Shoulder & Arm Problems

Tennis Elbow

Tennis elbow (lateral epicondylitis) causes pain and tenderness on the outer part of the elbow.

It is not caused exclusively by tennis – it can be caused by any activity that overuses the wrist extensor muscles – the muscles that bend the wrist back.

You can get tennis elbow from such diverse activities as gardening, working on a computer, carrying heavy objects or repetitive gym work.

The symptoms of tennis elbow can also result from a neck injury.

Symptoms of tennis elbow may include:

  • Pain and tenderness along the outer part of the elbow
  • Pain when bending the wrist back or raising the middle finger, with or without resistance
  • Weakness of the wrist muscles
  • Pain with elbow movements
  • Pain when gripping


Physiotherapy treatment can help with tennis elbow by:

  • Advising rest of the area, either by avoiding the painful motion or by wearing a wrist resting splint or an elbow strap
  • Reducing pain and inflammation with icing and electrotherapy
  • Restoring normal muscle and tendon extensibility and strength with massage, exercises and stretches
  • Correcting posture, movement patterns and sports techniques to eliminate the causative factors and prevent recurrence

Golfer's Elbow

Golfer’s elbow (medial epicondylitis) causes pain along the inner part of the elbow. It can caused by repetitive downward movement of the wrist (wrist flexion), or by a injury to the area.

As with tennis elbow, the symptoms of golfer’s elbow can also be caused by a problem with the neck, or can result from arthritic changes within the joint itself.

Symptoms of golfer’s elbow include:

  • Pain and tenderness along the inner part of the elbow
  • Pain with repeated wrist flexion movements and possibly when bending the wrist down and twisting the forearm in
  • Pain when gripping
  • Weakness of the wrist muscle

The approach to treatment is fundamentally the same as with tennis elbow.

Shoulder Pain

The shoulder is the most mobile and versatile joint in the body. It is a relatively unstable joint, getting most of its support from the surrounding muscles, tendons and ligaments. Consequently, strains placed on the shoulder can cause damage to these soft tissue structures resulting in shoulder pain.

Shoulder pain can also result from degenerative changes leading to damage of the joint structures themselves, or it can be a result of a neck problem.

The pain may be local to the joint or it may spread to areas surrounding the shoulder and down the arm.

Shoulder pain can also result from degenerative changes leading to damage of the joint structures themselves, or it can be a result of a neck problem.

The pain may be local to the joint or it may spread to areas surrounding the shoulder and down the arm. 

Symptoms of shoulder problems include:
  • Limited ability to lift the arm forwards or sideways due to pain and stiffness
  • Weakness of the arm
  • Pain at night when lying on the affected side
  • Difficulty in dressing, washing, driving and doing overhead activities
  • Fear of adopting the ‘hands-up’ position
Physiotherapy treatment can help shoulder problems by:
  • Reducing pain with corrective control exercises, electrotherapy and advice on home pain management
  • Restoring a full range of motion and muscle power with joint mobilisations and exercises
  • Aiding a return to sport with a sport specific rehabilitation programme

Frozen Shoulder

Frozen shoulder (adhesive capsulitis) is a condition in which the soft tissue surrounding the glenohumeral joint of the shoulder becomes inflamed. The affected joint becomes stiff, greatly restricting motion and causing severe chronic pain. Onset of frozen shoulder is usually gradual, with symptoms increasing over a period of months.

Physiotherapy is an effective treatment for frozen shoulder, gradually stretching the joint through passive mobilisations performed at various points throughout its range of movement.

The patient will also be given a program of stretches to be performed at home.

RSI - Repetitive Strain Injury

RSI is a condition that is ergonomic in origin – it is usually associated with performing repetitive movements in a consistently poor position.

Typical causes of RSI include:

  • Working at a desk or using a keyboard
  • Carrying a heavy bag on one shoulder
  • Driving
  • Watching television

Typical symptoms of RSI are short bursts of intense pain in the back, shoulders, arm, wrists or hands. Often the pain affects multiple parts of the body and is increased by activity. There may also be associated weakness.

Treatment of RSI begins with a thorough examination which includes gathering information on work and lifestyle. It is followed by an in depth assessment of posture, joints, muscles and nerves.

Finally, an individually tailored treatment programme is produced, which may include advice on working patterns and positions, a home exercise programme and appropriate mobilisation of the affected parts of the body.

CTS - Carpal Tunnel Syndrome

Carpal Tunnel Syndrome is a painful condition affecting the hands. Symptoms of pain, tingling and/or numbness are typically felt in the thumb and adjacent two or three fingers. These can be particularly troublesome at night.

The cause of Carpal Tunnel Syndrome is usually compression of the nerve to the hand at the wrist but problems in the neck can also produce similar problems.

Physiotherapy can help by mobilising structures in the neck and around the wrist which helps to take the pressure off the nerve. Splints can also be used to provide support over night and exercises undertaken to improve the strength and mobility of the muscles in the arm.

Other shoulder and arm problems, we treat