Shoulder injuries are very common. They are also varied and can be difficult to diagnose. The shoulder joint inherently has a large range of movement, which means a greater demand is placed on muscles and ligaments to provide stability.

‘Traumatic’ injuries to the shoulder like dislocations and fractures are usually diagnosed and treated quickly because they are pretty difficult to ignore! But the majority of shoulder pain that we see as physios is of insidious onset – incidental pain that has built up gradually or has seemingly come out of nowhere. Usually, this type of pain starts as the ‘odd niggle’ – something that is pretty easy to ignore and often is. A ‘niggly’ shoulder is often described as:

  • a catch of pain,
  • a twinge with certain movements,
  • a dull ache that comes and goes; or
  • low level pain after exercising

It is normally something you feel you can ‘push through’ and doesn’t interfere with any of your daily activities.

What causes a ‘niggly’ shoulder?

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The exact cause may vary from one person to the next, but a ‘niggly’ shoulder usually means that one or more structures (like the muscle, tendon, bursa etc) are being irritated. Often this is because the shoulder joint itself is not moving in an optimal way and is placing strain or pressure on surrounding structures. At this low level of discomfort, the exact structure that is causing discomfort is probably not relevant. What is more important is identifying possible contributing factors and preventing it from getting worse.

So what contributes to a ‘niggly’ shoulder?

Discomfort in the shoulder is usually caused by positions that are:

  • poorly controlled, and/or
  • poorly supported

and that are either

  • repetitive and/or
  • sustained

Some of the most common positions that can contribute to niggly shoulders are:

  • Sustained periods of sitting with rounded posture – i.e desk workers or new mums feeding/nursing/carrying babies
  • Carrying a baby / heavy bag / pram with poor posture or inadequate shoulder strength
  • Repetitive reaching behind or overhead activities without adequate strength/control
  • Doing weighted exercise with poor technique – push ups, chest press, shoulder press etc
  • Sleeping positions that place the shoulder in it’s end of range (eg. whole arm tucked under the head or arm overhead)
How should you manage a niggly shoulder?
Don’t ignore it!

This doesn’t mean you have to call the physio right away, but at least acknowledge your shoulder isn’t 100% and might be trying to tell you something.

Modify possible contributing factors

This can be the most effective thing you will do! Have a think about your possible causes and do your best to correct them. This might mean:

  • sitting with a lumbar support so your shoulders don’t round
  • cutting back the weight on your shoulder press, or cutting out potentially aggravating exercises all together until your pain settles
  • paying a bit more attention to drawing your shoulder blades down and in when carrying a bag/baby or when sitting at a desk
Try some basic strengthening exercises for your rotator cuff

Try the following exercises throughout the day. Do 3 reps each time, holding for at least 15 seconds on each repetition and don’t allow your pain to be greater that 4/10.

1. Back of hand into wall press

isometrics shoulder

Take the arm slightly (about 30degrees) away from your body. With the palm facing inwards, gently push the back of your hand into the wall, as if taking your whole arm away from your body.

2. External rotation in neutral

ER into wall 2

ER into wall

Bend your elbow to 90degrees. Draw your shoulder blade down and in. Imagine you’re trying to rotate your forearm outwards as it pushes into your other hand or into the wall

3. Belly press

Isometric IR

Place the hand against your belly, rotating at the shoulder push your hand and wrist into the belly, allowing your elbow to move forward.

Call the physio!

If the niggle doesn’t settle or is not significantly improving within the week, give us a call! We will assess your shoulder thoroughly, help you to understand your condition and what might be contributing and will work with you to get your shoulder back to feeling 100%.

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