Shoulder pain treatment with your physical therapist is based on addressing the specific cause of your symptoms. To better understand shoulder injuries and treatment, it often helps to first have a basic understanding of the anatomy and function of this part of the body.
It may surprise you that the entire arm has only one little bony connection to the body – the sternoclavicular joint located at your chest. As a “ball and socket” joint, the glenohumeral joint (what we think of as the “shoulder”) has a lot of mobility. In fact, it is typically the most mobile joint in the entire body.
With all of the shoulder’s mobility comes the inherent need for stability. Where does this stability come from? We get some stability from supporting ligaments and cartilage, but the majority of its stability comes from a strong, balanced and coordinated muscular system.
Passively, the shoulder gets some stability from the labrum, which is a ring of cartilage that surrounds the “socket” (the glenoid). The glenoid is very shallow like a wide soup bowl. What the labrum does is it helps to deepen the glenoid to create more contact and stability with the head of the arm bone (the humeral head).
Labral tears are common and can be caused by either an acute injury or by repetitive stress. Common symptoms include shoulder pain, “clicking” or “popping” and feelings of instability in the shoulder.
Actively, the shoulder gets most of its stability from supporting musculature. Of great importance are the four muscles collectively known as the ‘rotator cuff’: supraspinatus, infraspinatus, teres minor and subscapularis. These four small muscles work together to hold the “ball on the socket” (head of the humerus on the glenoid cavity) when you are reaching, pushing, pulling, lifting, and carrying.
Rotator cuff tears are common, even in individuals with no shoulder pain. These can be caused by either acute or repetitive use injuries. Shoulder pain is often felt when lifting your arm, pushing or pulling. Rotator cuff tendonitis or tendonosis is another common cause of shoulder pain.
The shoulder is a dynamic grouping of multiple joints and includes the sternoclavicular joint, acromioclavicular joint, glenohumeral joint and the scapulothoracic joint. All of these work together to create full arm motion and function.
Oftentimes impingement of rotator cuff muscles/tendons occurs due to poor coordination between the different aspects of the shoulder. Impingement typically causes pain when reaching out at shoulder height or overhead.
The acromioclavicular joint (AC joint) sits at the top of the shoulder and is often sprained when falling onto your shoulder, running into an object or falling onto an outstretched arm. Pain is typically felt when reaching across your chest, overhead or when directly pressing on the joint. You may also see a bump called a “key step” at the top of your shoulder if severely sprained.
Arthritis can affect the shoulder as well, restricting motion and limiting strength due to pain.
For all of the injuries and conditions mentioned above, physical therapy care can be an effective option for shoulder pain treatment by addressing the underlying cause of your injury and dysfunction and restoring motion, strength, stability and daily function.
In most cases of shoulder pain or injury, physical therapy is the first line of treatment. Even if you have a labral tear or rotator cuff tear, evidence shows that physical therapy can be just as effective as surgery in many cases. You are also likely to save on costs and time loss.
Your physical therapist will help you determine if you would benefit from a consult with a surgeon if your injury or condition is unlikely to improve with conservative treatment.
Following shoulder surgery such as labral repair, rotator cuff repair, debridement, acromioplasty, joint replacement or reconstruction, physical therapy care is integral in helping you to restore motion, strength and function and to reduce your pain. Your physical therapist will work closely with your surgeon to optimize the results and outcomes from your surgery, and to avoid re-injury or post-surgical complications.
There is much, much more to discuss regarding shoulder pain treatment than can be put on one page. Our skilled Physical Therapists are more than happy to answer any questions you may have about your symptoms or condition.
If you are looking for relief from your shoulder pain, call us to schedule an examination with one of our skilled orthopedic physical therapists or Request an Appointment Online for a specific diagnosis and individualized treatment plan to get you moving in the right direction.