Physical Therapy for Shoulder Pain

Shoulder pain is a common complaint among people of all ages. The shoulder is a complex joint that can be easily injured, and the resulting pain may not go away without professional treatment.

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Physical therapy can help you to recover from shoulder pain

In the case of acute or chronic shoulder pain and injury, it’s best to seek professional help from a physiotherapist instead of trying to treat this injury on your own. 

A physiotherapist will use advanced diagnostics and treatments to get you back on track with your regular daily activities as quickly as possible. A proactive approach to the treatment of injury as well as prevention of injuries by restoring the function of the shoulder joint as well as the surrounding supportive tissues is always better than a reactive one.

Types of Shoulder Conditions We Treat

Let’s take a look at some of the conditions that are common causes of shoulder pain, what you should do if you experience any symptoms, and how physiotherapy can provide treatment options that might help get rid of them for good!

Frozen Shoulder

Frozen shoulder is also known as adhesive capsulitis is a condition where there is a tightening of the shoulder joint and often results in a painful loss of motion. This can be related to adhesions and scar tissue formation in the soft tissues that surround the shoulder, including the shoulder muscles.

These soft tissue restrictions can result from surgery, immobilization, or shoulder injury, and the structures surrounding the shoulder socket become stuck due to a variety of reasons which “freezes” the shoulder in place.

Frozen shoulder is commonly seen in three phases:

Freezing – In the freezing phase, it is common for people to experience a deep ache in their shoulder and more intense pain on overhead movements. Limited mobility begins.

Frozen – In the frozen phase, pain is reduced to a dull ache but the range of motion remains limited and mobility becomes more restricted.

Thawing – Once thawing occurs, a noticeable improvement in range of motion and pain can be felt.

Physiotherapy can address and remedy your unique form of frozen shoulder. The main goal is to increase mobility and function of the shoulder girdle without pain.

Rotator Cuff Injuries

The rotator cuff is a group of muscles, tendons, and ligaments that make up your shoulder’s “cuff” or covering.

Rotator cuff tendons play an important role in stabilizing the humerus bone of the upper arm and when healthy allows for a wide range of motion. It also assists in actions such as side-to-side movements, lifting objects above the head, and rotating the arm out to the side.

The rotator cuff can be injured due to repetitive actions or through a single incident that throws out your normal range of motion, such as falling onto an outstretched arm. When this happens damage often occurs to one or more tendons in the rotator cuff. This leads to inflammation, pain, and a reduced range of function.

In the case of a torn rotator cuff, there will likely be a higher degree of pain as well as shoulder instability issues following the injury.

In the case of a torn rotator cuff, there will likely be a higher degree of pain as well as shoulder instability issues following the injury.

Typical symptoms include:

-Pain when you reach overhead or behind your back. The pain can become worse and be felt during sleep and everyday activities such as driving, cooking, and using the computer.

-Discomfort or sharp pain when laying or applying pressure to the injured shoulder area.

-Weakness in lifting the arm away from the body due to difficulty contracting all of the muscles in this area

– Painful arc (pattern of motion) when you reach overhead

If you think that you have a rotator cuff problem, it is important to seek treatment from a physiotherapist. After being assessed they will develop an individualized plan that includes manual therapy techniques to reduce pain and increase motion. They can also prescribe strengthening exercises that are tailored to your specific shoulder problems.

Rotator Cuff (post-surgery)

Often rotator cuff injury is treated with surgery, either arthroscopic or open depending on the severity of damage to the tendon. After shoulder surgery, patients will be placed in a sling for several weeks followed by physiotherapy.

Physiotherapy for this group is very important as it can speed up recovery and return to normal use of your shoulder. Treatment may include manual therapy techniques, gentle mobilization exercises, and passive range of motion to help prevent stiffness and scar tissue build-up.

Stiffness is a common complaint following surgery as your shoulder experiences some loss of range of motion as the result of swelling, inflammation, and lack of use.

Often, patients will be given specific exercises to complete at home with a focus on retraining the muscles that provide stability and strength around the shoulder joint. They may be prescribed anti-inflammatory medication as well as pain medication by their doctor depending on their level of discomfort.

Shoulder Impingement

Shoulder impingement occurs when there is incorrect positioning of the shoulder leading to poor mobility of the socket joint. The shoulder’s tendons become irritated due to frequent stress from shoulder dysfunction causing an often painful impingement.

Impingement can be caused by poor posture, rotator cuff dysfunction. Weakened muscles in the upper back and overly tight chest muscles that allow your shoulders to hunch forward is commonly seen. 

When this imbalance becomes chronic, similar to frozen shoulder, the joint is unable to move in a natural pattern and it causes a loss of range of motion.

Assessment will be completed to determine if you are experiencing impingement or something else such as rotator cuff tendinitis, shoulder bursitis and joint pain. Treatment focuses on decreasing painful movements and maintaining joint mobility all while encouraging proper posture and strengthening surrounding muscles.

Shoulder Tendinitis

Tendinitis in your shoulder will become inflamed and painful, creating a loss of strength that will cause difficulties performing even simple tasks. Like other forms of tendinitis, this is caused by injury overuse or excessive trauma. When there is dysfunction in the shoulder’s movement it can lead to inflammation of the tendons. Once injured, the tendons are less able to glide smoothly within the tendon sheath causing pain and swelling (tenosynovitis).

Treatment may include manual therapy techniques, and exercises to improve postural muscle strength to realign the shoulder joint, provide pain relief and increase your range of motion. The treatment focuses on restoring function through mobilization exercises and strength in surrounding muscles that support functional movement and good posture. Once healthy joint capacity is achieved, increasing resistance can provide better functional strength overall.

Bicipital Tendinitis

This is an inflammatory condition of the upper biceps tendon. The tendon of the long head of the bicep is responsible for connecting the muscle to the bone and the biceps tendon is very strong but overuse can result in inflammation, pain, and weakness around the shoulder. A physiotherapist will assess if you have tendonitis or bicipital tenosynovitis.

Treatment typically includes rest and manual therapy techniques such as soft tissue massage and gentle mobilization of the shoulder joint. Strengthening exercises are an important part of treatment once you are pain-free and the focus is on building strength around the shoulder joint.

Rotator Cuff Tendinitis

Tendinitis in the rotator cuff can be caused by a number of things such as aging, poor posture or a sudden injury. Poor posture can cause chronic stress of the tendons which puts them at greater risk for further damage and over time impingement may occur. Lifting heavy objects improperly is often a cause of rotator cuff tendonitis.

Treatment focuses on reducing pain and inflammation while improving strength around the shoulder joint to help you return to your activities. Manual therapy and exercises will be prescribed once the shoulder has been assessed and found to have minimal pain. Your physiotherapist will also help you increase your range of motion and improve your posture.

Shoulder Bursitis

Bursa are small fluid-filled sacs that sit between the muscles and bone to reduce friction. If the bursa becomes inflamed it will be painful to move your shoulder joint due to a lack of lubrication.

Having bursitis in your shoulder typically results from a combination of factors such as muscular imbalances, overuse, and repetitive movements.

Treatment for shoulder bursitis typically includes manual therapy techniques to reduce pain and inflammation, followed by strengthening exercises that focus on the rotator cuff. If you are experiencing bicipital tendinitis your treatment will include your physiotherapist teaching you ways to stretch tight muscles that may be contributing to the problem.

AC Joint Injuries

Injuries to the acromioclavicular joint also known as the AC joint will usually result from a direct impact. Anything from falling awkwardly on an outstretched hand to a collision in contact sports can cause damage to your shoulder.

AC separation is often seen in those who participate in contact sports and this injury occurs when ligaments and tendons that support the joint are overstretched or torn.

If you have an AC joint injury your physiotherapist will focus on reducing pain and inflammation, restoring movement to the joint, and regaining strength in surrounding muscles. Your treatment focuses on manual therapy techniques such as massage, laser treatments, acupuncture, and soft tissue mobilization along with specific exercises to restore joint function and strength.

Shoulder Labral Tear

The shoulder labrum is a specialized ring of cartilage that sits around the glenoid (socket) and provides cushioning and stability to the joint. It also allows for blood vessels and nerves to pass through which nourish parts of your shoulder.

Labral tears typically happen due to repetitive movements such as throwing, overhead lifting or any activity that puts high stress on the shoulder.

Treatment will focus on manual therapy techniques to reduce pain and inflammation, restoring movement to your shoulder joint along with strengthening exercises that help protect the joint. Your physiotherapist may prescribe you anti-inflammatory medication if needed which can also help improve pain levels.

Shoulder Arthritis or Shoulder Osteoarthritis

Osteoarthritis or arthritis in the shoulder is one of the main forms of arthritis and it typically develops due to age, injury, or overuse type injuries. Treatments focus on reducing pain and inflammation while restoring range of motion, strength, and function.

Your physiotherapist will take into account your age, the severity of arthritis along with any activity you might currently be doing that is aggravating your symptoms.  

If you are involved in sport it’s important to continue to train but build up gradually and take this into consideration when coming up with a treatment plan. Your physiotherapist can help take the pressure off your shoulder through manual therapy techniques such as massage and joint mobilization.

How Physical Therapy Helps with Shoulder Pain

Your physiotherapist will develop a personalized treatment plan that is specifically tailored to your condition. The main goals of shoulder pain management are to reduce inflammation, restore range of motion and strength as well as regaining normal movement patterns.

In cases of bursitis or AC joint injuries, manual therapy techniques may be used on the affected area along with specific exercises that focus on restoring range of motion and strength.

A common goal in all cases of shoulder pain is to build endurance in your muscles around the shoulder which supports the joint and helps to prevent future injuries in sports and in your daily tasks.

What if Shoulder Pain is Left Untreated?

If shoulder pain is left untreated, an acute issue can turn chronic. If the tendons are impinged or being abused due to dysfunction in the shoulder joint, you might end up with a rotator cuff tear. This will greatly impact your quality of life and can often lead to surgery if there is a complete tear.

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Treating Shoulder Pain With Physical Therapy

The sooner you seek physiotherapy treatment for these injuries or conditions, the better your recovery can be. With improved flexibility and strength, pain will also reduce allowing you to return to activities more quickly.

Essentially, small problems in the shoulder left untreated can result in bigger problems down the road. When it comes to every common cause of shoulder pain, an ounce of prevention is worth a pound of treatment.

Our Clients Success Stories​

My wife had a stroke 20 years ago that left her right side paralyzed and she walks with a cane and right leg brace. I was having lower back and shoulder pain. Manny and Denise have made significant improvements in my wife's balance and walking. Manny brought in a brace company to build her a new and different style of brace which has resulted in much less foot and leg pain after walking. My back and shoulder pain are now gone and I continue to work with them on conditioning and weight management.
Steve Jones
I have had the pleasure of working with Dr. Manny for 2 months for my right frozen shoulder. I suffered from having a frozen shoulder for a month before I was introduced to Dr. Manny and it severely limited me from being able to do the activities I needed to do like cooking for the family and driving. I have been so pleased with the way Dr. Manny took care of me and my R shoulder. He has taken the best care of me and is always so genuine, kind and compassionate. I have made a full recovery and I am now able to return to cooking, performing all my household chores and driving without any problems. Dr. Manny is the best physical therapist and I highly recommend him!
Ajitha Tose
Cannot recommend Manny and Denise with Impact Care Therapy enough! My Mom had a stroke 20 years ago and lost mobility of her right side and walks with a cane. She just started seeing Manny and Denise to get in better shape after having back pain and other issues for years from a sedentary lifestyle. The work they are doing with her is incredible! Watching her get her confidence back, believe in herself and push herself is amazing. Her balance is better, her strength is growing, and best of all, she’s challenging herself. Manny and Denise are so patient, motivating, caring, and determined to help others reach their goals. My Dad is also seeing them after years of shoulder pain, a sedentary lifestyle, and back pain. They are helping him get his strength and endurance back so he can start enjoying a pain free, active lifestyle like he wants. If you or one of your parents is looking to get out of a rut and take better care of their body, make the phone call to Impact Care Therapy. Best gift you can give yourself or your loved ones.
Nicole Fabozzi

Start Treating Your Shoulder Pain at Impact Care Therapy

We hope you’ve found this page informative and helpful. Shoulder health can affect the quality of life in younger people as well as older adults. Remember that once you’ve determined the cause of your shoulder pain, it is time to take action. The best way to do this is by seeking a professional physical examination from a physical therapist or doctor who specializes in rehabilitation for traumatic shoulder injuries.

The best way for a patient to recover from an injury is with physical therapy after the acute stage of healing has passed. This will allow them to regain mobility in their joints as well as build up strength before returning back to regular activities such as sports or work. Contact our physical therapy practice if you’re interested in starting a PT plan that’s right for you!

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