A trapped, or pinched, nerve in your shoulder can quickly stop your training in its tracks and, in some cases, cause debilitating pain.

　　So below, Rachel McCulloch, a rehab specialist and physiotherapist at Six Physio, offers a complete guide to this common athlete ailment, covering its causes, symptoms and, most importantly, treatment…

　　Why/how do you get a trapped/pinched nerve in the shoulder?

　　A pinched nerve in the shoulder occurs when there is pressure or compression on a nerve in the shoulder. It’s important to be aware that a pinched nerve or trapped nerve may not appear to look any different on medical imaging such as an MRI.

　　Often both terms are used to describe the collection of symptoms above but the main thing that has changed is the blood supply to the nerve.

　　Compression to a nerve could come about from a muscle spasm, body position (either in a sustained posture or repetitive position) or, in some cases, change to the surrounding tissues such as a disc protrusion, osteophyte or fracture.

　　There are often biomechanical factors that can be adjusted to improve technique and minimise your chances of these injuries. Triathletes can be susceptible to these injuries due to the repetitive nature of swimming and running, and the sustained position when on the bike.

　　The nerve can be ‘pinched’ or ‘trapped’ anywhere along its route, most commonly in the space between the neck and shoulder.

　　As a swimmer, one must consider flexibility as a big driver for these injuries; too little flexibility through your upper back and shoulders, and you might be relying too much on neck rotation for your breathing.

　　Also, a dominance to breathe on one side can build over time to bring about pronounced asymmetries.

　　A bike that isn’t fitted properly will also impact neck, back, shoulder and wrist positioning also affecting the pathway of the nerve.

　　Our bodies cleverly compensate for our bike's shape which isn’t as useful as it sounds and can lead to these injuries – and others.

　　When running your posture and breathing have a huge impact on this upper quadrant of your body.

　　A chin that’s racing forward for the finish line, someone who watches the floor too much to check terrain, or even someone who relies on breathing with their accessory muscles in the neck can also be prone to a trapped nerve.

　　What does a trapped/pinched nerve in the shoulder feel like?

　　A pinched nerve in the shoulder, which can be a debilitating and painful condition that affects your ability to perform. The most common symptom of these is pain, which can range from a dull ache to a sharp shooting pain.

　　This pain may also radiate down the arm or into the neck. In addition to pain, you may also experience tingling or numbness in the affected area.

　　How long does a pinched nerve last in the shoulder?

　　This depends on the cause, and is specific to each individual. Find out the cause and you're already halfway there; make the suitable changes, have the correct treatment and deal with the contributing factors, and you could notice symptoms disappear almost straight away.

　　If there's a structural component to this, for example a disc problem in the neck causing the shoulder symptoms, then symptoms could last longer – in most situations it will resolve in 12 weeks.

　　Very rarely, but worth a mention, surgery can be indicated. If the cause is biomechanically, posturally or ergonomically driven then the appropriate changes will need to be made to get anywhere no matter how much treatment you have or painkillers you take.

　　How do you get instant pain relief from a pinched nerve?

　　Get an assessment from a physiotherapist or sports physician to confirm diagnosis, identify the cause and make a plan for managing this. Possible treatments include, but are not limited to:

　　Initially avoiding the aggravating position or activity

　　Painkillers

　　Massage/soft tissue techniques

　　Manual therapy techniques for surrounding joints

　　Ergonomic and functional assessments; while working, riding, running or even swimming.

　　Postural changes

　　Exercises to promote good posture and improved technique based on your body’s current and potential ability. This may involve some flexibility work, some strengthening or a mix of the two.

　　Acupuncture

　　Do pinched nerves go away on their own?

　　Yes they can do, but often identifying the contributing factors as to why you got the injury help resolve it quicker, give better outcomes, and prevent recurrence.

　　Can you massage out a trapped nerve in the shoulder?

　　Massaging done in the right way and at the right time is very helpful for trapped nerves when used in conjunction with other treatments.

　　Massaging the nerve itself in the acute phases will often cause further irritation due to the pressure and compressive nature of the massage on the trapped nerve.

　　However, massaging around the area and those factors that may contribute to the pinched nerve may help alleviate some pain and go one step toward recovery, especially in the case of a muscle spasm or tight muscle being a main factor.

　　A spasm in the upper fibres of trapezius can be a common site for nerve irritation due its usage within the body and its anatomy around the nerves.

　　Massaging this muscle in the first instance can create some relief, however it’s really important to identify why that muscle has gone into spasm in the first place.

　　A massage without identifying and resolving this issue might make things worse as that spasm could be there for a very good reason.

　　How to release a pinched nerve in the shoulder

　　1. Rest from the aggravating activities or postures.

　　2. Seek help to identify the cause and minimise the contributing factors.

　　3. Improve the blood circulation to the pinched nerve by: improving movement patterns, manual therapy performed by a physiotherapist, directed soft-tissue release to specific areas, improving posture and pain-free activity.

　　4. Check in with your technique and ergonomics with both your training and day-to-day activities.

　　In need of some treatment or additional advice? Six Physio has multiple clinics across London. Find out more here.