40 Years on the Run

When Is Enough Enough?


I have been seeing a physiotherapist for muscle spasms in my right shoulder. It seems to be much better after each visit, though the spasms persist. My physiotherapist keeps on telling me to come back for more sessions. I have already been for six treatments. It is quite an expensive exercise and sometimes it feels as if I’m paying money but not seeing the results. After how many physiotherapy sessions should one feel better? And how does one know where to draw the line and when to seek a second opinion? – KIM BRADFORD, HILLCREST

A muscle spasm is the body’s way of protecting itself against further injury. Spasms in the shoulder usually occur due to overuse or weakness of the muscle. Also, if you overstretch or have poor posture in the offi ce, muscle spasms can occur. Repetitive contractions of the muscle during stress or improper training methods can also lead to spasms.

Usually if it is not a complex problem, the muscle spasm should be relieved after the first three physiotherapy sessions. It all depends on the severity of the spasm. It is important that the underlying causes of the problem are treated because if they are not, the spasms will return very quickly, leading to more visits to your physiotherapist.

I usually give lots of advice with regards to ergonomics in the workplace and home, sleeping positions, pillow height and positioning, sporting technique and training methods. These could all be causes of your shoulder spasms.

A proper home stretching and strengthening programme is paramount in relieving the symptoms and sorting out the problem faster. I recommend six treatments to my patients and if there is absolutely no change in their symptoms, I reassess and then refer them to a specialist for further tests. I must  emphasise that you and your physiotherapist need to work together to solve the problem, thus it is vital for you to follow the advice and exercises given in order to get optimum results.



David van Wyk

Sport physiotherapist with private sport and orthopaedic practices in Elarduspark and Faerie Glen, Pretoria. Member of AS Eagles Running Club, sub-45min 10km runner.