The shoulder joint has the most mobility and freedom of any joint in your body!
It is a complex joint with a lot of different structures in it that can be a source of pain.

You may fall into a category where your pain came on gradually, and then an ultrasound or an MRI showed that you have impingement, bursitis, bursal thickening, or rotator cuff tendon tears. The reality is that there is nuance to shoulder injuries in that your asymptomatic should might show the same imaging findings. Now, that’s not to say that imaging is pointless.

Imaging has its time and place, but for the vast majority of gradual onset shoulder pain the prognosis is quite good, and your future does not have to be defined by your imaging findings. For exam, we know that a rotator cuff tendon tear is common in overhead athletes and that this does not prevent them from performing at the highest level symptom-free. Importantly, the majority of rotator cuff tendon tears, don’ t manifest as a full rupture. 

In other words, there may be a small hole somewhere in the tendon, but the rest of the tendon is healthy and capable of getting stronger!

Ultimately, we treat your shoulder as having a load versus capacity issue. In other words, the load that your shoulder is being subjected to is outweighing the shoulders capacity. Management will consist of progressing through a loading continuum until you can perform the currently aggravating activities that you want to do! We will prescribe exercises to help you bridge the gap between your current capacity and the external load that you are currently not tolerating. As physiotherapists, we will use various exercise prescription principles (e.g., biomechanical principles) to ensure you are getting the best and most appropriate exercise program that fits with your current presentation and goal.