Shoulder pain blog: what to do when your shoulder hurts
By Ihaia Kendrew (Ngāti Maniapoto)
Kia ora, kō Ihaia tōku ingoa. My name is Ihaia, I’m from Ōtautahi (Christchurch) and a 3rd year physiotherapy student at Te Whare Wānanga o Otago.
As part of a Summer Studentship, I had the opportunity to research and write about shoulder pain and how repeated pain events (also called flare-ups or setbacks) can be minimised. Some of my whānau and I have had shoulder pain, so being able to write something that hopefully they and others can benefit from is awesome.
The shoulder is an amazing joint that is cleverly designed with movement available in so many different directions. Unfortunately, sometimes pain intervenes when things aren’t quite right. When these events do occur, it can be valuable to have a plan.
This might look like:
Taking care of your shoulder when it hurts. What can I do right now?
Finding out what your triggers are and what brings on your pain. What could trigger my pain?
Overall maintenance and well-being. How can I look after my whole-body health?
You may want to work with your physiotherapist or other healthcare provider to find out what is most useful for you and to help you create a personalised plan.
Taking care of your shoulder when it hurts
Find out what you can do by yourself that is helpful, and what you might need from your healthcare provider.
To settle down the pain, try to avoid the movements or postures that stir it up, just for a short while.
Pacing — chunking tasks into shorter periods — can help to prevent pain getting worse later. Pacing is a skill that sets out how long you do tasks for, ensuring you don’t overdo it. More information and examples of this can be found here.
Gentle specific exercises can be helpful even during periods when the shoulder hurts. Scale the exercises back by doing them slower or by doing less repetitions at a time and combining them with breathing exercises.
Manual therapy or massage may be useful, others may prefer mirimiri or romiromi from a rongoā provider.
Some people find applying heat useful for their pain (for example a wheat bag), others might prefer cold.
If you need prescribed or over-the-counter pain medications, have a plan how you will seek these (from your GP and/or pharmacist).
Finding out what your triggers are and what brings on your pain
Try to keep track of what ‘triggers’ your shoulder pain or what makes the pain worse.
Triggers may include:
Specific movements or postures
Sleeping positions
Activities you do, particularly doing too much of the same activity at a given time
How you feel, for example, when you are feeling stressed out or, perhaps, anxious.
Once you know what your triggers are, find out whether they are avoidable, for example by doing the same task but in a slightly different posture or with a different movement.
If feeling stressed is a trigger, finding out how you can deal with that stress can also control the pain. A physiotherapist or other healthcare professional can assist with identifying your triggers and how you might be able to manage them.
Overall maintenance and well-being
A wide range of things can help to lessen pain events or a setback:
Shoulder-specific exercises are important to maintain and improve your strength and mobility. Some exercise examples can be found here.
Whole body exercise or activities that works for you. Going for a walk or bike ride, going to the gym, playing a sport you like. Anything that gets you moving, and you enjoy!
Have pain relief medication available for times you need it, so you can still do movements and activities throughout the day that you need to.
Take care of your general health as well as any other health conditions (for example being overweight, cardiovascular disorders or diabetes). Other health conditions can make your body more sensitive to pain or movement, particularly if the condition is not well controlled.
Breathing, relaxation, meditation and mindfulness. Practices like these can help you to relax and acknowledge stress you might have, while also helping you recognise how your body and shoulder feels. Hikitia Te Hā is an example of a breathing exercise with a te Ao Māori focus that can help to relax and calm the mind and body. Examples of relaxation and mindfulness techniques could be connecting to the whenua or water. More examples can be found from the Healthify webpage for Mindfulness and a sheet is available about Relaxation.
Good sleep hygiene is important for our hauora/well-being. It is important that you develop good sleeping habits, even if, at times, these are disturbed by pain.
Improve your mood: Connect with others and do something that is fun or brings you joy. Going for a walk with a whānau member, taking your tamariki (children) or mokopuna (grandchildren)to the park, or getting a coffee with a friend or work mate, are all good ways to boost your mood, relieve stress and, thereby, improve your well-being.
While one thing may work for you, it may not work as well for someone else.
Listening to your body, finding out what works for you, and incorporating these strategies into daily life can be pivotal to lessen the impact of pain on your life.
Ihaia’s Summer studentship was funded by an HRC project, ‘Stepped Rehabilitation for persistent shoulder pain’, and he was supported by kairangahau Dr Ricky Bell. The image was formatted by Christina Douglas (science communicator and project manager).