SHOULDER CONDITIONS

  •  The shoulder is one complex is one of the most mobile joints in our body. It requires a great deal of stability and coordination to work effectively. There are 8 muscles that connect to the scapula(shoulder blade), humerus (long bone of your arm) , and clavicle your collar bone. That doesn’t include the muscles that attach the scapula to the ribcage and neck. Often the shoulder, neck and upper back work hand in hand to stabilize and move the joint. If an imbalance starts to occur secondary to faulty posture, altered movement pattern, or overuse the shoulder often suffers. If the whole complex is not assessed there are often trickle down effects and reoccurrence of symptoms down the road. Physical therapy can help to evaluate the interconnectedness of the system and address the underlying cause which may be driving the symptoms.

COMMON DIAGnosis

Adhesive Capsulitis(Frozen Shoulder)

  • A very common condition that results often in a spontaneous loss of motion. Can be very painful and take months to resolve. Often motion overhead and reaching behind ones back can be very limited and painful. Physical therapy can be very helpful and educating the client in protective movement patterns and gradual stretching program to restore ROM.

Tendonitis

  • A common diagnosis that is defined as a tendon that has become inflamed. This usually results in painful active movement of the arm. Can be minor or severe and the timelines of recovery can vary. Physical Therapy will be beneficial in evaluating the driving factor of why the tendon became inflamed and instructing the client in activity modification and an exercise program to load the tendon in an appropriate manner that will promote healing.

Bursitis

  • Another common diagnosis that is usually localized to a specific point on the shoulder. The Bursa is a protective pad the cushions against friction within the joint. This condition occurs when there is excessive friction on the area that causes the bursa to become irritated and inflamed. Physical Therapy can identify the driving factor and design an a corrective exercise program to minimize the excess friction.

Labral tears

  • The Labrum is a part of the shoulder that helps to deepen the socket of the joint. Tears in the labrum can be due to macro-trauma like a fall or micro-trauma such slow wearing down over time. Some tears ultimately require surgery to correct the tear and allow the shoulder to regain a stable surface. Many small tears can be rehabilitated and the shoulder can regain enough stability to allow for functional ROM and strength. Physical therapy can develop a plan to support the surrounding structures and create more stability while avoiding surgery.

Shoulder Impingement Syndromes (SIS)

  • May also be called Swimmers Shoulder. Typically presents as pain in the shoulder with overhead motions or reaching be hind the back. May also occur with bursisits or tendonitis of the rotator cuff tendons. The cause is a rubbing of the tendon of rotator cuff against the bone which is painful. This may be caused by altered postures or over development of certain muscle groups that put the rotator cuff in a suboptimal position. Treatment often involves correcting faulty posture and balancing out muscle imbalances as well as education on activity modification.

Rotator Cuff Strain

  • A strain or tear is usually caused by overuse over time . The tendons that connect muscles to bones can overstretch (strain) or tear, partially or completely. This injury can also occur after a fall, a car accident, or another trauma to the shoulder. The extend of the damage to the muscle will determine the healing time and recovery a small strain can take a few weeks to heal where a large strain can take a few months. If the strain is severe enough surgery may be recommended to fix the torn tendon. Physical therapy can help develop a program to maximize ROM return and recovery of strength and function in the injured shoulder.

Post surgical

Rotator Cuff Repairs

  • There are injuries that require surgical correction to the rotator cuff. These are usually performed arthroscopically(with a tiny camera) The tendon that tore away from the bone is reattached. Often the patient is put in a sling for a few weeks and gentle range of motion is recommended, with gradual progression through a post surgical protocol. Typical recovery from this surgery can be anywhere from 8 months to 1 year. Pt is focused on restoring ROM early and improving strength, coordination and function.

Shoulder Replacements/Reverse Shoulder Replacements

  • In cases of severe osteoarthritis or other conditions, a shoulder replacement may be recommended. This involves replacing the joint with a prosthetic one. A reverse shoulder replacement is when the prosthetic reverses the ball and the socket so that the ball is attached to your shoulder blade and the socket is attached to the humerus. PT is used to restore ROM early on and prevent contracture of the muscles and soft tissue around the joint. Later on the rehab consists of strengthening, coordination and return of function.

Acromioplasty

  • A surgical procedure that involves shaving down a part of the shoulder called the acromion. This is typically performed when impingement of the shoulder is severe and conservative treatments have not been successful at reducing pain, or relieving the impingement of the rotator cuff tendon that supports the shoulder joint. Acromioplasty is also known as subacromial decompression. Physical Therapy is usually recommended afterward to restore ROM, strength, endurance, and functional capacity of the surrounding muscles and structures.

SLAP repairs

  • SLAP (Superior Labrum Anterior to Posterior) Lesion is a tear of the labrum or liner of the shoulder joint. This injury usually occurs from a trauma like falling out on an outstretched arm. If the injury is severe surgery is recommended and performed arthroscopically to re attach the torn parts of the labrum to the bone. After surgery Physical Therapy is usually performed to prevent contracture of the surrounding tissue and to restore ROM and strength in a slow progressive manner.

Disclosure: the information presented here does not substitute from a thorough medical examination. It is for information purposes only. If you have any questions about anything that is presented above please reach out to us and we can schedule a time to talk about any of the conditions listed above in more detail.