Why Physical Therapy Is Effective Relief for Shoulder Pain
Today I want to talk to you about why PT can provide effective relief for shoulder pain. Many people in our population have shoulder pain. They suffer aches and pains while lifting, reaching behind their backs or into back pockets for wallets for men, or reaching behind to hook or unhook a bra for women.
There’s so many things that we can look at as physical therapists that can help with shoulder pain.
Physical Therapy Starts with a Careful Analysis
When you come in for physical therapy, we’re certainly going to take a peek at your posture and your ergonomics, which means how you fit into your environment. It could be how you sit at a desk station or stand in the kitchen washing dishes. We’re going to watch your reaching and lifting mechanics and measure your strength. We’ll also take a peek at your joint alignment.
There are many structures in the shoulder that can cause pain or be affected and so limit a patient’s ability to function, lift and reach with the shoulder. We have many muscles, tendons and ligaments, not to mention multiple bones that can all feed into shoulder pain.
Shoulder Pain is Not All About Torn Rotator Cuffs
The number one pain-producing structure in the shoulder is the biceps tendon. Right in the front of your shoulder, that biceps tendon assists the rotator cuff in lifting the arm in different directions. But it also can compensate if our rotator cuff is weak.
When people come into our physical therapy practice, a lot of them think they must have torn their rotator cuffs because that’s all they hear about. In the shoulder, however, there are many structures that can be the source of a patient’s pain. You’ve probably heard of many different diagnoses from people with shoulder pain. Let’s look at several of these.
They might have been diagnosed with tendonitis or bursitis. What do tendonitis or bursitis mean? The “-itis” means inflammation. It’s a more acute problem in the shoulder.
There are many bursa throughout the shoulder. The most common one to become inflamed sits right between the ball and socket joint. When you go to lift your arm out to the side—if you have poor alignment or poor strength and mechanics—you can cause some pinching. That can pinch the tendons and the bursa, and cause that “itis” or inflammation.
The best thing you can do for inflammation at home is ice. Apply it for a minimum of 10 minutes, no more than 20 minutes, right on the cap of that shoulder. Placing ice right where the pain is originating can help to decrease some of the swelling.
Another condition you might have heard of is tendonosis. Now, “-osis” is a bit more of a chronic condition. You can also have tendinosis when the body has stopped trying to heal the tendon. The problem has been there for a while.
You might’ve heard about impingement. That word refers to the pinching that I was just talking about. When you lift your arm out to the side, if that ball and socket don’t glide just perfectly, things pinch.
Usually a person with this problem doesn’t have much pain lifting their arm lower down, but when they get in the middle range arc of motion, they get some pinching. Then they might feel a little better as the arm lifts more. Then at the very top, they might feel pinching again, right where the ball and socket meet.
About Frozen Shoulder
Another common thing that people hear about is frozen shoulder. That’s the layman’s term for adhesive capsulitis. The capsule is a fluid-filled sac that surrounds the ball and socket to keep that fluid in there so you have nice mobility. What can happen is that capsule can shrink down and limit your motion.
Initially that’s very painful. Later on, the pain starts to go away, but that range of motion is still very limiting and that can affect your function at home.
About Rotator Cuff Injuries
Obviously, there are also rotator cuff injuries. The rotator cuff actually has four muscles involved. Therefore, you have the potential for four tendons or muscles to be injured.
Again, an injury does not mean that there is a tear. Even if there is a tear, you might not need surgery for it.
If you suffer from shoulder pain, we want you to reach out to your physical therapist to see if surgery is actually required or if we can stick with that non-operative conservative care option.
Lastly, there is arthritis, basically, wear and tear. You can get arthritis everywhere. The shoulder is not exempt from that, but what we do want to try to prevent is that shoulder replacement, if possible.
Recovering from Shoulder Problems with Physical Therapy
Physical therapists have the training to identify if your progress through these different conditions is on track and matches what we think is going on.
Through all of our testing, we want to get to the root cause to make sure we’re treating the right structure involved. Then as we take you through your customized plan of care, if things are progressing as expected, wonderful. We’re going to get you back on track as soon as possible.
If you’re not progressing the way you want, we also can make appropriate referrals, maybe back to a physician to discuss whether you do need medications, injections, and surgeries. Obviously we want to try to avoid all that if possible and get you back to normal without those treatments.
If you’d like to reach out today to one of our physical therapists for a complimentary consultation or evaluation, please call us to schedule that consultation. Don’t wait and continue suffering from shoulder pain—call us today at (925) 284-3840.
Lauren Masi is a Doctor of Physical Therapy, board-certified clinical specialist and certified athletic trainer. She earned her bachelor’s degree in physiological science from UCLA, a master’s degree in physical therapy from CSU Northridge, and a doctorate from the University of St. Augustine. As owner of Lafayette Physical Therapy and Bay Area Physical Therapy, she has assembled a skilled team to provide highly personalized and effective care. Lauren’s extensive career encompasses expertise in various physical therapy techniques, including Mulligan and Paris methods, myofascial release, and spinal mobilization. Lauren enjoys horseback riding and family time when not treating patients.