Shoulder Pain

Clinical Assessment, Diagnosis & Rehabilitation Planning

Shoulder pain is one of the most common musculoskeletal complaints and one of the most frequently misunderstood. The shoulder is not a single joint, but a complex system involving the shoulder joint, shoulder blade, ribcage, spine and nervous system. Pain often reflects how load is managed through this system, rather than isolated “damage.”

At London Osteopathy & Pilates, shoulder pain is approached through diagnosis-led assessment, followed by treatment and rehabilitation designed to restore movement control, strength and tolerance.

Why Shoulder Pain Often Persists

Many people experience shoulder pain that:

This usually occurs because:

movement control around the shoulder blade is poor
thoracic (upper back) stiffness increases shoulder load
neck contribution is overlooked
strength exists, but endurance and coordination do not
return-to-load is rushed

Treating the shoulder in isolation rarely solves the problem.

Common Shoulder Pain Presentations

We frequently assess patients with:

pain lifting the arm or reaching overhead
discomfort during pressing or pulling exercises
night pain when lying on one side
clicking or catching sensations
weakness or fatigue during repetitive tasks
symptoms aggravated by desk posture

Clinical Assessment — What We Evaluate

1) History and symptom behaviour

We explore:

2) Physical examination

May include:

shoulder joint mobility
scapular movement and control
thoracic spine mobility
neck contribution
muscle activation patterns
neurological screening where appropriate

3) Movement and load tolerance

We assess:

Treatment Approach

Osteopathic manual therapy

Used selectively to:

Rehabilitation and Clinical Pilates

Key components include:

Why Rehabilitation Is Essential

Without rebuilding control and endurance:

Rehabilitation aims to make the shoulder robust, not fragile.

Measuring Progress

We track:

When to Book

Book an assessment if shoulder pain:

David Canevaro : 07904 153486

davidcanevaro@hotmail.com