By Dr. Adam M. Cramer, PT, DPT
Of all the joints in your body, the shoulder joint has the greatest range of motion.
Because of its incredible mobility, it is more likely to be injured or sustain painful problems. And when it does become painful, it impacts almost everything you are trying to do.
Shoulders sustain sprains and strains, dislocations, tendinitis, torn rotator cuffs, bursitis, frozen shoulder, fractures, arthritis and a host of other injuries and conditions.
Because it is such a mobile joint, you can hurt it in falls, when you strain to try to reach something, when you lift something heavy, and even when you throw a ball or play a game. Sometimes it become injured and painful just from a gradual irritation or deterioration over time.
If you don’t get it treated when the pain starts, it has the potential to lead to larger problems.
Where do you look for relief of shoulder pain?
Too often when twinges of pain erupt from the shoulder, busy people just pop a pain-killer and push on through their day. The next day hurts even more, so they take a few more pills and continue without seeking help or they seek out a surgeon who can only provide surgery as an option when they actually don’t want or even need surgery.
This practice leads to a continuing and escalating shoulder problem as well as other side effects of increased dependency on pain-killers, unnecessary MRI imaging, ineffective steroid injections and life threatening surgery!
In fact, according to a report released three years ago by the National Institutes of Health (NIH), our culture’s tendency to treat chronic pain with a one-pill-fits-all-mindset has created a “silent epidemic” regarding the use and possible overuse of opioid reliance.
They suggest that we must urgently consider nonpharmacological approaches to treating pain, including physical therapy.
“The overriding question is whether we, as a nation, are currently approaching chronic pain in the best possible manner that maximizes effectiveness and minimizes harm,” the NIH panel said. The answer to that question, they concluded, is no.
The panel specifically mentions physical therapy as an effective nonpharmacological treatment and noted that many people are not aware of this and other options to opioids.
How your physical therapist can help your shoulder pain
When you consult with a doctor of physical therapist because of shoulder pain, you can expect that first you will be evaluated so that they can determine the cause of your pain and then an effective way to treat it the same day.
We will use a combination of hands on treatment to loosen the muscles and joints and combine it with dry needling, laser therapy, electrical stimulation, hot and cold treatments, and Kinesio tapping. Add to that stretching and strengthening exercises including gentle pendulum exercises and education on proper posture and movement to decrease the pain.
Some common shoulder problems we treat include rotator cuff tendonitis, bursitis, frozen shoulder, stroke recovery and shoulder fracture.
Rotator cuff tendonitis occurs when the rotator cuff tendons that attach to the arm bone in the area directly underneath the bony prominence of the shoulder blade get pinched under the bone and become sore and inflamed and painful creating bursitis.
Frozen shoulder, also known as adhesive capsulitis, occurs as your shoulder gradually loses motion and become painful. It can be debilitating and painful if it is not treated.
Shoulder fractures result from falls and accidents. When you fall on your outstretched arm, a shoulder fracture is often the painful result. You can injure your collarbone, humerus or scapula or all three in a bad fall or accident.
What you can expect from your physical therapy
It takes time for your shoulder to heal. It is important that you move at the pace your physical therapist advises, because you need to avoid re-injury as you struggle to regain normalcy.
With each visit you will receive Pain relieving treatment so control pain and inflammation without pharmaceuticals. You will also be program of exercise to do at home between visits to continue to heal and strengthen your shoulder.
Physical therapy has been researched as an effective method for treating and overcoming shoulder pain and the results have been consistently positive.
One of the most quoted studies, A Randomized, Controlled Clinic Trail of a Treatment for Shoulder Pain, was published as far back as 1997 in the peer-review scientific journal, Physical Therapy.
Study proves effective of physical therapy in treating shoulder pain
The aim of the study was to evaluate the effectiveness of physical therapy as a treatment approach to shoulder pain. A total of 66 volunteers with shoulder pain were randomly allocated to a treatment group that gave them one month of physical therapy aimed at restoring function of their shoulder muscles or to a control group who received no treatment.
Throughout the trial, the participants were routinely tested for pain intensity, range of motion (ROM), isometric muscle force, functional impairment, and self-perception of improvement.
Overall, the subjects who received the physical therapy showed improvement in pain-free status and had a more flexible range of motion as well as a higher self-perception of improvement.
In contrast, study authors Karen A. Ginn, Robert D. Herbert, Wendy Khouw, and Rebecca Lee observed that the subjects who received no physical therapy at all deteriorated slightly over the period in their ROM and functional impairment measures.
“These results suggest that the physical therapy approach used in this study is effective in improving shoulder function in subjects experiencing pain of mechanical origin,” they concluded. “The results also provide little evidence of spontaneous recovery over a one-month period.”
In other words, your physical therapist can help you heal from your shoulder pain avoid surgery saving you money and returning you to your normal life. Just leaving your shoulder alone to heal won’t help you at all.
Dr. Adam M. Cramer, PT, DPT, is a licensed physical therapist, shoulder specialist and owner of MyoFit Clinic in Chardon and Middlefield, Ohio.
National Institutes of Health. News Release. NIH says current treatment of chronic pain has created “silent epidemic;” More focus needed on non-drug approaches. PT News. Jan. 14, 2015
Ginn, Karen A. et all. A Randomized, Controlled Clinical Trial of a Treatment for Shoulder Pain. Physical Therapy. Volume 77, Issue 8, Pages 802-809 https://academic.oup.com/ptj/article/77/8/802/2633184