Shoulder Pain
Reaching the top shelf, sleeping on your side, throwing a ball with the kids - a painful shoulder inserts itself into everything. Because very different problems can feel similar, getting the diagnosis right is where we start.
Your care, at a glance
The questions worth asking any clinic — answered up front.
Who you'll see
Cooper has a particular interest in neck and shoulder injuries — useful when the two overlap — and Jonty lists shoulder pain among his core interests, with a strength-and-conditioning background suited to cuff rehab. Complex cases can be reviewed by Dr Steve Saunders.
How we assess it
Structured differential assessment separating cuff-related pain, frozen shoulder, instability and neck referral, with objective strength testing of the cuff and scapular muscles — and honest interpretation of any imaging.
How we treat it
Progressive, graded strengthening matched to the diagnosis, hands-on therapy and dry needling to settle symptoms, and a staged return to overhead work, sport and sleep-friendly nights.
When you progress
- Cuff and scapular strength targets met on re-testing
- Pain-free functional range for your daily demands
- Sleeping through the night without shoulder pain
- Task- and sport-specific testing before full return
The evidence behind this approach
A systematic review of randomised trials found exercise significantly improves pain and function in rotator cuff-related shoulder pain, and synthesised the rehabilitation protocol our programs align with (Kuhn, J Shoulder Elbow Surg 2009). Objective strength re-testing tells us the program is actually closing your deficit — see how we measure outcomes.
Why it happens
The most common culprit is rotator cuff-related pain: the deep stabilising muscles of the shoulder struggling with more load than they currently tolerate - after a spike in activity, years of overhead work, or simply time. Other frequent causes include frozen shoulder (a stiff, intensely irritable capsule that follows its own timeline), instability after dislocation, and pain referred from the neck that never involved the shoulder at all.
Each of these is managed differently, which is why shoulder rehab that skips the diagnosis so often disappoints.
How we assess it
We take a detailed history, then work through movement, strength and specific clinical tests to separate cuff-related pain from stiffness, instability and neck referral. We measure shoulder and scapular strength objectively so your program targets a quantified deficit rather than a guess.
A word on scans: imaging findings like bursal thickening or partial cuff tears are common in pain-free shoulders, especially with age, so a scan alone rarely settles the question. We help you interpret any imaging you have in the context of your actual examination - and tell you honestly when a scan or specialist opinion genuinely is needed.
How we treat it
For cuff-related pain, the evidence points firmly at progressive exercise: graded strengthening of the rotator cuff and scapular muscles, built from a level your shoulder tolerates towards the overhead capacity you actually need. Hands-on treatment and dry needling can settle symptoms along the way, and we address any neck contribution directly.
Frozen shoulder is managed on its own terms - respecting the irritable phase, restoring movement as the shoulder allows, and keeping expectations honest about timeframes. Instability rehab centres on control and strength through range, with return-to-sport testing before contact or overhead sport resumes.
Working with your doctor
Some shoulders need more than physio - true traumatic cuff tears in younger patients, suspected fractures, or frozen shoulders where an injection can shorten the miserable early phase. We screen for these at the first visit and work with your GP or a specialist when they apply, rather than persisting with a plan the evidence doesn't support.
Getting back to what you love
The goal is a shoulder that lets you sleep, work, train and play without negotiation. We rebuild it progressively, re-test strength against your baseline, and clear you for overhead and loaded tasks by criteria.
Book online through HotDoc at our Adelaide CBD or Edwardstown clinic - no referral needed, with HICAPS for on-the-spot private health claims.
Frequently asked questions
Do I need a scan for my shoulder pain?
Usually not at first. Imaging findings such as bursitis or partial tears are common in people with no pain at all, so scans can mislead as easily as inform. A thorough clinical assessment sorts most shoulders out; we will tell you clearly if your presentation is one that genuinely warrants imaging.
Should I get a cortisone injection?
Sometimes an injection has a role - notably in the early, highly irritable phase of frozen shoulder - but for most rotator cuff-related pain, exercise remains the treatment with the best long-term evidence. We will give you an honest view for your case and liaise with your GP if an injection is worth considering.
How long does a frozen shoulder last?
Longer than anyone would like - typically many months, moving through irritable, stiff and thawing phases. Physiotherapy cannot rush the biology, but it can keep you moving, manage the pain phase sensibly, and restore strength and function as the shoulder lets go.
Can I keep going to the gym?
Almost always, with modifications. We work out which movements your shoulder tolerates, adjust the ones it does not, and keep the rest of your training running while the shoulder rebuilds - fitness lost waiting for a shoulder is fitness you have to earn back twice.