Physical Therapy for Shoulder Pain
Shoulder injuries are a common source of pain. The most common conditions that physical therapists treat are adhesive capsulitis (frozen shoulder), shoulder instability, dislocations, multidirectional instability, tendonitis, impingement, rotator cuff tears, separated shoulder, labral tear.
Shoulder Instability and Dislocation
Shoulder instability occurs when the shoulder is dislocated, or moves completely out of its socket, requiring a medical professional to “relocate it.” The shoulder can also slip out of the joint but spontaneously move back into place, which is called a subluxation. Having an “unstable” shoulder does not necessarily mean that it has completely dislocated. Instability puts shoulders at risk, especially for athletes or when falling on an outstretched hand. Physical therapy can help strengthen the muscles that support the shoulder joint, avoiding or helping to rehabilitate a dislocated shoulder.
A shoulder separation is an injury to the ligament between the shoulder blade and the collarbone. An “AC Separation” is commonly the result of a fall on the end of the shoulder, which leads to the collar bone “sticking up.” There is often pain and swelling associated with the injury, but physical therapy can restore motion.
Tendonitis and Impingement
Tendonitis is an inflammation of the shoulder tendons. The signs of inflammation are pain, warmth, redness, tenderness to touch, and loss of function. Shoulder tendonitis, often called rotator cuff tendonitis, can occur when the rotator cuff is overloaded, fatigued, traumatized, or experiencing degenerative changes. Pinching or impingement of the rotator cuff tendons occurs when the arm is raised overhead repeatedly, is raised overhead with a heavy load, or after the shoulder is slept on. Physical therapy can help restore proper strength and movement without the use of injections, medication, or surgery.
Tears in the Shoulder
There are two common tears in the shoulder: rotator cuff and labral tears. Rotator cuff tears happen in younger patients when they experience trauma, such as a fall. In middle-aged and senior patients, tears are usually the result of a gradual wearing out of the rotator cuff tendon(s). The signs and symptoms are pain and weakness in the shoulder, often radiating down the middle of the arm, especially when the arm is raised overhead. Labrum or labral tears are usually associated with trauma, instability of the shoulder, or repetitive throwing. The signs and symptoms are painful clickings, locking, or popping. Instability may be present, as the labrum cannot properly hold the ball in the shoulder socket. A common labral tear is a SLAP tear, which involves the bicep tendon as well. Surgery is a last resort for shoulder tears, with physical therapy treatment often bringing relief.