One group of patients that I enjoy working with are athletes who have shoulder pain. Often they are confused that they are developing pain when they are regular gym goers and consider themselves to be strong. My job as a physiotherapist is to get these people back to high levels of performance without being inhibited by their pain.
There are different types of athletes that are treated. The most challenging are those who perform high velocity and high power movements. The shoulder is an unstable joint and high speed movements are difficult for the rotator cuff muscles to synchronise and keep everything under control. The rotator cuff muscles are a group of smaller, stabilising muscles within the shoulder that work to keep the ball of the arm joint (Humeral head) pinned into the shallow socket of the shoulder (glenoid fossa).
The key thing to establish in an assessment is how the shoulder is moving, and the strength of the different muscles. The shoulder and scapula positioning tells you a lot about the balance of a shoulder joint, and then identifying the strength of different muscles. If there is imbalance, weakness or instability in any of the muscles of the shoulder, then it is important to restore these. Re-establishing balance within the shoulder joint is a very important step, and then strength can be universally improved.
If there are any structures that have injury, then these must be given the correct protocols to encourage and facilitate healing and repair. This may involve establishing normal range of movement and then progressions to strengthening can be achieved.