Shoulder pain is a common issue among people of all age groups. It affects the young, the collegiate athlete, the active, the sedentary middle-aged person, and the elderly. Shoulder pain can be caused by numerous different factors. This is why seeing a physical therapist for shoulder pain is crucial in order to recover.
Working with a physical therapist can help you heal without the use of unnecessary injections, medication, or surgery.
When people complain about having shoulder pain it can be interpreted in many different ways. Some people refer to the shoulder in a broader sense in that they might be actually referring to their scapula, neck region, or thoracic region rather than what most people consider the shoulder or glenohumeral joint. In order to identify what the problem truly is, you have to go to a trained professional such as a physical therapist. They can test the various structures that may or may not be causing an individual pain.
What Causes Pain In the Shoulder Region?
There are four main areas that can contribute to shoulder pain. These areas include the neck, collarbone, scapula, and shoulder blade. There are also some minor areas that can contribute to shoulder pain that should be considered as well. Shoulder pain can be caused by ligament sprains, dislocations, tendon issues, fractures, nerve or vascular issues, and muscle strains.
Rotator Cuff Pain
One of the most common causes of shoulder pain is caused by rotator cuff issues. A rotator cuff is a group of four muscles that help stabilize and move the joint appropriately. The muscles consist of the supraspinatus, infraspinatus, subscapularis, and teres minor. Through different manual muscle tests, and special tests a physical therapist can help identify if these muscles are the cause or are contributing to a person’s shoulder pain.
There are also other muscles that are in the region of a shoulder that can cause pain as well. The biceps, upper traps, lower traps, med traps, scallions, coracobrachialis, and the deltoid. Being able to identify these other muscles accurately and testing them to find out if they are contributing to shoulder pain is another key component of treating shoulder pain successfully.
An Impinged Shoulder
One of the common issues with rotator cuff dysfunction is called impingement syndrome. Impingement syndrome is when the rotator cuff will get irritated on the bones surrounding it. There is a small bone over the rotator cuff called the acromion which is actually a part of the scapula. The rotator cuff will rub against the acromion and cause swelling and inflammation. As a result, this then leads to a narrowing of the space between the rotator cuff and the bone which can lead to more impingement syndrome. This will only cause further irritation of the rotator cuff.
Decreasing inflammation of the shoulder, as well as stretching and manual therapy, can help to improve the space between the rotator cuff and the acromion. In addition, this can decrease symptoms.
What Causes Pain Under the Shoulder Blade?
The AC joint is the joint between the clavicle and the acromion. These two bones are held together by ligaments that can become sprained or disrupted completely to cause instability in the joint. Injury to this joint can vary in severity depending on how severe the ligaments are sprained or disrupted. Disruption of these ligaments will cause the clavicle to rise up and sometimes cause what’s called a step-off deformity in the shoulder. This looks like there is a raised clavicle in one shoulder compared to the other when it happens.
Surgery may be necessary in some of the more severe cases in order for it to get better and to allow an active individual to return to sports.
Physical therapy can also help reduce symptoms of this through strengthening exercises, manual therapy, deep tissue laser therapy, and various other techniques to reduce associated muscle soreness.
The above-listed conditions are a small sample of different diagnoses that cause shoulder pain. In order to determine the cause of shoulder pain, a trained physical therapist is vital in determining what specifically is wrong. And more importantly how to get better from the injury. These are a few more common causes of shoulder pain and how a physical therapist can help with them.
Osteoarthritis
Osteoarthritis of the shoulder can be a very painful and debilitating condition. People who have severe osteoarthritis will oftentimes complain of grinding or catching the joint when moving it in certain ways. In more severe cases with any movement of the shoulder.
Physical therapy can help reduce the symptoms of osteoarthritis through strengthening exercises to help stabilize the joint better. These different modalities are also used to decrease the inflammation associated with arthritis in the joint.
Thoracic Outlet Syndrome
Thoracic outlet syndrome is a painful syndrome that is caused by compression of the neurovascular structures in the shoulder and neck region. The nerves and sometimes the blood vessels in this area can be restricted by different muscles such as the scalene and the pectoralis minor. Symptoms include numbness and tingling down the arm as well as a reduction in impulse in the arm. Treatment through soft tissue work to the tight muscles involved as well as stretching, and education on sleeping positioning can help with thoracic outlet syndrome.
Frozen Shoulder
A frozen shoulder is a very painful condition that is oftentimes correlated with a traumatic injury and even diabetes and thyroid issues. Frozen shoulder is characterized by the inability to move your arm in various directions including overhead, and reaching behind your back. Frozen shoulder is a condition in which the joint capsule and ligaments become severely tight due to the adhesion buildup within their structures. These regions are strong enough that the shoulder gets bound down and is unable to move normally.
This can be a very painful condition that is debilitating and limits a person’s ability to perform basic activities such as getting dressed and doing recreational activities. Physical therapy consisting of progressive manual therapy, soft tissue work, stretching, and exercises can help to improve the range of motion and decrease the pain in the shoulder.
Physical Therapy Intervention
In many instances, our bodies can heal by themselves from these injuries. However, if you are having shoulder pain that is persistent and unchanging then it is imperative that the problem is diagnosed quickly and accurately. This is the best way to avoid more serious complications down the road that can result in a more serious intervention like surgery.
Scott and his team are the best physical therapy group I have worked with. They are professional, caring, and make it such an enjoyable experience. I appreciated their expertise, keeping me motivated, and changing things up as my shoulder improved. I’m so grateful for their help and would recommend them to anyone that needs physical therapy.
Shari Nyman
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Everyone is different. You may require one or two visits, or an extended care plan over several weeks or months. If you’re ready for relief, and tired of “masking” your pain, treat the cause, not just the symptoms! Contact RX Rehab Physical Therapy today and get on track to healing.
* Physical therapy has been proven to be as effective as surgery. Ann Rheum Dis. 2005 May:64(5).