following advice should help you to get started:

Pain relief:  Basic painkillers (like paracetamol) or non-steroidal anti-inflammatory drugs or gels, (such as ibuprofen) are cheap and easily available over the counter without the need for prescription.  These can be very effective as they lessen your discomfort and importantly allow you to keep your shoulder moving.  However, please check the labels for instructions/safe usage and any possible reasons why you should not use them.  If you are currently taking any form of medication it is advisable to consult your GP or pharmacist before taking additional pain relief.

Heat or Ice:  Heat is often useful for easing pain using a hot water bottle or wheat pack.  Use for 15-20 minutes at a time and repeat several times a day as necessary.  However, if you have had a recent injury or flare-up you may find it more therapeutic to use an ice pack to reduce your pain/irritation.  A packet of frozen peas wrapped in a tea-towel works well.  Leave in place for up to 15 minutes at a time.  Again, this can be repeated several times a day if found helpful. 

Rest vs. activity:  It is usually best to carry out your normal activities, but try not to overdo it.   Let pain be your guide; short-lasting/temporary discomfort is fine but worsening or constant 24/7 pain indicates you are likely doing too much and need to take things a little easier.  You need to pace yourself to start with and try to do a bit more each few days.  You will find keeping your shoulder gently moving more comfortable than complete rest.

Scans or imaging:  Scans or imaging are rarely indicated as these often correlate very poorly with symptoms.  Most people without shoulder pain have changes on scans or imaging that doesn’t cause any symptoms at all.

Exercise

Exercise can be an extremely beneficial treatment for your shoulder pain as it can gradually build the tolerance and load-capacity of your tissues and help ease stiffness and soreness.  Shoulders can respond really well to gradual strengthening over a course of a few months.  

Try this exercise programme 2-3 times a day.  A small increase in pain is OK if it goes away within 30-60 minutes and not worse the next day.  If this happens, do not worry, do fewer repetitions the next time and then gradually build up again.  It may take 5-6 weeks before you start to see improvement.  

If your shoulder pain does not start to improve over the next 6 weeks, or gets worse despite the exercises, then you can self-refer yourself to see a Physiotherapist for an assessment.

Exercise 1 - Wall Slides

Stand close to a wall.  Slide your hand up and down the wall at a steady pace as high as comfortable

Perform 2-3 sets of 8-10 repetitions aiming for slight ache/fatigue

When you can perform this exercise easily you can progress by doing it without the support of the wall and adding a light weight

Exercise 2 - Wall Presses

Stand facing a wall at arm’s length distance with your arms outstretched for a push-up

Slowly bend both elbows bringing your chest towards the wall then return

Perform 2-3 sets of 8-10 repetitions aiming for slight ache/fatigue

When you can perform this exercise easily you can progress and increase the load by moving your feet further away from the wall

Exercise 3 – Shoulder External Rotation

Sit next to a table with your elbow supported on a pillow.  Make a fist, keep your elbow bent and then rotate your forearm to point upwards before returning slowly to the start position.

Perform 2-3 sets of 8-10 repetitions aiming for slight ache/fatigue

When you can perform this exercise easily you can progress by adding a light weight

Exercise 4 - Cross-Body Arm Stretch

Support your painful arm across your mid-chest and gently pull with the other arm at the elbow to achieve a stretch feel across the sore shoulder.  Avoid if producing a pinching pain in your shoulder

Hold 30 seconds

If the above exercises are too difficult or painful then you could try the following easier exercises as a start:

Exercise 1 – Lying Arm Sways

Lie on your back

Raise your weaker arm in the air to point to the ceiling (with the help of the other arm if needed)

Then slowly perform small arm sways or circles as comfort allows

Aim for 2-3 minutes if manageable or till discomfort/fatigue.  Repeat after a short rest

Exercise 2 – Gentle Wall Pushes

Stand side-on close to a wall with your arm by your side

Press the arm gently sideways into the wall enough to elicit muscle work but gentle enough to be completely tolerable for 30-40 seconds

Rest for 30-40 seconds then repeat again 2-4 more times

This can help ease the pain and can be repeated if helpful throughout the day to give pain relief for a few hours at a time

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