Why your shoulder still hurts after a clear scan

A lot of the shoulders that come to Ines arrive with the same story. Months of pain reaching up or behind, a scan that came back with nothing serious on it, and a feeling that the problem has just been dismissed. The scan was right. It is also answering a different question from the one you are asking.

What a scan sees

A scan shows structure: a tear, a bone spur, fluid where there should not be any. Most shoulder pain in people under sixty is not caused by any of those. It comes from how the shoulder is being used, which is to say how the muscles around the shoulder blade and the rotator cuff are sharing the work, and a scan of a shoulder at rest cannot see that at all.

What an assessment sees

We watch you lift your arm and watch what the shoulder blade does while you do it. We test the cuff muscles one at a time against resistance. We find the movements that hurt and then change one thing, the position of the blade, the load, the speed, and see whether they still hurt. Usually something changes in the room, and that is the diagnosis: a shoulder that is irritated by a pattern, not damaged by an injury.

What the treatment is

Mostly load. Specific exercises for the muscles that are not pulling their weight, started at a level that does not flare the pain and progressed on your phone week by week. Hands-on work has a place for a stiff shoulder, and we use it, but nobody has ever been massaged into a strong rotator cuff.

Six to twelve weeks is a normal course. If your scan was clear and your shoulder still hurts, that is exactly the shoulder we are set up for.