What we treat · Shoulder Pain
A shoulder that rest hasn’t fixed
You cannot sleep on that side. Reaching for anything above shoulder height is something you plan now, not something you do. You rested it, maybe had a cortisone shot, and it was genuinely better — right up until you tried to use the arm properly again. Shoulders almost never recover from being protected. They recover from being loaded well, which is close to the opposite of what most people are told.
Samantha — 5 years of 7/10 shoulder pain
A kickboxer who'd had it for five years. Pain went from 7/10 to 1/10 in 20 minutes.
Your results may vary.
Play video: Client testimonial — Samantha, 5 years of shoulder pain rated 7/10 Why didn’t rest work?
It worked. That is the trap. Rest takes the pain away and takes the tolerance with it.
The shoulder calms down, so you go back to the pressing or the swimming or the two hours of overhead work your job involves. The demand hasn’t changed. Your capacity is lower than it was when you stopped. It flares, and the obvious conclusion is more rest.
By the time most people reach me they have been round that loop three or four times, and each lap ended with a smaller shoulder than the last. The way out is to load it at a dose it can take today, then raise that dose deliberately until it comfortably clears what you actually ask of it.
What about my rotator cuff tear?
It probably matters less than the report made it sound. Cuff tears turn up on the scans of huge numbers of people with no shoulder pain at all, and the rate climbs steadily with age.
That does not make yours irrelevant. It means a tear on a piece of paper does not, on its own, explain your symptoms or decide that you need an operation.
The evidence for progressive loading as a first-line approach to degenerative cuff problems is now substantial, with outcomes comparable to surgery across a good number of trials. Some shoulders genuinely do belong with a surgeon — traumatic full-thickness tears, real loss of function, a shoulder that cannot be lifted at all. If yours is one of those I will say so at the first session rather than sell you eight of them.
Heather — 6 weeks of 10/10 shoulder nerve pain
A fitness instructor with six weeks of nerve pain. Pain went from 10/10 to 1/10 in 45 minutes.
Your results may vary.
Play video: Client testimonial — Heather, 6 weeks of shoulder nerve pain rated 10/10 Is it impingement?
That word has quietly fallen out of use, and for a good reason. The picture of a bone pinching a tendon has not held up.
Decompression surgery — built entirely on that idea — has performed poorly against placebo procedures in controlled trials. Which is about as direct a test of a theory as this field gets.
What tends to be true instead is less tidy, and it is a web rather than a single fault:
- a tendon that has become irritable and reacts to more than it used to
- strength lost through the middle and upper part of the range
- a movement pattern quietly rebuilt around protecting it
- months of broken sleep, which lowers the threshold for all of the above
All four respond to the same thing. Not to a label.
What does the work look like?
First we find the boundary — what the shoulder tolerates right now, honestly measured rather than guessed at. Then the program starts just inside it and moves it.
Alongside that we deal with the two things that come with every long-running shoulder and get treated as side effects: the disrupted sleep, and the guarding you are no longer aware of doing.
You keep using the arm the whole time, modified where it needs to be. Total rest is almost never the answer, and it is usually the thing that got the shoulder here.
Common questions
Should I get a cortisone injection?
It can be a useful window — pain down far enough to start loading properly. As a standalone treatment it tends to disappoint, because it does not change the capacity problem underneath. That is a conversation for you and your physician; I will work with whatever you decide.
Can I keep lifting or swimming?
Usually yes, in a modified dose. Keeping you in your sport while we fix the shoulder is an explicit goal, not an afterthought.
How long does a shoulder take?
Shoulders are typically slower than backs — tendons adapt at their own pace. Expect six to eight sessions with meaningful independent work between them, and an honest estimate after the first assessment.
Judy — 6 months of 10/10 shoulder pain
A mom who'd been at 10/10 for six months. Pain went from 10/10 to 4/10 in 60 minutes.
Your results may vary.
Play video: Client testimonial — Judy, 6 months of shoulder pain rated 10/10 Why can it change this fast?
Pain is produced by your nervous system, not simply reported by your tissues. When pain outlasts healing, what usually keeps it going is a protection response — guarding, avoiding certain movements, a system that has learned to read ordinary load as danger. That's a learned pattern, and patterns can shift quickly when you give the system genuinely new information. Fast change proves the pain is changeable. Making it hold is the work that follows, and for most people that's six to eight sessions.
Once the pain settles, what then?
Shoulders are where the gap between 'not painful' and 'actually reliable' is widest. Pressing, swimming, throwing and carrying all ask for capacity you don't get back by simply becoming pain-free — you get it back by building it.
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