“I woke up with a shoulder issue, I have no idea how I got it. My surgeon sent me to physical therapy. Upon looking at reviews, I decided to try Farmingdale Physical Therapy West. I was very impressed with the facility and particularly with my therapist, Scott.
Now, after 4 weeks, my functionality is 50% better and continuing to improve. The tingling sensation in my hand is now rare and I feel I am being treated correctly.” -Mark B.
The shoulder is the most complex and mobile joint in the human body. It moves through more than 180 degrees of motion in many directions and must be able to rotate, slide and spin. There are a variety of muscles that have to work in concert to ensure the shoulder joint tracks properly with everyday activities. It is made up of the humerus bone, scapula (shoulder blade) and clavicle (collar bone). There are technically 4 joints that make up the entire shoulder complex.
Poor posture, weakened muscles, injury, and lack of proper range of motion can all factor into shoulder pain. Shoulder pain is typically felt in the muscles between the shoulder and neck, as well as the outside shoulder radiating down. Where your pain is can determine what structures are involved.
It is important to note that just because your pain is felt in one location, it is often not the source of the trouble. For example pain on the outside of the shoulder can be from an impingement of the joint or problems with the rotator cuff muscles. However, this can be caused by poor positioning and functioning of the shoulder blade, which is the real culprit. Treat the source of the problem and the irritation will resolve.
What Causes Shoulder Pain?
Rotator Cuff Injury
There are a number of conditions that can cause shoulder pain. The most common cause is a rotator cuff injury. A rotator cuff injury can be due to tendinitis, bursitis, or tears. Rotator cuff injuries frequently occur in individuals who repeatedly perform overhead movements, such as painters and tennis players. Rotator cuff tears or strains can also occur after a fall or car accident. Bursitis is inflammation of a bursa, which is a fluid filled sac that sits between muscles or tissues to cushion and reduce friction. The 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.
Other causes of shoulder pain include referred pain from a pinched nerve in the neck, frozen shoulder, or instability in the joint. Frozen shoulder is another name for “adhesive capsuilitis”, which is an inflammatory condition causing a stiffening of the shoulder, pain, and loss of motion. 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 it.
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.
Shoulder dislocations typically occur from falling onto an outstretched arm or a direct blow to the shoulder when falling on it. 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 the labrum, 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.
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 his/her protocol to rehab your shoulder after surgery.
Diagnosing The Cause of Pain In The Shoulder and Treatment
It is important that when you have shoulder pain, you have our experts evaluate your motion, strength, coordination and joint mobility. By determining the root cause of your pain, we can then treat it effectively for fast pain relief, improved motion, strength and return to normal activities. The goal is to restore your normal shoulder movement without pain. If you had shoulder surgery, our physical therapists will work closely with your physician to follow their rehabilitation protocols. Our physical therapists use different treatments and modalities to treat shoulder conditions. Interventions generally consist of active shoulder motion, passive range of motion, joint mobilizations, soft tissue work, shoulder scapular stabilization and rotator cuff strengthening. Other modalities of treatment include ultrasound, heat therapy, electrical stimulation, massage, joint mobilization and cold therapy. These treatment modalities are a perfect adjunct to exercise. All of these treatment modalities help decrease pain, reduce swelling, improve circulation and decrease muscle tension. Your physical therapists will also instruct you in home exercises to enhance recovery from a shoulder injury. Call us today to discover how we can quickly resolve your shoulder pain and get you back to the activities you love.
Have you suffered a shoulder injury? Do you have shoulder pain and don’t know why? Get the answers and treatment you need to get on the path to recovery. Get shoulder pain relief with physical therapy. Contact us at Bethpage & Ronkonkoma, NY centers for a personalized consultation and effective treatment plan. Our certified and skilled physical therapists have helped many others recover from a shoulder injury and can help you too. Recovery is just a phone call away.