Dealing with acute or chronic back pain can be exhausting and frustrating. It is especially so when back pain interferes with your ability to move comfortably, work, or enjoy everyday activities.
As a BASRaT-reg GSR (Graduate Sport Rehabilitator), I see firsthand how back pain and sciatica impact physical health and mental well-being. Receiving the most appropriate back pain treatment goes a long way to alleviating symptoms and helping you to regain mobility and confidence.
Remember that not all back pain is the same. It can vary in intensity, duration, and underlying cause, and is generally classified as acute, chronic, or linked to sciatica.
This guide aims to help you understand the different types of back pain, recognise common symptoms, and know when it’s time to seek professional help. Understanding your pain is the first step towards recovery and regaining confidence in movement.
Acute Back Pain
Acute back pain refers to pain that starts suddenly—often following a specific event or injury. It’s usually sharp, intense, and acts as a protective response from your body to alert you that something isn’t quite right.
Common Causes of Acute Back Pain
Acute pain often stems from muscle strain, ligament sprain, or other soft tissue injuries. Common triggers include:
Lifting heavy objects with poor technique
Sudden twisting or awkward movements
Falls or accidents
Overuse during sport or physical activity
Typical Symptoms
Acute back pain may feel like a stabbing, shooting, or aching discomfort. You might experience:
Muscle spasms
Pain that radiates into the buttocks or thighs (but usually not below the knee)
Reduced mobility or stiffness
Pain that worsens with movement or certain postures
How Long Does It Last?
Most cases of acute back pain improve within a few days to a few weeks as tissues heal naturally. Rest alone isn’t always the best strategy—gentle, guided movement helps to speed up recovery and prevent stiffness.
When to Seek Help
You should seek professional assessment if:
The pain is severe or not improving after a few weeks
You experience numbness, tingling, or weakness in your legs
The pain follows a major injury
You develop fever, unexplained weight loss, or bladder/bowel changes
Chronic back pain is defined as pain that persists for more than 12 weeks, even after the initial injury or cause has healed. It may develop gradually and can fluctuate in intensity over time.
Common Causes
Chronic pain may develop for several reasons, including:
Ongoing muscle tension or imbalance
Degenerative changes such as arthritis or disc degeneration
Poor posture or occupational strain
Nerve irritation
Persistent inflammation or delayed tissue healing
Symptoms
Chronic back pain often presents as a dull ache, burning sensation, or sharp, ongoing discomfort. It may also lead to:
Muscle stiffness or weakness
Fatigue and reduced flexibility
Difficulty sleeping or concentrating
Emotional effects such as frustration, anxiety, or low mood
Key Differences from Acute Pain
Unlike acute pain, chronic back pain isn’t always linked to a single cause and may be influenced by several factors, such as stress, lifestyle, and movement habits. Addressing these factors holistically is crucial for long-term relief.
Risk Factors
You may be more at risk of chronic back pain if you:
Have had a previous back injury
Lead a sedentary lifestyle
Are over the age of 40
Have poor posture or heavy manual work
Experience high stress levels or smoke regularly
➡️ Learn more in our Chronic Back Pain Leaflet, including evidence-based treatment and rehabilitation options.
Sciatica
Sciatica is a specific type of back pain caused by irritation or compression of the sciatic nerve—the longest nerve in the body, running from your lower back through the hips, buttocks, and down each leg.
What Causes Sciatica?
Common causes include:
Herniated disc
Spinal stenosis (narrowing of the spinal canal)
Bone spurs
Muscular compression from tight gluteal or piriformis muscles
Sciatica Pain Points
Recognising the Symptoms
The hallmark sign of sciatica is pain that travels from the lower back down one leg. It may feel like:
A sharp, burning, or electric-shock-like pain
Numbness or tingling in the leg or foot
Muscle weakness
Increased pain when sitting or bending forward
How Sciatica Differs from General Back Pain
While general back pain often stays localised, sciatica follows a distinct nerve pathway, typically affecting one side of the body.
Risk Factors
Factors that increase your risk of developing sciatica include:
If your back pain is disrupting daily life or not improving with active rest and self-care, you must seek professional advice. As a Graduate Sport Rehabilitator, my role is to help you restore function, reduce pain, and regain confidence in movement through evidence-based assessment and rehabilitation.
When to See a Specialist
Book an appointment if:
Your pain lasts longer than three weeks
Pain limits your mobility or sleep
You experience tingling, weakness, or radiating pain
There’s a history of trauma, fever, or unexplained weight loss
The Importance of an Accurate Diagnosis
A thorough assessment is key to identifying the underlying cause of your pain. This may include a physical examination and, where necessary, imaging such as an MRI or CT scan. Getting the right diagnosis ensures your treatment plan is safe, targeted, and effective.
Self-Care Tips
While waiting for your appointment, try:
Applying heat or cold to reduce pain and stiffness
Staying active with gentle, pain-free movement
Avoiding prolonged bed rest
Using over-the-counter pain relief if advised by a pharmacist
Practising good posture and ergonomic habits
➡️ For practical at-home strategies, the NHS is a good resource for advice on managing Sciatica Pain NHS Advice
Final Thoughts
Understanding the difference between acute, chronic, and sciatica-related back pain empowers you to take control of your recovery. While acute pain often resolves naturally, chronic pain and sciatica may require professional rehabilitation and lifestyle adjustments.
If you’re struggling with ongoing back pain, remember — you don’t have to face it alone. With the right guidance and rehabilitation, you can return to the activities you love and live pain-free.
👉 Book your consultation with a Graduate Sport Rehabilitator today to receive an assessment and a personalised treatment and exercise plan designed around your goals and lifestyle.
Disclaimer
This article is for educational purposes only and should not replace professional medical advice. Always seek the guidance of a qualified healthcare provider for assessment, diagnosis, and treatment specifically for your individual needs.
A woman sitting at a low table with a laptop, looking down at her phone
Introduction
What if better posture could transform how you are perceived, how you perform, and ultimately what progress you make in your career? Could your posture influence whether or not you land that coveted promotion at work? Is posture really that powerful?
Yes, and here’s why!
Research shows that posture influences brain chemistry, altering mood and optimising cognitive performance.1 By sitting straighter or standing taller, we exude more confidence, think more clearly, and project a stronger leadership presence. Posture affects how others perceive our credibility and authority. It directly impacts our own mindset, energy, and focus. Refining our posture can alter how others perceive us. It signals confidence and expertise in meetings, presentations, and even casual chats.
Why Posture Is Important
This article will help you sharpen your awareness of your body posture with 7 tips to identify and correct poor habits. By adopting an optimal posture, you minimise strain on muscles and ligaments, reducing the risk of developing musculoskeletal disorders and associated pain. Refining how you stand, sit, and move is not just about comfort, credibility, and career progression—it’s also about safeguarding your long-term health.
What Does Good Posture Look Like?
How can you check your posture? A simple method is to stand with your back against a wall, ensuring your shoulders, hips, and head are in contact with it. Ask your partner or a friend to take a photo of you in underwear from the front, sides, and back. Take a side-view photo and draw a line down the side of your body as in the diagram.
According to Kendall 2, the line should pass through the ear lobe, centre of the neck bones, shoulder joint, midway through the trunk, the greater trochanter of the femur, midline of the knee, and slightly in front of the lateral malleolus of the ankle. When standing correctly, the three natural curves of the spine—neck (cervical), mid-back (thoracic), and lower back (lumbar)—experience the least stress.
What Are Some Of The Factors That Influence Posture?
Anatomy
Posture is shaped by many anatomical factors, some of which we can influence more than others:
Leg length differences: Some people naturally have one leg slightly longer than the other. A doctor or physiotherapist might suggest orthotics, and with the right strategies, posture can still be improved.
Scoliosis: A curvature of the spine can affect how we hold ourselves. A doctor’s assessment can help guide support, and corrective exercises by a qualified fitness practitioner can go a long way to maintaining strength and alignment.
Breast weight (for women): Breast weight is often underestimated but can affect posture, causing rounded shoulders, forward head posture, and neck, back, or shoulder strain. Research at the University of Portsmouth has shown that a well-fitting, supportive bra not only eases these issues but also helps women move comfortably and participate fully in sport and daily life.
Wheelchair users: Posture isn’t just about standing. Even when seated, alignment can be adjusted to support presence, connection, and confidence.
Pathology
Illness and injuries to bones and joints. Examples are arthritic changes and fractures that heal incorrectly
Pain following whiplash injury or degeneration of spinal intervertebral discs
Changes in bone density as we age
Occupational/Recreational
Long hours working at a desk
Delivery drivers and couriers who spend extended time driving
Impact of regular exercise vs. inactivity and a sedentary lifestyle
Type of sport/recreation, eg, tennis player vs. committed cyclist, swimmer, body builder
Emotional/Psychological
Stress, anxiety, poor sleep, and negative self-talk can all subtly show in our body language, impacting posture
Life events such as bereavement, the loss of a job, or divorce
Posture naturally mirrors mood and confidence. Feeling nervous in social or work settings can impact how we stand and maintain eye contact, influencing the impression we make on others.
This list is not exhaustive, and some factors are outside of our control. But by noticing how emotions shape posture, you can adjust and stand with more confidence and power.
Here are 7 tips to help you connect to and showcase your power through posture.
Stand tall. Imagine a string pulling your head up from the top of your skull—keep your chin tucked in. Avoid tilting your head back or to the side. Drop your shoulders down and back, keep your back and knees straight, and lightly engage your core. Have a friend take a photo. This posture may initially feel odd, but comparing before and after shots will show the difference.
Let’s get physical. Correcting your posture in the mirror is easy, but can you keep it up all day—at work, with the kids, doing chores? Seeing a physical therapist for exercises to strengthen weak muscles and lengthen short ones makes a significant difference. New habits take time to embed, but a physical therapist’s advice and support can make it much easier.
Step to it. Foot orientation affects standing posture. If your feet roll inward, it can strain your knees, hips, back, and shoulders. A physical therapist can prescribe corrective exercises or refer you to a specialist podiatrist for further examination.
Bust Up. We mentioned the importance of a well-fitting, supportive bra, but what does that mean? Professor Joanna Wakefield-Scurr, Head of Bra Science and Breast Health at Portsmouth University, has extensively studied the impact of proper bra support. Her team collaborates with schools, military servicewomen, athletes, and others to emphasise the crucial role of appropriate bra support in women’s health.5
Wind your neck in. Originally an East London phrase meaning “calm down,” “wind your neck in” has taken on new relevance in the age of smartphones. Would you believe there is now a medically recognised overuse condition called “text neck”—caused by holding the head forward for long periods while using mobile devices? The ideal head position is when the earlobes align with relaxed, back-and-down shoulders. Why does this matter? A head weighs 4.5 kg – 5.5kg. A forward tilt of 2 – 3 cm can increase the strain on the muscles and ligaments by up to 6 times. This leads to headaches, shoulder and back pain, nerve irritation, and even a ‘Dowager’s Hump’. Treatment includes reducing screen time, strengthening exercises, and physical therapy. The first step is to become aware of your mobile phone habits, especially your head position while using them.
Core Blimey! Another classic East London expression—expect to hear it at the gym when an East Londoner clocks your impressive six-pack! A strong core transforms your lower back and pelvis into a powerhouse for sports like running, cycling, swimming, and rowing. How do you achieve it? Look for a certified STOTT® Pilates instructor. These targeted exercises strengthen the spine and engage the core. A skilled instructor will assess your posture, pinpoint weak muscles, and design a customised programme.
Stand for Success. Sitting for long periods can affect both posture and overall health. Using a sit-to-stand desk, if available, helps circulation and focus. If not, regular breaks and short walks—especially outdoors—make a big difference. Standing tall and sitting upright not only supports posture but also boosts confidence and presence. So, walk with intention, greet the world with a smile, and let improved circulation and alignment enhance your natural, confident energy.
Lastly! Sip, Don’t Skip
Keep hydration high by sipping water throughout the day—use a marked bottle to stay on track. A well-hydrated body is healthier, sharper, and more confident, so step up, fuel up, and set yourself up for success!
References
Awad, S., Debatin, T. and Ziegler, A., (2021). ‘Embodiment: I sat, I felt, I performed – Posture effects on mood and cognitive performance’. Acta Psychologica, 218, p.103332.
Kendall, F., Kendall McCreary, E. and Provance, P., 1993. Muscles Testing and Function. 4th ed. Baltimore: Williams & Wilkins.
Mills, C., Exell, T.A., Wakefield-Scurr, J. and Jones, M.E.A., 2024. Modelling the female torso and breast during physical activity: Implications on spinal loading. Journal of Sports Sciences, pp.1–11. Available at: https://doi.org/10.1080/02640414.2024.2394748 [Accessed 17 September 2024].
Fiebert, I., Kistner, F., Gissendanner, C. and DaSilva, C., 2021. Text neck: An adverse postural phenomenon. Work, 69(4), pp.1261-1270.
In today’s fast-paced world, achieving true relaxation can feel like an insurmountable challenge. Suggestions to work fewer hours, to create that elusive ‘work-life balance,’ or to avoid tense situations may seem unrealistic. So, how do you find a solution that does not require inconvenient lifestyle changes? Massage Therapy is a tried and tested approach to managing stress and enables a state of rest to be achieved.
What do the Experts Say?
Massage Therapy comprises a variety of techniques. Some are more well-known than others, such as Effleurage, Petrissage, and Tapotement. An advanced technique, Myofascial Release, can lead to a phenomenon known as Fascial Unwinding, where dysfunctional tissues are guided along the pathway of least resistance until free movement is achieved. Dr Viola Frymann, a doctor of Osteopathy, studied with William Garner Sutherland, the Father of Cranial Osteopathy. She was a pioneer and an advocate of this form of therapy in the 1960s. Today, John F. Barnes, Ruth Duncan, Dr Budiman Minasny, and John Upledger are among the foremost practitioners in this field.
Some may argue that finding the time and the money for massage therapy will only add to their stress. Common perceptions that it is ‘too expensive,’ or ‘I don’t have the time,’ or ‘it’s selfish and indulgent when I have other, more important priorities,’ often hinder individuals from seeking the help they need. Consider that prioritising your mental and physical well-being by taking regular time out for your own self-care is not selfish or indulgent. By doing so, you safeguard your overall health, potentially saving you from costly medical bills or having to take time off work for additional health issues. It is like putting on your own oxygen mask first to be able to help others who are in your care.
What Evidence is there?
Research has shown that massage therapy is highly effective in the management and reduction of stress because it enables the client to reach a state of deep relaxation. This leads to a healthier and more vibrant lifestyle. In a study carried out at Khon Kaen University, Thailand, comparing traditional Thai massage with Swedish massage among patients with back pain, the researchers found that massage therapy is an effective primary health care treatment for this disorder (Catchawan et al., 2005).
Another study conducted at the City University of New York found that the effects of a single massage therapy session on physiological and psychological factors were significant. They found considerable overall improvement in resting heart rate, tension-anxiety, and mood (Cowen et al., 2006). All things considered, it is essential to recognise that regular massages go far beyond mere pampering. They are a valid and effective way to take care of your overall health. Furthermore, you may discover increased energy and time to tackle daily tasks and work, ultimately reducing the stress caused by everyday contributing factors.
The Impact of Prolonged Stress
Stress shows up differently in various individuals. Some experience a racing heart rate, shallow and elevated breathing rate, difficulty concentrating, feeling overwhelmed, and anxious. Others may feel exhausted, depressed, lethargic, and tearful. Stress is a normal part of everyday life and arises from multiple sources, such as work, school, relationships, and family responsibilities. However, family conflicts, social challenges, economic worries, and health concerns may hinder participation in leisurely activities. Additionally, chronic illnesses, pain, or injuries contribute to an inability to relax, poor-quality sleep, and feeling demotivated.
Cortisol is an essential hormone that is produced in the Adrenal Glands. It plays many important roles, including:
Managing stress responses
Optimising metabolism
Reducing inflammation
Regulation of Blood Pressure
Cortisol, the hormone triggering the ‘fight or flight’ response, promotes motivation and goal achievement. While essential for survival in the face of physical threats in the past, chronic cortisol release due to prolonged stress in today’s fast-paced life is detrimental to long-term well-being.
Stress affects every aspect of the body, leading to muscle stiffness, pain, headaches, fatigue, stomach and digestive issues, and sleep difficulties. Prolonged periods of high stress levels make it more of a challenge to control behaviour and to make sound judgments. This can contribute to overeating, substance abuse, withdrawal, neglected exercise routines and failure to achieve personal and professional targets. Maintaining healthy stress levels is crucial for staying on track to achieve objectives.
How does Massage Therapy Reduce Stress?
As shown above, research shows the effectiveness of massage therapy on physiological and psychological factors. Several physiological effects occur that contribute to stress reduction, including:
Increased release of Endorphins: Serotonin and Dopamine
Decreased production of Cortisol.
Endorphins are the ‘happy hormones’ that alleviate anxiety. Serotonin promotes happiness, well-being, and prevents depression. Dopamine increases motivation and eliminates self-doubt. These positive hormones are often deficient in individuals experiencing stress, anxiety, and loneliness.
Massage Therapy works on Sensory Nerve Endings within the tissues. Mechanoreceptors located in muscles, joints, ligaments, tendons, and fascia are activated when tissue is loaded with any force, such as compression, touch, stretching, or pressure. Massage stimulates the release of endorphins, serotonin, and dopamine – neurotransmitters that transmit feelings of well-being through the nervous system. Stress and anxiety are reduced, and overall mood is elevated.
In Conclusion…
Massage Therapy offers a pathway to relaxation and stress relief. By prioritising mental and physical health through regular massage, the negative effects of stress can be offset, leading to improved overall well-being and a more fulfilling life.
Massage Therapy, including Fascial Unwinding are mechanical, musculoskeletal techniques that release tension in the fascia. Equally important are the physiological changes that occur in response to touch, pressure, shear, and vibration. Do not underestimate the transformative power of massage therapy in your quest for balance, relaxation, and tranquillity. See the list below for references and suggestions for further reading.
References and Further Reading
Catchawan, U. et al., (2005) ‘Effectiveness of traditional Thai massage vs Swedish massage among patients with back pain associated with myofascial trigger points.’ Journal of Bodywork and Movement Therapies9, pp.289-309
Cohen, V. et al., (2006) ‘A Comparative study of Thai massage and Swedish massage relative to physiological and psychological measures.’ Journal of Bodywork and Movement Therapies 10, pp. 266 – 275
Van der Kolk, Bessel. The Body Keeps the Score. 1st ed., Penguin, 2015.
Mate, Gabor. When the Body Says No. 1st ed., Vermilion, 2019.
Duncan, Ruth. Myofascial Release. 2nd ed., Human Kinetics, 2021.
Heartbreak and the pain of loss are universal, and few songs capture that raw emotion as poignantly as Tom Petty and the Heartbreakers’ “A Woman in Love (It’s Not Me)” from their iconic ‘Hard Promises’ album (1981). Dubbed the “most dramatic track” on the album by Billboard, the song fuses Petty’s raw, emotion-filled vocals with Mike Campbell’s searing, soul-piercing guitar riffs, creating a visceral depiction of love’s harsh realities. With its haunting lyrics and gripping melodies, this track hits the emotional core, resonating deeply with anyone who has ever loved and lost.
Tom Petty: A Legacy of Resilience
For fans, Petty’s music became an anthem of heartbreak, resilience, and freedom. From his gritty, rootsy sound to lyrics that capture the spirit of rebellion, Petty’s work was a soundtrack for many. His tragic death in 2017, caused by an accidental overdose after struggling with hip pain and other health issues, raises a critical point: the importance of pain management in sustaining a high quality of life, especially for performers who pour just as much energy—if not more—into creativity, rehearsals, and performing.
The Cost of Passion: Musicians and Pain Management
Petty’s final tour is a testament to his enduring dedication. Despite the toll on his body, he completed 53 shows with a hairline fracture to the hip, an injury that worsened as he continued performing. His family believes that, unable to cope with the pain, he relied heavily on painkillers, which ultimately led to his accidental overdose. Petty’s story highlights a broader issue in the music industry: artists perform under extreme physical demands but often lack the structured medical support available to athletes.
Hip health is essential for mobility, impacting daily activities like walking and standing. Injuries to the hip, whether fractures, bursitis, or issues with the piriformis muscle, can lead to chronic pain and severely reduced quality of life. Petty’s case underscores the risks musicians face when injuries are left untreated or poorly managed. Osteoporosis – NHS
Hidden Health Risks for Musicians
Professional musicians endure long tours, irregular work hours, and intense physical and mental demands. Studies show musicians face high rates of musculoskeletal pain, mental health challenges, and conditions like hearing loss, heart disease, and more. While athletes have access to physical therapists, nutritionists, and trainers, musicians often lack similar support systems, which can lead to untreated injuries and chronic conditions. Shoulder Impingement Syndrome
Health programs designed for musicians could help them manage these unique challenges and reduce the risk of injuries. By promoting healthier practices, we can better support artists who sacrifice so much for their craft.
Understanding Hip Health and Its Vital Role
The hip joint is central to our ability to move and carry body weight, making it one of the most critical joints for mobility. However, the hip’s durability doesn’t make it immune to injury. Common hip issues include:
Bursitis: This condition, where fluid-filled sacs near the hip joints become inflamed, causes pain that often worsens during activities like climbing stairs or crossing legs.
Piriformis Syndrome: Inflammation in this muscle can press on the sciatic nerve, causing pain that often radiates down the leg, making it uncomfortable to perform daily tasks.
Hip Dislocations: Often caused by high-impact injuries, hip dislocations require immediate medical attention to prevent long-term mobility issues.
Diagnosing hip issues early and undergoing the right treatments, such as physical therapy or surgery, can significantly improve quality of life and mobility, emphasising the need for awareness around hip health, especially for performers.
The Dangers of Painkillers: Learning from Personal Experience
For many, including Tom Petty, pain management can lead to reliance on painkillers. It’s a risk I understand personally. I recall a night during university when, due to severe pain, I mistakenly took more paracetamol than was safe. The timely arrival of the paramedics and prompt admission to a Dublin hospital undoubtedly saved my life. Overdose risks are real, even with over-the-counter medications like paracetamol and ibuprofen. Opioids, often prescribed for severe pain, are especially dangerous due to their addictive potential and risk of overdose, which can lead to respiratory failure. Drug addiction: getting help – NHS
Pain Meds: The Risks of Misuse and the Need for Caution
Tom Petty’s tragic overdose is a stark reminder of how easy it is to fall into dangerous patterns with pain medication. Common painkillers, while accessible, carry risks that can lead to life-threatening complications when misused or over-relied upon. For this reason, awareness and careful monitoring are crucial, especially for those using pain medication long-term. NHS England » Reducing long-term opioid use
Strategies for Safe Pain Management
To mitigate the risks of painkiller misuse, follow these safety strategies:
Stick to Prescription Guidelines: Always adhere to prescribed dosages, and avoid combining medications without consulting a doctor.
Recognize Overdose Symptoms: Signs like confusion, extreme drowsiness, and slowed breathing can signal an overdose and should prompt immediate medical help.
Naloxone Access: Naloxone, a medication that reverses opioid overdoses, has proven life-saving. Increasing its availability to doctors for their patients can reduce fatalities from accidental overdoses.
These steps are essential for anyone relying on pain medications, as is broader public awareness of the risks associated with common pain relievers. https://rdcu.be/dYiiZ
Supporting Musicians’ Health: A Necessary Shift
The importance of supporting musicians’ health and well-being cannot be overstated. Just as athletes benefit from dedicated health teams, musicians could also benefit from similar resources to manage their physical demands, prevent injuries, and handle mental health challenges. Investing in health programs and support networks for musicians is a proactive way to prevent tragedies like Petty’s and foster a sustainable environment for artists.
Tom Petty’s legacy lives on in his music and the lessons his life and passing offer about the need for comprehensive pain management. His story calls attention to the broader issues artists face with health and well-being. Through greater awareness and support, we can ensure that artists’ contributions are celebrated for years to come without risking their lives in the process.
For more on hip health and pain management, consult your local provider. In the UK, the NHS offers excellent support.
In Memory of Tom Petty: A Heartfelt Tribute
RIP Tom Petty. Through every song, you shared a piece of your soul that forever touched mine. You were a poet for all, capturing universal truths in every lyric. Your passing was a powerful reminder of life’s fragility and the value of health. Thank you for your music, spirit, and legacy that inspired me to live fearlessly and authentically, and to focus on what truly matters.
Bosi, Bráulio. The American Music Teacher; Cincinnati Vol. 67, Iss. 1, (Aug/Sep 2017): 16-20
Niemeier, B.S., Larsen, D. (2020). Current Health Issues of Performing Artists: Implications for Health Promotion. In: Lee, SH., Morris, M.L., Nicosia, S.V. (eds) Perspectives in Performing Arts Medicine Practice. Springer, Cham. https://doi.org/10.1007/978-3-030-37480-8_4
European Commission: Directorate-General for Education, Youth, Sport and Culture, Vermeersch, L., Van Herreweghe, D., Meeuwssen, M., Van der Jeught, H. et al., The health and wellbeing of professional musicians and music creators in the EU – Insights from research for policy and practice, Publications Office of the European Union, 2023, https://data.europa.eu/doi/10.2766/481949
Volkow, N.D. and McLellan, A.T., 2016. Opioid abuse in chronic pain — misconceptions and mitigation strategies. New England Journal of Medicine, 374(13), pp.1253-1263. doi: 10.1056/NEJMra1507771.
Chidiac, A.S., Buckley, N.A., Noghrehchi, F. & Cairns, R., 2023. Paracetamol (acetaminophen) overdose and hepatotoxicity: mechanism, treatment, prevention measures, and estimates of burden of disease. Journal Title, pp.297-317. Published online 12 July 2023.
Volkow, N.D., et al. (2014) ‘Drug addiction: the neurobiology of behaviour gone awry’, The New England Journal of Medicine, 370(4), pp. 363-373.
Larson, A.M., et al. (2005) ‘Acetaminophen-induced acute liver failure: Results of a United States multicenter, prospective study’, Hepatology, 42(6), pp. 1364-1372.
Palis, H., Xavier, C., Dobrer, S., et al. (2022) ‘Concurrent use of opioids and stimulants and risk of fatal overdose: A cohort study’, BMC Public Health, 22, 2084. doi: 10.1186/s12889-022-14506-w.
Boyer, E.W., 2012. Management of opioid analgesic overdose. New England Journal of Medicine, 367(2), pp.146-155. doi:10.1056/NEJMra1202561.
Life has a way of reshaping our paths when we least expect it. For me, the turning point came after 15 years of teaching A-Level Biology and GCSE Science. My love for teaching and lifelong learning was undeniable, but I found myself on an unexpected journey, transitioning from the classroom to health and wellness advocacy. Through a journey of resilience and self-discovery, I’ve come to understand the importance of balancing a career with personal well-being, and I hope my story can inspire others to do the same.
A Love for Learning from the Start
My passion for learning started in childhood, nurtured by my father. He encouraged my curiosity through educational games, sparking a love for discovery. A pivotal moment came when, at 10 years old, I dismantled a transistor radio out of curiosity but couldn’t reassemble it. With my father’s help, we rebuilt it together, and that experience ignited my desire to understand how things work—a passion that led me into a rewarding teaching career.
The Rewards and Struggles of Teaching
Teaching was incredibly fulfilling. I loved seeing students have their “lightbulb moments” and grow in confidence. But over time, the pressure and demands of the profession led to burnout. Like many teachers, I found myself exhausted, and during a period of sick leave, I realized I needed to focus on my health.
Health and Wellness: A New Path
During my time off, I rediscovered fitness and fell in love with it. As my health improved, I saw a new career path opening up. I trained as a fitness instructor, teaching Spin, Aqua, and Aerobics classes. My struggles with chronic back pain pushed me to learn more about managing pain and staying active, which eventually led me to pursue a Level 5 Sports and Remedial Massage Therapy Diploma. This was followed by a Master’s in Sports Rehabilitation. With these skills, I shifted from teaching students to helping others heal their bodies. Read about how Sports Massage can reduce stress here
Entrepreneurship and Hard Lessons
Starting my own therapy business was exciting but challenging. The uncertainty of entrepreneurship was overwhelming, and I missed the structured routine of teaching. When an opportunity to return to the classroom arose, I took it, thinking I could balance both roles. But the demands of juggling teaching and wellness left me burned out again, and after a health scare, I realized my true calling was in health and wellness.
My Mission: Health, Wellbeing and Empowerment
Now, I focus on helping others—especially women—lead active, pain-free, and fulfilling lives. One of my most meaningful experiences was completing a charity cycling challenge from London to Paris in memory of my stepson, Paul. The journey, dedicated to my late stepson Paul, reinforced my commitment to promoting the importance of prioritising health and well-being. Read more here.
Finding Balance and Looking Ahead
I strive to maintain a healthy work-life balance, practicing what I teach through exercise, nutrition, and mindfulness. Looking to the future, I hope to run a successful practice combining health, wellness, and personal development coaching. My dream is to build a portable business, allowing my family and me to live in Israel.
My Motto and Advice
I live by the motto: “To forgive is to set a prisoner free and discover the prisoner was you.” (Corrie Ten Boom, Holocaust survivor and writer). To me, it’s about freeing yourself from limiting beliefs. My advice? Know your values and stay persistent. When you’re clear about what matters most, decisions become easier, and challenges are just part of the journey to success.
Do you get a sharp, debilitating pain in your shoulder when you are performing certain tasks? Brushing your hair, putting on clothes or showering? When you raise your arm out to the side and then upwards over your head, do you alternate between no pain and pain? For example, during the first part of the moment you don’t feel any pain, and then suddenly your shoulder “catches?” There is sharp pain, followed by no pain again as you continue to move your arm upwards. These are all signs of a condition called Shoulder Impingement Syndrome (SIS).
What is Shoulder Impingement Syndrome?
The tendons of the rotator cuff muscles that stabilize the shoulder get trapped as they pass through the shoulder joint in a narrow bony gap called the sub-acromial space. Impingement refers to the friction of tendons moving against bone. Repeated pinching and irritation of the tendons and bursa (the padding under the shoulder bone) can cause inflammation and pain.
Read on to discover common shoulder injuries, their symptoms, prevention methods, causes, treatment protocols, and rehabilitation exercises.
How common is Shoulder Impingement Syndrome?
Shoulder complaints are the third most common musculoskeletal problem after back and neck disorders. Women experience the highest incidents as do people aged 45–64 years. Of all shoulder disorders, shoulder impingement syndrome (SIS) accounts for 36%, making it the most common shoulder injury.
You shouldn’t experience impingement with normal shoulder function. When it does happen, the rotator cuff tendon becomes inflamed and swollen, a condition called rotator cuff tendonitis. Likewise, if the bursa becomes inflamed, you could develop shoulder bursitis. You can experience these conditions either on their own, or at the same time.
The injury can vary from mild tendon inflammation (tendonitis), bursitis (inflamed bursa), calcific tendonitis (bone forming within the tendon) through to partial and full thickness tendon tears. These may require surgery. Over time the tendons can thicken due to repeated irritation, perpetuating the problem as the thicker tendons battle to glide through the narrow bony sub-acromial space. The tendons can even degenerate and change in microscopic structure, with decreased circulation within the tendon resulting in a chronic tendinosis.
Graphic to show shoulder impingement
What Causes Shoulder Impingement?
Generally, SIS is caused by repeated, overhead movement of your arm into the “impingement zone.” This causes the rotator cuff to contact the outer tip of the shoulder blade (acromion). When this repeatedly occurs, the swollen tendon gets trapped and pinched under the acromion. The condition is frequently called Swimmer’s Shoulder or Thrower’s Shoulder, since the injury occurs from repetitive overhead activities. Injury could also arise from simple home chores, like hanging washing on the line, or a repetitive activity at work. In other cases, it can be caused by traumatic injury, like a fall.
Shoulder impingement has primary (structural) and secondary (posture & movement-related) causes:
Primary Rotator Cuff Impingement is due to a structural narrowing in the space where the tendons glide. Osteoarthritis, for example, can cause the growth of bony spurs, which narrow the space. With a smaller space, you are more likely to squash and irritate the underlying soft tissues (tendons and bursa).
Secondary Rotator Cuff Impingement is due to an instability in the shoulder girdle. This means that there is a combination of excessive joint movement, ligament laxity, and muscle weakness around the shoulder joint. Poor stabilisation of the shoulder blade by the surrounding muscles changes the physical position of the bones in the shoulder, which increases the risk of tendon impingement. Other causes include weakening of the rotator cuff tendons due to overuse, for example in throwing and swimming, or muscle imbalances between the shoulder muscles.
In summary, impingement usually occurs over time due to repetitive overhead activity, trauma, previous injury, poor posture, or inactivity.
The statue complains of shoulder pain from holding up the lantern all the time.
Rotator Cuff Biomechanics
When your rotator cuff fails to work normally, it is unable to prevent the head of the humerus (upper arm) from riding up into the shoulder space. This causes the bursa or tendons to be squashed. Failure to properly treat this instability causes the injury to recur. Poor technique or bad training habits are a common cause of overuse injuries.
Over time pain causes further dysfunction by altering your shoulder movement patterns which may lead to a frozen shoulder. For this reason, it is vitally important that shoulder impingement syndrome is rested, and treated as soon as possible to avoid long-term damage and joint deterioration.
What are the Symptoms of Shoulder Impingement?
Rotator cuff impingement usually has the following symptoms:
An arc of shoulder pain approximately when your arm is at shoulder height and/or when your arm is overhead
Shoulder pain that extends from the top of the shoulder down the arm to the elbow
Pain when lying on the affected shoulder, night pain, and disturbed sleep
Shoulder pain at rest as your condition worsens
Muscle weakness or pain when attempting to reach or lift
Pain when putting your hand behind your back or head
Pain reaching for the seat-belt, or out of the car window for a parking ticket
Painful Arc when raising the arm out to the side
Who Suffers Shoulder Impingement?
Impingement syndrome is more likely to occur in people who engage in physical activities that require repeated overhead arm movements, such as tennis, golf, swimming, weight lifting, or throwing a ball. Occupations that require repeated overhead lifting or working above shoulder height also increase the risk of rotator cuff impingement.
How is Shoulder Impingement Diagnosed?
In the United Kingdom, only doctors can diagnose. However, physical therapists can form an accurate clinical impression using some specific manual tests. An ultrasound scan may be useful to detect associated injuries such as shoulder bursitis, rotator cuff tears, calcific tendonitis or shoulder tendinopathies. An x-ray can be used to see bony spurs that may have formed and narrow sub-acromial space. See your GP in the first instance to arrange a referral.
What does the Treatment Involve?
Many structures can be injured in shoulder impingement syndrome. How the impingement occurred is the most important question to answer. This is especially important if the onset was gradual. Your static and dynamic posture, muscle strength, and flexibility all have important roles to play. The rotator cuff is an important group of 4 muscles that control and stabilise the shoulder joint. It is essential to assess the muscles around the thoracic spine and shoulder blade and to treat these too, because they work together with the entire shoulder girdle. A good therapist will look beyond the obvious to get to the root of the problem. Only then can a bespoke treatment strategy be planned.
Stages of Rehabilitation
To effectively rehabilitate this injury and prevent recurrence, you need to work through specific stages with your therapist.
These stages may include:
Early Injury: Protection, Pain Relief & Anti-inflammatory Treatment
Regain Full Shoulder Range of Motion
Restore Scapular Control and Scapulohumeral Rhythm
Restore Normal Neck-Scapulo-Thoracic-Shoulder Function, including posture correction
Restore Rotator Cuff Strength
Restore High Speed, Power, Proprioception and Agility Exercises
Return to Sport or Work
The early stages of treatment will involve manual therapy, including massage to relieve pain and relax shortened structures as well as mobilisation techniques to restore normal shoulder movement. Massage therapy is well-documented as an aid to deep relaxation, and hence improved sleep quality. Discover more about the role of massage therapy in stress relief here. Sleep is essential to any healing process. Find a Sports Massage Association (SMA)-registered therapist here: https://www.thesma.org/PublicMemberDirectory
Other Treatment Methods
Strapping and taping are known to provide additional support and reduce pain. Other modalities such as ultrasound and interferential therapy are particularly beneficial. As you move through each stage of treatment your therapist will prescribe rehabilitation exercises specific to your shoulder, posture, sport, and/or work demands. Find a Complementary and Natural Healthcare Council (CNHC)-registered practitioner here: https://www.cnhc.org.uk/#gsc.tab=0
Your doctor can administer a corticosteroid injection to relieve pain if conservative (non-surgical) methods fail to reduce the pain and inflammation. Once your pain settles, it is important to assess the strength and flexibility of the neck and thoracic spine to ensure that your shoulder impingement does not return once the injection has worn off.
Conclusion
Some shoulder impingements will respond positively and quickly to treatment. However, many others can be incredibly stubborn and frustrating, taking between 3-6 months to resolve. Each person will respond differently, depending on the severity of the injury. It is also important to note that each progression must be carefully monitored as attempting to progress too soon to the next level can lead to re-injury and frustration. For more specific advice about your shoulder impingement, drop me a line, or give me a call. Alternatively find a British Association of Sports Rehabilitators & Trainers (BASRaT)-registered therapist in your area: Register Check — BASRaT
Disclaimer
The information contained in this article is intended as general guidance and information only. It should not be relied upon as a basis for planning individual medical care or as a substitute for specialist medical advice. Please see your doctor if you are suffering from shoulder pain.
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