Shoulder Pain
Pain reaching overhead, and pain that stops you sleeping on that side: usually a rotator cuff problem, and usually treatable without surgery.
Common symptoms
- , Pain reaching overhead or behind your back
- , Difficulty sleeping on that side
- , Weakness lifting the arm out
- , A painful arc partway through raising the arm
- , Clicking or catching
Common causes
- , Kitesurfing, windsurfing and sailing loads
- , Carrying dive tanks and heavy equipment
- , Repetitive overhead work
- , Rotator cuff tendon irritation or tearing
- , Poor shoulder blade control
The coast shoulder
More of our shoulder caseload comes from the water than would anywhere inland. Kitesurfing and windsurfing hold the arm overhead under sustained tension, which the rotator cuff tolerates poorly without conditioning. Sailing adds repeated pulling. And diving causes more shoulder trouble on land than in the water: tanks are heavy, awkward, and usually carried on one side.
Hotel and kitchen work contributes the rest: repeated overhead reaching, hour after hour.
Getting the diagnosis right
“Shoulder pain” covers rotator cuff tendinopathy, impingement, instability, frozen shoulder and referred pain from the neck. They feel similar to the patient and need different treatment, which is why assessment matters more here than in most regions of the body.
We test through range, load the cuff in specific positions, watch the shoulder blade, and screen the neck. That normally identifies the problem without imaging.
Strength is the treatment
For most shoulder pain the answer is progressive loading of the rotator cuff and the muscles controlling the shoulder blade. It is unglamorous, takes a couple of months, and the evidence behind it is strong.
How we treat it
- , Rotator cuff and scapular strengthening
- , Manual therapy to restore range
- , Activity and load modification
- , Sleep positioning advice
- , Post-surgical rehabilitation where relevant
Typical recovery: 6–12 weeks for most rotator cuff problems
See a doctor urgently if you have
- !Inability to lift the arm at all after injury
- !Obvious deformity after trauma
- !Marked sudden weakness without pain
- !Fever with a hot, swollen shoulder
These are not physiotherapy problems. Go to a doctor or hospital rather than booking with us.
Treatments that help
Common questions
Why does it hurt most at night?
Lying on the shoulder compresses irritated tendons, and without daytime distraction the pain registers more. Sleeping on the other side with a pillow supporting the sore arm usually helps considerably.
Will I need surgery?
Most people do not. Progressive strengthening resolves the majority of rotator cuff pain, including many partial tears. Large traumatic tears in younger patients are the main exception.
Can I keep kitesurfing?
Often, with modification: reduced session length, easier conditions, and specific strength work between. Complete stoppage is rarely necessary and rarely helps.
Book a physiotherapist on the coast
Clinic appointments in Nyali, or a physiotherapist at your door from Mtwapa to Diani. Same-week slots.