Exercises for Shoulder Pain

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Shoulder pain is a common form of musculoskeletal pain following SCI and is often the result of increased physical demands, awkward or over-use of the upper extremities as the individual with SCI compensates for loss of lower limb functioning (Curtis et al. 1999). Curtis et al. (1999) has noted, “tightness of the anterior shoulder musculature, combined with weakness of the posterior shoulder musculature both seem to contribute to development of shoulder pain in wheelchair users (Burnham et al. 1993; Curtis et al. 1999; Millikan et al. 1991; Powers et al. 1994and may be further complicated by paralysis and spasticity in the individual with tetraplegia (Powers et al. 1994; Silverskiold & Waters 1991)”. The prevalence of shoulder pain in SCI individuals ranges between 30-100% (Curtis et al. 1999) and is a consequence of increased physical demands and overuse (Nichols et al. 1979; Pentland & Twomey 1991, 1994).

Table 10: Shoulder Pain Management Post SCI


Resistance training significantly improvement pain intensity based on the WUSPI (Serra-Ano et al. 2012; Nash et al. 2007; Nawaczenski et al. 2006) and upper limb range of motion (Serra-Ano et al. 2012) post intervention. Shoulder exercise education is not sufficient in reducing shoulder pain compared to control (Curtis et al. 1999). The use of MAGIC wheels two-gear wheelchair reduced shoulder pain; while normal personal wheel chairs were reported to increase in shoulder pain (Finley & Rodgers 2007).


There is level 2 evidence (from one prospective controlled trial and two pre-post study; Nawoczenski et al. 2006; Serra-Ano et al. 2012; Nash et al. 2007) that a shoulder resistance training reduces the intensity of nociceptive shoulder pain post-SCI.

There is level 4 evidence (from one pre-post study; Finley & Rodgers 2007) that the MAGIC wheels 2-gear wheelchair results in decrease of nociceptive shoulder pain.

There is Level 1b evidence (from one RCT; Curtis et al. 1999) that shoulder exercise education may not improve shoulder pain.

  • A shoulder resistance training reduces post-SCI nociceptive shoulder pain intensity.

    Shoulder exercise education may not improve shoulder pain.

    MAGIC wheels 2-gear wheelchair reduces nociceptive shoulder pain.