Shoulder Pain
Pain reaching overhead and pain that stops you sleeping on that side: usually rotator cuff, usually treatable without surgery.
Common symptoms
- , Trouble reaching up or behind you
- , Waking when you roll onto that side
- , The arm giving out when you lift something
- , A patch of the movement that hurts, above and below which it is fine
- , Grating or catching as it moves
Common causes
- , Repetitive overhead or lifting work
- , Carrying heavy loads on one side
- , Rotator cuff tendon irritation or tearing
- , Poor shoulder blade control
- , Falls, including from a bike or boda boda
Getting the diagnosis right
“Shoulder pain” covers rotator cuff tendinopathy, impingement, instability, frozen shoulder and referred pain from the neck. They feel similar to the patient and need different treatment, which is why assessment matters more here than almost anywhere.
We test through range, load the cuff in specific positions, watch the shoulder blade, and screen the neck. That usually identifies the problem without imaging.
Work and falls
Two dominant sources here. Repetitive overhead and lifting work (building, loading, market and farm work) produces gradual-onset cuff problems. And falls, particularly from bikes and boda bodas, produce the acute end: collarbone fractures, dislocations, and the long stiff recovery that follows a period in a sling.
Both respond to progressive loading. The second usually needs more patience, because the tissue has been immobilised as well as injured.
Strength is the treatment
For most shoulder pain the answer is graded loading of the rotator cuff and the muscles controlling the shoulder blade. Unglamorous, takes a couple of months, and the evidence behind it is strong.
How we treat it
- , Graded loading of the cuff and shoulder blade muscles
- , Hands-on work to free the joint
- , Working out which work task to change
- , Getting your sleep position sorted
- , Rehabilitation after a sling or an operation
Typical recovery: Six to twelve weeks for most cuff problems, longer after a fracture
See a doctor urgently if you have
- !Inability to lift the arm at all after injury
- !Obvious deformity after trauma
- !Marked sudden weakness without pain
- !Fever with a hot, swollen shoulder
These are not physiotherapy problems. Go to a doctor or hospital rather than booking with us.
Treatments that help
Common questions
Why does it hurt most at night?
Lying on the shoulder compresses irritated tendons, and without daytime distraction the pain registers more. Sleeping on the other side with a pillow supporting the sore arm usually helps a great deal.
Will I need surgery?
Most people do not. Progressive strengthening resolves the majority of rotator cuff pain, including many partial tears. Large traumatic tears in younger patients are the main exception.
I broke my collarbone in a boda accident and the shoulder is still weak. Normal?
Yes, and it needs deliberate rehabilitation rather than time alone. Weeks in a sling produce stiffness and marked wasting around the shoulder blade, and that does not reverse on its own.
Book a physiotherapist in Nakuru
Clinic appointments in Milimani, or a physiotherapist at your door across Nakuru. Same-week slots.