Pure Physio Blog

My shoulder is unstable…

Published on
13 Mar 2020

Written by
Kate Senini
Consultant Physiotherapist

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The Pure Physio team spent a thought provoking afternoon with Specialist Physiotherapist David Frances, an esteemed clinician in our industry.  The focus of the afternoon was on shoulder pain and instability and to consider that our assessment may reveal that the cause of your symptoms may not simply be coming from the shoulder joints. 

David Frances made the all important point that the true ability to diagnose a shoulder presentation is in the assessment.  It is all too often that clinicians do not take enough time to consider the details in what you, the patient, may be telling us.  There are so often clues that indicate that the onset of shoulder pain may be linked to problems in the neck, or the upper back. Furthermore the initial contributing factor may be even lower down the body!  After all we are all one person, and there are so many intricate connections between each of our joints and how we function as a whole. 

The team were challenged in particular around the importance of trunk stability; usually referred to as “The Core”.  We looked at the relationship between athletes with poor control and stability through their trunk and how this leads to overuse or abnormal use of the shoulder to compensate. 

In these instances simply “treating” the shoulder will not provide our patients with the outcomes that they are looking for.  We need to be better and more thorough than that. 

We engaged in rehabilitation approaches to regain normal trunk control and movement, address balance and muscle timing of the trunk, and then look at how that impacted normalising movement and strength around the shoulder.  Examples that we considered were tennis serves, swimming freestyle, or a cricket fast bowling motion. In all three sports the ability to control movement through the trunk was pivotal in enabling normal movement of the shoulder. 

Pure Physio pride ourselves on taking one hour for our initial assessments and examinations, as well as spending dedicated quality time to ensure we are retraining the whole body toward normal movement when a patient may have presented with what they believe to be an isolated shoulder issue.  Remember as a patient all may not be as it seems…

If you are suffering from shoulder related pain or weakness then book an appointment today as we would love to look beyond the surface and gain deeper insights into the true reasons behind your presentation.  And then work toward the outcomes that you as a patient are striving for! 

About the Author

Kate Senini — Consultant Physiotherapist

Kate was a founding partner at Pure Physio in 2010 after returning from working in the UK. Recently Kate has decided to focus exclusively on her clinical role. Helping people recover from injury and prevent future injuries has always been her true passion!

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