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Shoulder Pain

Specialist Musculo-Skeletal Physiotherapist Michael Otto provides expert diagnosis and treatment of shoulder pain and injuries.

Treatment is offered for a variety of shoulder problems from simple stiffness to a recurring injury that you can't get to the bottom of.

What to expect?

  • Assessment with the aim of diagnosing the cause of your shoulder problem.
  • Accurate advice on the best way to manage your shoulder pain.
  • Referral to NHS services with recommendation for an MRI scan if necessary.
  • Effective hands-on treatment to resolve or speed up healing of your shoulder injury.
  • Treatment aimed to prevent shoulder pain recurring by restoring good posture and muscle balance.

The shoulder joint has large range of movement and a complex structure and is particularly prone to becoming painful when there are muscle imbalances around the shoulder, neck and rib cage.

There are multiple structures that can be injured in the shoulder. They often refer pain into the general shoulder area, so the pain does not always identify the injured structure on its own. On you first visit, orthopaedic tests will be conducted with the aim of identifying the damaged shoulder structure.

Common Shoulder Injuries

Impingements are when structures get compressed in the shoulder. Tendons can get compressed leading to Tendonitis of the rotator cuff muscles, and Bursas can get compressed leading to Bursitis.

The Rotator Cuff can be injured when the muscles are overused, often as a result of playing a sport.

Frozen shoulder can often appear in the absence of a direct injury. It starts with severe shoulder pain and will often progress to a severely reduced range of movement in the shoulder. The symptoms of frozen shoulder can often last for a long time and early Physiotherapy is important.

Meniscal tears can often occur when you fall on an outstretched shoulder, or following a shoulder dislocation.

Treatment of Shoulder Pain

Every shoulder and every shoulder injury is different, so treatment is tailored to the individual patient.

Hands-on treatment such as soft tissue techniques directed at tendons and muscles, joint mobilisations, and acupuncture are used to settle the injury down and help aid healing.

If you are suffering from recurring shoulder pain, treatment will be aimed at restoring balance to the shoulder and surrounding areas of the body. This is done through Scapular setting exercises, retraining the shoulder blade to move correctly, and shoulder stability exercises to improve balance in the rotator cuff muscles.

The posture and position of the rib cage is also very important as the shoulder lies next to it. Some people may need to adjust their posture to realign their rib cage.

Posture in Shoulder Injuries

The space between the shoulder and the rib cage is very important as multiple structures run through here which when damaged can produce shoulder pain.

The space between the front of the shoulder and the rib cage is often compressed or impinged in people with muscles that are tight at the front of the chest. This could be because of excessive exercise, or more commonly simply due to different posture types.


This compression at the front of the shoulder is particularly common in people who either have rounded shoulders (left picture) or a rib cage which is lifted up or tilted back into the shoulders (right picture). This commonly causes impingements of the rotator cuff muscles. 


Another common muscle imbalance is found in people who have over-active upper shoulder muscles, and these people often suffer with muscular aches and may be more likely to develop shoulder injuries.