Shoulder pain is one of the most common conditions seen in Maplecare Physiotherapy clinics.
The main goal of physiotherapy is to improve your daily quality of life by decreasing your pain and increasing your strength and mobility. If you have pain or difficulty reaching for something on a high shelf, getting dressed, tucking in a shirt or reaching into your back pocket, or have been avoiding some of these activities due to pain, stiffness or weakness, it is likely that physical therapy can help.
Common shoulder conditions include:
1. Frozen Shoulder. (Adhesive Capsulitis)
A frozen shoulder is often the diagnosis given to anyone with a sudden onset of shoulder stiffness or pain accompanied by a loss of range of motion of the shoulder joint. This pain may often spread into the neck, shoulder blade, arm and hand. This, in turn, can have a dramatic impact on your activities of daily life and your sleep.
A full assessment by a Maplecare physiotherapist is therefore vital to confirm whether or not this is the problem and that the correct shoulder treatment and advice is given. If left untreated the condition can naturally resolve but this usually takes 1-2 years.
Causes of a frozen shoulder:
It can occur anytime for no apparent reason but is more common if you are:
- Female
- Over 50
- Diabetic
Symptoms may include:
- Pain
- Difficulty sleeping
- Inability to move your arm properly, even with help
- Dressing becomes painful and difficult
2. Shoulder Impingement
Every time we raise our arm above our head or behind our back we squash certain structures.
This includes the tendons and muscles that move our arm in specific directions. Normally this is not a problem but, if the tendons, muscles or the bursae become injured or inflamed, pain may result when you lift your arm or reach up your back.
Pain can often spread into the neck, shoulder blade, arm and hand because the shoulder is not being used properly. Physiotherapy can help with the pain and tightness in those areas as well.
Shoulders can stiffen and weaken quite quickly, so early shoulder treatment is vital.
Once the pain is is addressed, we will look at why the problem may have occurred and modify how you work or exercise in order to prevent a re-occurrence.
Specialized stabilizing exercises prescribe by a Maplecare physiotherapist can help position the shoulder correctly, reducing the pressure on the injured tissues in the future.
Causes of shoulder impingement
- Rounded posture
- Repeated shoulder movements. Throwing, racquet use, work patterns
- Falls or injury
- Poor technique/overuse of weights
- Aging of tissues
3. Rotator Cuff injury
As the shoulder is a somewhat unstable joint, it relies more on the muscles around it to support it and stabilize it. This job is done partly by the four rotator cuff muscles. If any of these muscles are injured in a fall, in sports or because of a chronic irritation to the area, an injury to the rotator cuff may occur.
This may result in pain, weakness and difficulty with activities where you lift your arm. Pain can often spread into the neck, shoulder blade, arm and hand because the arm is not being used properly. Physiotherapy can help with the pain and tightness in those areas as well.
Once the pain is is addressed, we will look at why the problem may have occurred and modify how you work or exercise to prevent a re-occurrence.
4. Arthritis
Arthritis is a change in the surface of a joint – a wearing of the joint or a bone spur – which usually occurs over time as we age. The more common type of arthritis, osteoarthritis, is less common in the shoulder than in other joints of the body.
Rheumatoid arthritis however (which is an auto- immune problem) does often affect the shoulder joint. Sufferers are usually under the care of a rheumatologist as it can be a severe and debilitating condition.
With either form of arthritis, Maplecare Physiotherapy can help with the pain, range of movement strength and stabilization of the shoulder.
5. Shoulder Fracture
A fall onto the shoulder may result in a break (a fracture) of the humerus bone.
Unless the fracture is severe and stabilized with surgery and pins and plates, it is rest in a sling is that prevents the fracture from moving and allows the healing to progress. It is not possible to put a cast around the shoulder.
Resting the shoulder even for a short time causes stiffness and tightness and this has to be addressed once the fracture is healed and movement is allowed.
However, while the fracture is healing, there are things you can do to keep the muscles around the shoulder as strong as possible. This will make rehabilitation quicker and easier once the rest period is over.
Physiotherapy
Physiotherapy treatment is essential in the early stages of shoulder pain to prevent the condition becoming more complex and difficult to resolve and cause secondary problems such as neck pain, headaches or a frozen shoulder. Studies have shown that physical therapy can improve your quality of life, and in some cases, prevent surgical intervention. The stronger you are before surgery results in a faster recovery post surgery.
If surgery is required, physiotherapy may be beneficial both before and after surgery. The goals of your pre-surgical physical therapy could include strength development, education and development of a home exercise routine.
Maplecare’s physiotherapist will assess your strength and range of motion, check your functional abilities (like reaching up and behind your back) and discuss your goals in order to develop a personalized treatment plan to relieve your shoulder pain and restore your mobility.
Physiotherapy may include:
- Heat, ice, ultrasound, electrical stimulation, acupuncture for pain
- Gentle stretching
- Manual therapy
- Tissue release or massage
- Specialized taping techniques to reduce pain and support the delicate muscles around the shoulder and neck
- Strength and mobility exercises
- Specialized stabilizing exercises to position the shoulder correctly, improve strength and reduce the pressure on the injured tissues in the future.
- Give advice on activity modification and work-place ergonomics
- Develop a comprehensive and patient specific home exercise program
- Assess and make adjustments to any poor movement patterns
- Education and prevention of further injury
