Wrist & Hand Pain
Sub-Acromial Impingement Syndrome
The clinical features of impingement tend to be pain on most shoulder movements and activities above 90 degrees elevation and in sports people during overhead activities such as throwing or tennis serving.
Treatment is aimed at settling down the symptoms through soft tissue techniques, electrotherapy, taping, exercises and postural education or corticosteroid injection.
Rotator Cuff Tendinopathy
Treatment for rotator cuff tendinopathy includes manual therapy techniques, electrotherapy modalities and rehabilitative exercises. A corticosteroid injection into the sub-acromial space may reduce the patient’s symptoms sufficiently to allow commencement of an appropriate rehabilitation programme.
Rotator Cuff Strains / Tears
Complete and partial tears of rotator cuff tendons are commonly seen in older patients who present with shoulder pain during activity. Such patients often complain of an inability to sleep on the affected shoulder. The treating physiotherapist will carry out numerous tests to confirm a diagnosis and may refer the patient for an ultrasound or MRI scan. If the tear is small, conservative treatment with the physiotherapist is appropriate. Full thickness rotator cuff tears require surgical repair.
Frozen Shoulder (Adhesive Capsulitis)
The diagnosis of frozen shoulder, or adhesive capsulitis, is relatively easy to make. Patients typically present with a combination of severely restricted shoulder flexion, external rotation (hand behind head), abduction and internal rotation (hand behind back).
In terms of treatment, one management option is wait for it to resolve on its own with the aid of appropriate stretching exercises. Otherwise, a combination of manual therapy techniques, postural correction advice and rehabilitation exercises are most beneficial. Should the symptoms not resolve, or prove to be severely limiting and painful, then surgical referral would be indicated.
Why Physiotherapy Works - Don't Wait Too Long!
With a correct diagnosis in the first instance, the aim of physiotherapy is early pain reduction, regaining any lost range of movement at the shoulder and ultimately a return to full strength and function. By waiting too long, small problems can become bigger and take longer to fix !! You’ve been warned !!