STADS Physiotherapy
Shoulder pain
You use your shoulder all day long. That’s why it’s good when it moves freely again.
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You feel a sharp pain when you reach for something in a high cupboard, putting on your coat is a struggle, or you wake up at night because you’re lying on your shoulder. Shoulder pain is common and can be stubborn. On this page you’ll read how your shoulder works, where the pain comes from, how long it can last and what you and we can do about it.
What is shoulder pain?
Your shoulder is the most mobile joint in your body. The head of your upper arm sits in a small, shallow socket on your shoulder blade, a bit like a golf ball on a tee. That mobility comes at a price: the shoulder relies heavily on muscles and tendons for its stability. An important group is the rotator cuff, four muscles that keep the head of your upper arm neatly in the socket while you move. Your shoulder blade, collarbone and upper back play a part too.
Shoulder pain is an umbrella term. The most common form is called subacromial pain: pain around the rotator cuff tendons and the bursa under the roof of the shoulder. This used to be called ‘impingement’, but we now know that the tendons usually don’t actually get trapped. Other causes include a frozen shoulder, an unstable shoulder or problems with the joint between the collarbone and shoulder blade. Sometimes shoulder pain comes from the neck.
What symptoms can you have?
- Pain at the front or outside of your shoulder, sometimes spreading to your upper arm
- Pain when lifting your arm, especially above shoulder height
- Pain when lying on the affected shoulder, so you sleep worse
- Difficulty getting dressed, combing your hair or reaching behind your back
- Less strength in your arm
- A stiff shoulder or the feeling that your arm can’t move as far
What causes shoulder pain?
With a lot of shoulder pain, the balance between load and load capacity plays a big part. Tendons adapt to what you ask of them, but they need time to do so. If you suddenly do much more than you’re used to, such as a week of painting, a new sport or lots of overhead work, the tendons can become irritated. On the other hand, a period of little movement can actually lower your load capacity.
Factors that increase the risk of shoulder pain:
- Repeated work above shoulder height, such as in construction or cleaning
- Throwing sports, swimming, tennis or volleyball, especially if you build up quickly
- Getting older: tendons become less resilient over the years
- Diabetes and thyroid problems (especially with frozen shoulder)
- A fall onto your arm or shoulder
An ultrasound or MRI often shows wear or small tears in the tendons, even in people without pain. So a finding like that doesn’t always explain your symptoms, and it doesn’t mean your shoulder can’t get stronger.
How long does shoulder pain last?
Shoulder pain often takes some patience. Some of it clearly eases within a few weeks. For others, recovery takes a few months, and some people have pain for longer or get it again later. How it goes depends on the cause, how long you’ve had the pain, your work and your general health.
A frozen shoulder follows its own, longer course, often a year or more. With tendon problems, recovery usually happens gradually, with better and worse weeks. That’s normal. What matters is that, looked at over a few weeks, things are heading in the right direction.
What helps: staying active, gradually making your shoulder stronger and spreading heavy loads sensibly. Waiting a long time and sparing your arm completely often makes recovery slower. If things haven’t improved after a few months of exercise, we’ll discuss next steps with your GP.
When should you see a physiotherapist?
- Your shoulder pain hasn’t eased after two to three weeks
- You can’t lift your arm properly any more or have less strength
- You’re sleeping badly because of the pain
- You can’t work or do your sport the way you want
- You’ve had shoulder pain before and want to prevent it coming back
- You want to know which exercises are good for your shoulder
Can’t work it out on your own?
Our physiotherapists and occupational therapists are happy to help. In most cases you can come without a referral, in Eindhoven or Tilburg.
When should you see your GP straight away?
- After a fall or accident with severe pain, swelling or a misshapen shoulder
- If you suddenly can’t actively lift your arm after a fall or injury
- If your shoulder is red, warm and swollen and you have a fever or feel ill
- If you have pain in your shoulder or left arm together with chest pain, shortness of breath or sweating: call 112 (emergency number) immediately
- If you have unexplained weight loss or pain that continues day and night for no clear reason
How STADS helps with shoulder pain
At STADS, we start with a proper conversation. When did the pain start, which movements bring it on and what do you want to be able to do again? Then we examine your shoulder, shoulder blade, neck and upper back. This gives us a picture of the likely cause and lets us rule out anything you need to see your GP about.
We explain what’s happening in your shoulder and what you can expect from your recovery. Together we set concrete goals, such as sleeping without pain again, hanging out the washing, working or getting back to sport.
The foundation of the treatment is exercise therapy. Your tendons and muscles get stronger when you load them in the right way. That’s why we build up the exercises step by step, gently at first and later heavier or sport-specific. We also teach you how to manage the load sensibly in daily life, without sparing your shoulder completely. Massage or mobilisation can sometimes bring temporary relief, but they are an addition at most.
For long-standing tendon problems with calcium deposits, shockwave therapy can be added to the exercises. If you play sport, our sports physiotherapy helps you return to your sport safely. After treatment, you can keep training under supervision with medical fitness.
What can you do yourself?
- Keep using your arm within what feels reasonable. Complete rest usually makes the shoulder stiffer and weaker
- Spread heavy or overhead jobs over several days
- At night, put a pillow under your arm or in front of your chest if lying down is painful
- Use heat or cold, whichever feels better to you
- Build your sport back up gradually and keep an eye on the pain during and after exercise
Read also
Related complaints
Good to know
Frequently asked questions
Do I need a referral?
No. In most cases you can come to us for physiotherapy and occupational therapy without a referral from your GP. At your first appointment, we start with a short screening. We check whether your complaints are suitable for treatment by us, or whether it would be wise to see your GP first. If you do have a referral, feel free to bring it along.
Is the treatment covered by my insurance?
That depends on your health insurance and whether you have a supplementary package. Physiotherapy is usually covered by your supplementary insurance, up to a certain number of treatments per year. For some chronic conditions, a different arrangement applies under your basic insurance. For more information, see our page on reimbursements and rates or check your policy.
Do I need an injection in my shoulder?
Not always. An anti-inflammatory injection (corticosteroid) can give temporary relief when the pain is severe. That can help you get back to exercising. In the longer term the effect is limited, and exercise therapy remains the foundation. Whether an injection makes sense is something to discuss with your GP. We’re happy to help you think it through and adjust the treatment accordingly.
A small tear has been found in my tendon. Do I need surgery?
Usually not. Small tears in the rotator cuff tendons are common, especially after the age of fifty, even in people without symptoms. For many people, exercise therapy and a gradual build-up give good results. With a large tear after an accident, especially in younger people, surgery may be considered. The orthopaedic surgeon will assess that.
Can I keep playing sport with shoulder pain?
Often you can, perhaps in an adapted form. A little pain during sport is fine, as long as it settles quickly afterwards and isn’t clearly worse the next day. You can temporarily cut back on overhead movements such as throwing, smashing or front crawl. Your physiotherapist will help you with a build-up plan, so you don’t have to stop completely.
Our locations
Two practices, one team
In Eindhoven and Tilburg, physiotherapists and occupational therapists work together under one roof. Choose the practice that’s easiest for you.
Eindhoven
Centrally located on Geldropseweg, with spacious treatment rooms and a large exercise room. Easy to reach by bike, public transport and car.
Address
Geldropseweg 28
5611 SJ Eindhoven
Free parking behind the building
Tilburg
Right in the heart of the Reeshof, close to the A58 exit. Also easy to reach from the surrounding villages.
Address
Reeshofweg 40
5036 BK Tilburg
Mon to Fri, 08.00–18.00
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