Shoulder Pain

The shoulder is the most mobile joint in the body — and one of the most commonly overlooked.

Shoulder pain covers a wide range of presentations — rotator cuff injuries, impingement, frozen shoulder (adhesive capsulitis), AC joint problems, biceps tendinopathy and referred pain from the neck and upper back. Each has a different mechanism, a different timeline and a different treatment approach.

What they often share is that they take longer to resolve when the underlying cause isn't properly identified early. Shoulder pain that's been managed with rest and anti-inflammatories for months tends to present with more compensatory patterns layered on top of the original problem — which makes treatment more complex.

Why the neck and thoracic spine matter

The shoulder doesn't operate in isolation. How the thoracic spine moves, how the scapula sits and tracks, how the neck loads — all of these directly affect how the shoulder joint functions. Restricted thoracic mobility is one of the most common and most overlooked drivers of shoulder impingement and rotator cuff overload.

Similarly, pain that presents in the shoulder is sometimes referred from the cervical spine — particularly at C5 and C6 — and treating the shoulder locally in these cases produces limited results. Assessment needs to include the full kinetic chain.

How Dr Chase approaches it

Assessment covers the shoulder joint itself, the rotator cuff, the scapula, the AC joint, the thoracic spine and the cervical spine — because where the pain is and where it's coming from are often different places. Neurological assessment is included where nerve involvement is suspected.

Treatment draws from joint mobilisation of the shoulder, thoracic and cervical spine, myofascial release through the rotator cuff and surrounding musculature, lymphatic drainage where inflammation is significant, and rehabilitation guidance to restore strength and range of movement progressively. For frozen shoulder, treatment is tailored to the stage of the condition — inflammatory, freezing and thawing phases each require a different approach.

Shoulder problems rarely resolve fully without addressing the whole picture. Getting that assessment right early tends to significantly shorten the overall recovery time.