Shoulder Pain Relief
Why can’t I figure out how to treat my shoulder pain?
Shoulders: We carry the weight of the world on them, but we don’t spend a lot of time trying to learn about them. Yet our shoulders are each incredibly complicated joint systems. The positive aspect of this complexity is that your shoulders allow your body to undertake an amazing range of activities. On the downside, when something goes wrong with one or both of them, it can be complicated to treat on your own. Get rid of your shoulder pain today!
Our innovative care strategies at MTI Physical Therapy will help you find quick relief. Each one of your shoulders is made up of four joints, which are connected not only to one another but form the connecting unit to your shoulder blades, collarbone and upper arms. Because of this interdependence, any problem with your shoulder often means trouble performing functions that require almost any kind of upper-body mobility.
What causes shoulder pain?
There are many reasons why your shoulder could be hurting, so requires a little effort to identify the tissue that hurts, as well as the underlying causes of why it broke down. The shoulder is a complex “ball-and-socket” joint, meaning the head of the upper arm bone, or “humerus,” fits perfectly in the corresponding space within the shoulder blade, or “scapula.” Pain or impairment of any of the four joints of the shoulder complex, or it’s tendons or muscles, can be part of a sudden injury, athletic overuse, poor posture, or even referred pain from your neck. Aggravating injuries include shoulder dislocation and broken arms, rotator cuff tearing, and falls or blows to your torso.
Imaging does not show pain. You may have a negative MRI but still have shoulder pain, weakness, restricted joint motion and faulty shoulder mechanics. You may also have “positive” findings on your MRI with a joint that is pain-free or normal. “Aging on the inside” often leads to changes in tissue that are normal but described as “degenerative” on imaging. An MRI should be used as part of a more thorough clinical evaluation. Finding the source of your pain, however, is just the beginning. Often the cause of your problem relates to a breakdown in the mechanics of how the joints and muscles work together in the shoulder. The rotator cuff is a complex set of muscles that control how your joint moves, so larger muscles on the outside of your joint, such as the deltoid muscle, can move the arm. Breakdown in the coordination of your rotator cuff can lead to impingement pain in your shoulder. Our physical therapists are movement experts, trained to pinpoint the cause of your pain through a variety of diagnostic techniques, as well as identify any breakdown in the mechanics of how your shoulder moves.
Looking at the primary shoulder joint is just the beginning. Muscles connect from the shoulder joints and shoulder blade to your neck. This relationship can often aggravate each other, lending itself to the chicken or egg question. If you are experiencing persistent shoulder pain, it may be that your neck has not been adequately assessed in relation to your shoulder, with a subsequent treatment plan addressing both areas together. This is right in the wheelhouse of our OMPT trained physical therapists. We do this every day.
Less common is “referred pain” in your shoulders from heart disease or gallbladder problems. These conditions often come with other symptoms outside the shoulder that would suggest a deeper health issue requiring consultation with your physician.
What does physical therapy do to stop shoulder pain and stiffness?
Physical therapy is a natural, easy, and comfortable way to find relief for shoulder pain, without the need for harmful drugs or invasive surgery. Physical therapy treatment for the shoulder should always be pain-free. Whether you are undergoing a medical treatment or practicing self care by exercising, if the activity is causing pain in your shoulder, you are risking further injury to tissue, altering the normal activation patterns of your muscles, and teaching your body to move abnormally and compensate when in pain. For these reasons, our treatments push the shoulder without causing additional pain. Our highly trained OMPT trained physical therapists perform soft tissue work and joint mobilization to reduce pain, reduce muscle spasm and increase range of motion. This may also involve spinal mobilization of the neck to reduce shoulder pain or improve muscle activation, as well as to your mid-back, to improve posture and shoulder mechanics.
Therapeutic exercise can be used to specifically train your tendon or cartilage to improve tissue repair. Therapeutic exercise can also be dosed specifically to increase local circulation, reducing inflammation, and bringing needed oxygen and energy to healing muscles. Specific movement assessment leads to exercises designed to improve the coordination of how the ball and socket joint of the shoulder moves, to avoid further tissue damage or pain. Once we have you moving correctly, it is time to build endurance and strength. This can be designed and dosed to progress in the clinic, as well as transition to doing therapeutic exercises at home. To help healing tissues get even stronger than they were prior to an injury, they often require continued therapeutic exercise long after they are pain-free.
A combination of soft tissue work, joint mobilization, therapeutic exercise, patient education and home exercise is the recipe for returning to a pain-free and active lifestyle.
Are you experiencing any of these conditions related to shoulder pain?
As previously mentioned, the complexities of the shoulder joint presents many opportunities for pain-causing conditions. Some of the most common causes of shoulder pain include:
Rotator cuff tear:
The rotator cuff is composed of four muscles, tendons, and soft tissue that surround the shoulder joint. The job of the rotator cuff is to correctly guide the movement of the shoulder joint. With injury, overuse, poor posture, or even age, the rotator cuff can be partially or completely torn. Depending on the severity and situation, sometimes surgery is needed, but often the correct physical therapy treatments can help reduce pain and restore strength to the rotator cuff to compensate for the partial tear. If surgery is needed, physical therapy is an integral part of the rehabilitation process, leading you to a full recovery.
Impingement:
Impingement typically occurs because of abnormal movement and tracking of the humeral head as you lift your arm overhead. Pain typically occurs when lifting your arm at or above 90 degrees. Sharp pain can be felt at the top of the arm where the impingement occurs, but a dull aching pain can also be felt on the lateral side of arm due to inflammation in the joint, which is caused by the impingement.
Tendinitis:
Tendinitis refers to a breakdown in the collagen of a tendon. This can occur in the rotator cuff tendons, but the Biceps tendon is also a common location. Often, tendon pathologies result from overuse associated with the demands of a laborious job, overhead activity, or sport. Therapeutic exercise can address tendon repair and healing, progressing to strength training. Education can also assist in prevention of reaggravation when returning to work or sport activities.
Frozen shoulder:
Also known as “adhesive capsulitis,” frozen shoulder can occur if your arm has been in a case or sling for a while, or if you have been bedridden for an extended period of time. Frozen shoulder results in a painful loss of motion in the shoulder with a tightening of the shoulder joint that severely limits motion. You may have been told to give it two years and it will “thaw”. Rather than suffer this long and waiting it out, there is a lot we can do to reduce pain, improve joint mobility and range of motion. Manual therapy and therapeutic exercise is indicated with the frozen shoulder diagnosis.
Arthritis:
The two main forms of arthritis that affect the shoulder are osteoarthritis and rheumatoid arthritis. Osteoarthritis occurs when the cartilage in the shoulder joint experiences significant “wear and tear,” typically due to age or excessive overuse. Rheumatoid arthritis occurs when the immune system decides to attack the membranes surrounding the shoulder joint, resulting in pain and inflammation. Both of these result in painful loss of motion, weakness to the shoulder muscles, and difficulty performing normal, daily tasks.
Ready to get started?
Don’t let your shoulder pain limit your physical abilities any longer! Whether you’re in need of post-surgical rehab or are hoping to avoid surgery altogether, our highly trained physical therapists will put a comprehensive, custom treatment plan together that is designed to target the various parts of your complex shoulder system.
Contact us today at our Bellevue, Edmonds, Magnolia, Fremont, First Hill, WA physical therapy clinic and we will get you the help you need to quickly relieve your shoulder pain.