Simple physiotherapy exercises could be the most effective treatment for shoulder pain according to University of Ulster research.

A new study combining the results of previous clinical trials worldwide has revealed that exercise reduces pain, improves muscle strength and enhances overall quality of life.

Catherine Hanratty, a PhD student from the University’s Health and Rehabilitation Sciences Research Centre, said: “Shoulder pain is the third most common musculoskeletal problem seen by GPs with approximately 3 in 10 people experiencing shoulder problems at any one time. Treatment is estimated to cost the health service £100 million per year.

“The majority of people with shoulder pain are diagnosed with subacromial impingement syndrome (SAIS), which is often caused by sustained overuse, overhead work or poor posture. Genetic factors may also play a role.
“It affects people from all walks of life from elite athletes to tradesmen and office workers. It is also a major problem faced by patients with rheumatological conditions.”

Catherine’s research, which has just been published in a leading journal entitled ‘Seminars in Arthritis and Rheumatism’, is the first study to combine the results of previous clinical trials carried out in the area of exercise and shoulder impingement from around the world.

“Analysis of the results and effectiveness of exercise across all available clinical trials demonstrates that physiotherapy exercises are effective at reducing pain and improving muscle strength, function and general well-being for patients. Unsurprisingly, the longer patients performed the exercises, the greater the reduction in their pain.
“Doctors often refer patients with shoulder impingement for physiotherapy treatment, yet despite its widespread use, clinicians and researchers have been unsure how effective exercises actually are. For the first time this study provides definitive answers.”

Catherine has now begun a new randomised controlled trial exploring exercise management of shoulder pain. This work is being undertaken in collaboration with physiotherapists in the Northern and Belfast Health and Social Care Trusts and an international team of researchers from the University of Ulster, Keele University and the Mayo Clinic based in the United States.

She said: “I hope that the results of this study combined with the new clinical trial will help physiotherapists and doctors improve the outcomes for people with shoulder pain.”

Dr Joseph McVeigh, one of Catherine’s PhD supervisors from the Health and Rehabilitation Sciences Research Centre at Ulster, added: “This study represents a major step forward for the evidenced based management of shoulder pain; for the first time clinicians can say with confidence that physiotherapy exercises work for shoulder impingement syndrome. We are looking forward to the results of our randomised controlled trial and are hopeful that we can further demonstrate the effectiveness of physiotherapy management of this very debilitating condition.”

Perfecting Your Posture

Posture can make a tremendous difference in your life. Feeling younger, stronger and more confident are simply a few of the changes good posture can promote – not to mention helping to improve your breathing, advance your functional performance, and decrease your risk of injury. Over time, good posture can also go a long way to preventing painful physical strain on your joints and optimizing your quality of life.
So, how can you tell if you need to improve your posture?

  • Collapsed arches in your feet
  • Elevated hip or shoulder
  • One side of the body rotated forward or back
  • Pelvis and hips tilted to the front, back or side
  • Rounded back • Drooping chest and shoulders
  • Head sitting forward

Tips to Improve Posture

  1. Find neutral – this is the position in which your unique spine and anatomy is best suited to deal with external stresses and challenges. This position can be found in standing, sitting, and moving.
  2. Remind yourself frequently – good posture doesn’t happen “by accident”. Even individuals with excellent core and hip strength have to remind themselves to sit/stand “tall”. Post-it notes at your desk or in the car can be very helpful.
  3. Don’t ignore the upper body – good posture doesn’t just rely on strong abdominal and low back muscles. Functional exercises should also focus on developing the muscles of the upper and mid-back, as well as stretching exercises for the chest and shoulders.
  4. Visualize your posture – one of the best ways to attain good posture is to “picture” yourself sitting/standing and moving “tall”. It’s an easy way to improve the health of our spine.
  5. Develop hip and abdominal muscles – weakness and inflexibility of hip and abdominal muscles can cause misalignment of your pelvis. This can result in adjustments in the spine that make it more vulnerable to injury. Remember to include hip and core strengthening and stretching exercises as part of your rehabilitation routine. Better posture is a key to good health so remember to stand tall!