Shoulder Pain
Rotator cuff and impingement problems that hurt when you reach overhead or sleep on that side, usually very treatable without surgery.
Common symptoms
- , Pain reaching overhead or behind your back
- , Difficulty sleeping on that side
- , Weakness lifting the arm out to the side
- , A painful arc partway through raising the arm
- , Clicking or catching with movement
Common causes
- , Gym pressing with poor mechanics
- , Repetitive overhead work or sport
- , Rotator cuff tendon irritation or tearing
- , Poor scapular control
- , Age-related tendon change
Getting the diagnosis right
“Shoulder pain” covers several quite different problems: rotator cuff tendinopathy, impingement, instability, frozen shoulder and referred pain from the neck. They look similar to the patient and require different treatment, which is why an assessment is worth more than a generic exercise sheet.
We test the shoulder through range, load the cuff in specific positions, check the scapula, and screen the neck. That usually identifies the problem without imaging.
Strength is the treatment
For the large majority of shoulder pain, the answer is progressive loading of the rotator cuff and the muscles controlling the shoulder blade. It is unglamorous and it takes a couple of months, but the evidence behind it is strong.
How we treat it
- , Rotator cuff and scapular strengthening
- , Manual therapy to restore range
- , Load modification for gym and overhead athletes
- , Dry needling for surrounding muscle tension
- , Post-surgical rehabilitation where relevant
Typical recovery: 6–12 weeks for most rotator cuff problems
See a doctor urgently if you have
- !Inability to lift the arm at all after an injury
- !Obvious deformity following trauma
- !Marked, sudden weakness with no 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
Do I need surgery for a rotator cuff problem?
Most people do not. Structured strengthening resolves the majority of rotator cuff pain, including many partial tears. Large traumatic tears in younger patients are the main exception.
Why does it hurt most at night?
Lying on the shoulder compresses irritated tendons, and without daytime distraction the pain is more noticeable. Sleeping on the other side with a pillow supporting the sore arm usually helps.
Can I keep going to the gym?
Usually yes, with modifications, often changing the angle of pressing rather than stopping altogether. Bring your programme and we will adjust it with you.
Book a physiotherapist in Nairobi
Clinic appointments in Westlands, or a physiotherapist at your door anywhere in Nairobi. Same-week slots.