Shoulder Pain

Pain in your shoulder can be a result of many different causes. The most common source of pain is related to the rotator cuff. There is also an area called the subacromial space, in which there is a bursa – a sac of fluid  – under the high part of the shoulder, that can become inflammed and painful. Other causes of shoulder pain include bony abnormalities, trauma such as a fall, overuse, osteoarthritis and thickening of the ligaments in the shoulder area, known as tendinitis. Most of us often incur shoulder pain due to repetitive motions and overuse. Shoulder pain can even keep you up at night if you tend to sleep on your side, as it continues to compress the rotator cuff and subacromial area.

The Rotator Cuff: What It Is

The shoulder is made up of multiple joints and muscles, with the primary joint being the ball and socket. The shoulder and arm are connected to our bodies by only the collar-bone and muscles surrounding the shoulder blade. While the shoulder is considered a ‘ball and socket’ joint, it functions more like a golf ball sitting on a tee. The four muscles that make up the rotator cuff then surround the head of the humerus and provide support and stability during movement. The most common cause of pain in the shoulder is due to an impingement of the rotator cuff and/or subacromial bursa. This is typically secondary to an underlying problem such as the shoulder blade (scapula) not functioning as it should.

The supraspinatus is one of the rotator cuff muscles that sits on top of the shoulder, and its tendon extends under the outside of the shoulder bone. Because of its location between bones, it’s a common area of injury and impingement. The tendon can become sore and swollen when it gets pinched between the bones which can also cause irritation to the subacromial bursal sac.

Frozen Shoulder: How It’s Caused

shoulder-pain

Adhesive Capsulitis is the medical term for Frozen Shoulder. It’s a shoulder condition that limits the range of motion. It’s cause is difficult to explain but can be caused by long periods of inactivity, diabetes or surgery. As a result, the shoulder joint does not have proper space to rotate and move normally. Symptoms typically include stiffness, pain or swelling in the shoulder. Gradually, the ability to move the shoulder becomes less and less, and reaching for an item may even become impossible. There are multiple stages, so getting help as soon as you have symptoms is important. Soft tissue work as well as neuromuscular re-education can help to restore proper ROM and decrease pain quickly. 

Treatment at Reneu

We will perform a comprehensive exam and evaluation that includes strength and motion testing, and special orthopedic tests. This will help to determine if there is a tear in the rotator cuff, labrum, as well as the diagnosis and prognosis. An MRI is not always needed, as our orthopedic tests are very specific and it most likely won’t change the course of treatment. It is also important to assess the mobility and strength of the thoracic spine and scapular stabilizing muscles to allow for full and proper movement at the shoulder. If there is not improvement after a few session, our expert PTs will continue to reassess and refer for imaging if needed.

Your treatment may include manual therapy, range-of-motion exercises, functional training, soft tissue massage and rotator cuff strengthening exercises. We also help to educate you on how to improve posture and avoid future injury to the shoulder. Often, patients are given a home exercise program for lifelong protection and health of the shoulders. In the case of treating the shoulder, “no pain, no gain” is not the best practice. Pain in the shoulder usually means the structures are being irritated or injured. Our Physical Therapists utilize a variety of manual techniques to promote muscle and tendon healing, shoulder and thoracic spine mobility, and neuromuscular re-education techniques to improve the stability and strength of the shoulder at end ranges. Kinesio-taping techniques are often used on the shoulder as well to assist in proper scapular movement.