Sports Therapy · Brighton & Hove
Expert assessment and hands-on treatment for shoulder injuries and chronic shoulder pain, identifying what's actually driving your symptoms before any treatment begins.
Why Shoulder Pain Needs Careful Assessment
The shoulder has a greater range of motion than any other joint, which also makes it the most vulnerable to injury and the most frequently mismanaged. The same symptom pattern can arise from a dozen different causes, and what helps one will often make another worse.
In clinical practice, shoulder pain is one of the conditions where accurate diagnosis genuinely changes outcomes. Rotator cuff impingement treated as frozen shoulder, or AC joint pain treated as rotator cuff pathology, leads to wasted time and frustration. Getting it right from the start changes everything.
I treat a significant volume of shoulder presentations and take a structured assessment approach, orthopedic testing, movement analysis and a detailed history, before any treatment begins.
A significant proportion of shoulder pain is referred from the cervical spine or originates in the neck and upper thoracic region. Pain in the shoulder area that doesn't fit a typical shoulder pattern, or that doesn't respond to shoulder-focused treatment, warrants assessment of the neck as a contributing or primary source.
Conditions Treated
Each of these conditions has a distinct clinical picture and a different treatment approach. Accurate identification is the first step.
The rotator cuff is a group of four muscles and tendons that stabilise and move the shoulder. Tears, tendinopathy and impingement of these structures are the most common cause of shoulder pain. Presentation varies from a dull ache with overhead activity to sharp pain with specific movements and significant strength loss.
A progressive, often severely painful condition involving inflammation and thickening of the shoulder joint capsule. Characterised by significant loss of both active and passive range of motion, particularly external rotation. More common in women aged 40–60 and those with diabetes. Has three recognised stages: freezing, frozen and thawing.
Pain and pinching sensation with arm elevation, particularly between 60–120 degrees, the painful arc. Caused by compression of soft tissue structures in the subacromial space. Often driven by poor scapular control, rotator cuff weakness or postural factors rather than a structural problem in the shoulder itself.
Pain at the top of the shoulder at the AC joint, the junction of the acromion and clavicle. Common in contact sport athletes, weightlifters and those who have sustained a direct shoulder impact. Produces localised tenderness and pain at the end of range of horizontal adduction (cross-body movement).
Pain at the front of the shoulder, often radiating into the biceps. The long head of biceps tendon passes through the shoulder joint and is vulnerable to irritation and degeneration. Can occur independently or alongside rotator cuff pathology. Often aggravated by overhead activity and resisted elbow flexion.
Recovery following shoulder surgery, rotator cuff repair, labral repair, shoulder replacement or AC joint reconstruction, requires structured, progressive rehabilitation to restore strength, range of motion and function. The timeline and approach varies significantly depending on the procedure and surgeon's protocol.
A feeling of looseness, apprehension or giving way in the shoulder, ranging from subtle discomfort during overhead activity to frank dislocation episodes. Most commonly seen in younger athletes and those with previous dislocation. Requires a neuromuscular strengthening approach rather than passive treatment.
Right shoulder pain, particularly at the tip of the shoulder or into the right scapular area, can be referred from the gallbladder via the phrenic nerve. This pattern is becoming increasingly seen in clinical practice, with a notable rise linked to the use of GLP-1 weight loss medications such as Ozempic and Wegovy, which alter gallbladder motility and increase the risk of gallstone formation. If right shoulder pain is accompanied by nausea, upper abdominal discomfort or pain after fatty meals, gallbladder referral should be considered before assuming a musculoskeletal cause.
Pain perceived in the shoulder that originates from cervical disc, facet joint or nerve root pathology in the neck. Often accompanies neck stiffness or arm symptoms. Shoulder movement testing is relatively preserved, a key differentiating feature. Treating the shoulder in isolation produces temporary results at best.
How I Work
Shoulder treatment without accurate diagnosis is guesswork. My approach starts with structured assessment and works from there.
Orthopaedic testing, movement analysis and cervical screen to identify the primary pain source and any contributing factors before treatment begins.
Targeted work to the rotator cuff, posterior capsule, pectorals and upper trapezius to reduce pain, restore movement and address muscular imbalances.
Particularly effective for rotator cuff trigger points, biceps tendinopathy and chronic shoulder conditions where manual work alone has limited reach.
Specific mobilisation of the glenohumeral joint, AC joint and thoracic spine to restore normal movement mechanics and reduce stiffness.
Progressive rotator cuff and scapular stabiliser strengthening, the foundation of lasting shoulder health and the part most treatment plans skip.
Addressing the thoracic kyphosis and scapular dyskinesis that drives many shoulder presentations, particularly impingement and rotator cuff problems.
For Shoulder Pain Patients
After treating significant volumes of shoulder presentations, these are the patterns that consistently determine whether someone recovers quickly or goes in circles.
For most shoulder conditions, graded exposure to overhead movement is therapeutic. Complete avoidance leads to stiffness, weakness and fear-avoidance that prolongs recovery significantly, particularly for impingement and rotator cuff presentations.
Passive treatment, massage, manipulation, ultrasound, provides relief but doesn't build the rotator cuff and scapular strength that protects the shoulder. Without strengthening, most shoulder conditions recur.
Generic shoulder massage for an undiagnosed shoulder problem is one of the most common reasons people with shoulder pain don't get better. Different conditions need different approaches, and some need to be avoided in specific presentations.
Lying on the affected shoulder compresses the rotator cuff and AC joint throughout the night, a common and easily corrected aggravating factor. Side lying on the unaffected side with a pillow supporting the affected arm reduces nocturnal pain significantly.
Sustained forward head posture and thoracic kyphosis at a desk reduces the subacromial space and increases rotator cuff load. For many office workers, addressing workstation setup is as important as direct shoulder treatment.
Frozen shoulder in its early (freezing) stage responds to treatment. In the fully frozen stage, options are more limited. Early intervention for shoulder pain, before a simple problem becomes complex, consistently produces faster recovery.
"I've been dealing with a shoulder injury for quite some time, which also led to tennis elbow. I'd previously tried online physiotherapy and seen shoulder specialists, but unfortunately didn't see much improvement. After just two sessions with Tim, I'm already noticing a real difference."
Accurate assessment is the difference between going in circles and actually getting better. Book an appointment and let's identify what's actually driving your symptoms.