Shoulder Pain Relief

Post-Surgical

There are a variety of shoulder surgeries that may have to be done in order to stabilize the shoulder, repair damaged tendons or ligaments. With the advances in arthroscopic surgery, recovery times for shoulder injuries have improved, however physical therapy is still needed to reduce pain quickly, restore range of motion, improve strength and return the individual to the normal activities they like to do.

Sprain / Strain

A sprain in the shoulder involves the ligaments while a strain involves the muscles around the shoulder. A sprain / strain typically occurs because the tissue has been overstretched too quickly, resulting in micro-tearing of the tissue. This results in painful inflammation, typically increased with movement and use of the damaged tissue.

The damage from a sprain / strain can be minor or major, depending on the severity of the injury, person’s health and age. As we age, our tissue becomes less elastic and becomes more prone to tearing.

Frozen Shoulder

Frozen shoulder is a painful shoulder joint condition. In medical terminology it is called “adhesive capsulitis”. How frozen shoulder exactly begins is still a bit of a mystery, however, it typically occurs after a trauma or repetitive injury to the shoulder. Women in the pre and post–menopausal age range are more likely to experience frozen shoulder, however men can also experience frozen shoulder.

With frozen shoulder, the thick capsule of tissue that surrounds the shoulder joint begins to experience chronic inflammation. The body begins a cycle of inflammation and scarring that causes the capsule around the shoulder joint to contract and become limited in its flexibility. This causes very painful range of motion in the shoulder when trying to move the arm.

At the beginning of frozen shoulder it is very painful and range of motion becomes limited. This can be around 4–8 weeks in duration. After that, motion is very limited in the shoulder, but often not as painful. Depending on the severity of the condition, it can take sometimes up to a year to resolve and improve range of motion.

Dislocation

Dislocation of the shoulder typically occurs from falling onto an outstretched arm or a blow to the side or back of the shoulder when falling on it. This can happen in different sports activities or falls. Dislocations are managed medically to relocate the head of the humerus bone. Depending on the severity of the dislocation, your physician will typically prescribe physical therapy to help stabilize the shoulder joint and protect it during a recovery phase.

With frequent dislocations, the shoulder can become unstable as many structures in the shoulder get damaged and become too lax. By strengthening the muscles around the shoulder, stability can be increased in the shoulder, preventing future dislocations.

At times, dislocations can be quite severe and lead to tearing of cartilage, tendons, ligaments or muscles. In this case, surgery is often needed. After surgery physical therapy is an important part of recovery and returning to normal activities.

Labrum Tear

The labrum is a thick ring of cartilage around the socket part of your shoulder joint (glenohumeral joint). The labrum acts like a cup for the head of the humerus to sit in (like a ball inside a cup). The labrum gives stability to the joint and also helps to cushion as the shoulder joint moves.

The labrum can tear with injury from a blow to an outstretched arm or from repetitive injuries overhead. Sometimes, a labrum tear can be involved when the rotator cuff is torn. A common tear is called a SLAP lesion (Superior Labral tear from Anterior to Posterior). This is a tear of the labrum from the top part in front to back. This often needs surgical repair and we work with your physician on their protocol to rehab your shoulder after surgery.

Rotator Cuff

The rotator cuff is a group of muscles surrounding the shoulder. They are made up of the supraspinatus, infraspinatus, sub–scapularis and teres minor muscles. While these muscles are small and not that powerful, they play a critical role in how the shoulder moves. Without your rotator cuff, you would not be able to lift your arm very far from your side. The job of the rotator cuff is to guide the direction of the humerus head down and spin so that it clears the bony shelf above the socket called the acromion. When the rotator cuff is weak, the head of the humerus rides up slamming into the acromion above it.

The rotator cuff takes a lot of abuse over a lifetime and tearing is very common as we age. Many factors can lead to injury to the rotator cuff such as sports injuries, falls onto the shoulder or arm, repeat lifting or movements, poor posture or heavy lifting in abnormal positions.

Rotator cuff tears can be minor, causing pain and inflammation, or major which can require surgery. With surgery, depending on a variety factors such as the quality of the tissue, the extent of the tear and other health factors, the recovery can take between 3-6 months. Physical therapy is a very important part of preparing for surgery and rehabilitating after surgery.

Sports Injuries

Whether you are a professional athlete, high school athlete or just like to be active and play sports, injuries can occur. Many shoulder sports injuries occur because of a fall onto an outstretched arm or from repetitive overhead actions, such as swimming or tennis. Another reason for shoulder sports injuries is an imbalance which can occur in certain groups of the shoulder muscles if one group of muscles is stronger than another. For example, an athlete that has strong chest muscles, but weak rotator cuff muscles can put themselves at risk of injury.

Bursitis / Tendonitis

The ending of the word “itis” is defined as inflammation. Therefore, bursitis is inflammation of a bursa and tendonitis is inflammation of a tendon. A bursa is a fluid filled sac that sits between muscles or tissues to cushion and reduce friction. In the shoulder there is a rather large bursa between the deltoid muscle and joint. This is called the sub-deltoid bursa. This bursa can often become inflamed due to abnormal joint movements, poor posture and weakness of the surrounding musculature. This causes strain to the tissues and excessive friction on the bursa. People tend to feel pain with movement and especially movement out to the side or reaching behind them.

Tendons connect muscles to bones. In the shoulder common areas for tendonitis are in the rotator cuff tendons (supraspinatus, infraspinatus, teres minor and subscapularis) and bicep tendons. Pain can be felt deep in the shoulder or in the front of the shoulder. Pain is usually felt as a sharp, catching sensation with certain movements.