Physio Interview Series: Michael Poon
Most of my clients in Hong Kong who suffer from shoulder pain either those who have a passive lifestyle with a rounded shoulder, or those who do contact sport or racket sport. Those who have reduced shoulder flexibility, weakness of the rotator cuff and middle trapezius, pectoralis minor tightness are more prone to shoulder pain.
Common shoulder problems in Hong Kong
Among my clients I have in Hong Kong, many of them suffered from rotator cuff tendinopathy. The most common shoulder problem is a condition we called impingement syndrome. It can associate with bursitis, rotator cuff tendinopathy and/or bicep tendinopathy together as a combination. This can be disabling and present with pain, reduced range of motion and sometimes patients with impingement syndrome even have difficulty of putting clothes on.
Tell us more about your shoulder injuries clients?
Many Hong Kong people have to work for a long period of time throughout the day and even though many of them try to squeeze time to do sport such badminton and contact. When they injury their shoulder, some of they may lose their patience and discipline to follow the rehabilitation program fully.
Why do you want to be a physiotherapist that specialized in shoulder rehabilitation?
I played water polo for over 12 years and I suffered from shoulder pain on and off throughout my old days with water polo. Rotator cuff tendinopathy often comes with shoulder pain and it was one of the most common problems we encountered within the water polo team; and therefore, after becoming a physiotherapist, I input time to see how I could rehab myself and as well as how physiotherapy offers to prevent shoulder injury risk in sport setting.
Treatment of shoulder injuries
Treatment often starts with rebalancing their muscle activation and power. Soft tissue release, joint mobilisation and acupuncture can be used for pain relief and lessen muscle tension like pectoralis minor. Rotator cuff strengthening exercises and scapular control exercise are essential for regaining shoulder stability. Stretching to improve flexibility is also crucial. Then at the same time, I look into the injury mechanism to see if any technique or form of movement need to modify/improve for their sport/activity, progressively moving towards injury prevention stage.
Is the treatment/rehab process the same for everyone?
Treatment needs to be individualised for their daily routine and their demand in activity or sport. Some may need to look further down to the kinetic chain and see how they perform a movement as a whole for a more detailed treatment plan.
How to avoid shoulder injuries?
Many injuries are associated with trauma, sudden increased loading to a particular structure, or chronic overload; shoulder injuries are one of them. Trauma can be accidental but we can play smart and be alerted to avoid as much as we can. Loading management is another hot topic and it is applicable to all body parts including shoulder – it is important the body is not over-stressed and recovery strategies are implemented well and enough for your training.
Like all other injuries, we would try to eliminate all the risk factors as much as we can. Beware of your posture, build a sense of body control and awareness. Strengthening your rotator cuff in different scapular position can reduce its injury risk.
Any advice for people with shoulder injuries?
Rotator cuff tendinopathy can present with a dull ache at rest and when you load your shoulder, pain can shoot up. If it is at active inflammation stage, you may even find it swollen and warm. If you struggle to manage it yourself, do not hesitate to talk to your physiotherapist as soon as possible before this becomes refectory.
Find out more about Michael
Michael was trained in UK and returned back to HK to work for both public and private hospital before I chose my path to work in a musculoskeletal outpatient setting. He operated a staff clinic alone for a company in HK – mainly treating patients with common musculoskeletal problems, sport injuries and work rehabilitation. He completed his Masters in Sport Medicine and Health Science in CUHK in 2018.