Shoulder Pain Therapy & Injury Treatment

The shoulder is a ball and socket joint; it’s formed where the ball at the end of the humerus (upper arm bone) fits into the socket of the scapula (shoulder blade).

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1. Rotator Cuff Injury

Rotator cuff injuries can range from mild to severe.

2. Tendonitis

Tendonitis is an injury caused by overuse of the rotator cuff and causes it to become inflamed.

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3. Tendinopathy

This is a wear and tear condition of the soft tissue that can cause pain and disability. It’s associated with small tears in the rotator cuff or long head of a bicep tendon.

4. Frozen Shoulder

Also known as adhesive capsulitis, is a shoulder condition that causes significant loss in range of motion.The first sign of a frozen shoulder is usually pain that limits your arm movement, resulting in stiffness.

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5. Osteoarthritis

Osteoarthritis can accumulate over time, which is why the older you are, the more wear and tear you may have on the cartilage of your joints. Cartilage protects the ends of bones within a joint and allow them to move easily against each other.

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6. Bursitis

It can be a painful condition that affects the small, fluid-filled sacs called bursae that cushion the bones, tendons and muscles near your joints which reduce friction between structures during movement.

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7. Labral Tears

Athletes commonly suffer tears to the labrum, especially those involved in overhead sports. It is a common injury in the non-athletic population also, particularly the middle-aged and usually associated with degenerative changes.

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8. Shoulder Impingement

Shoulder impingement usually occurs after repeated overhead activity, like throwing or swimming. Shoulder tendons and bursae get impinged, or pinched, between the bones of the shoulder, making it painful to move your arm.

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9. Shoulder Instability

The term instability is a diagnosis that is given to the shoulder when it causes pain due to the ball of the joint being too loose and unable to move normally in the socket.

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10. Dislocated Shoulder

Complete dislocation is when the ball of the joint fully comes out of the socket. The person usually holds their arm against their belly unable to move it.

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11. Separated Shoulder

A separated shoulder is an injury to the ligaments that hold your collarbone (clavicle) to your shoulder blade. In the case of a mild separated shoulder, the ligaments may just be stretched.

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12. Post-Surgery Shoulder

If rehabilitation of shoulder pain fails, or there is a large rotator cuff tear or other significant tissue damage, your surgeon may recommend a surgical procedure.

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Frequently Asked Questions About Shoulder Pain & Injury

How do you prevent shoulder instability?
There are active and passive structures surrounding a joint that help with stability. In a shoulder joint, muscles such as the rotator cuff will provide active stability, whereas ligaments provide passive stability. If you are focusing on prevention and have not had any previous injuries to your shoulder, neck or back, strengthening the muscles surrounding the joint through exercise may be beneficial. However, there are many muscles that make up your shoulder joint (17 muscles that attach to your shoulder blade!). A physical assessment by a Physiotherapist will be able to determine any muscular imbalances and prescribe specific and individualized exercises. It is also a good idea to engage in a proper warmup and cooldown prior to any strenous physical activity/demand of the shoulder.
What should I do after shoulder therapy?
Depending on the injury, your physiotherapist will prescribe an individualized exercise program for you to carry out at home until your next visit. Being consistent with your treatment plan (which includes your exercise program) will lead to the best prognosis for any shoulder injury. Once you complete your shoulder rehab and are discharged from Physiotherapy, maintenance is going to be crucial to prevent any future injuries. Which your physiotherapist will go over prior to discharge.
What is the most common cause of shoulder pain?
One of the most common causes of shoulder pain is tendinopathy. Other causes of shoulder pain may include: muscle strain, ligament sprain, cartilage tear, bursitis, frozen shoulder, fracture, dislocation, adverse neural tension, and even a heart attack. During your assessment, your physiotherapist will be able to diagnose what is causing your shoulder pain.
How can I prevent tendonopathy?
"Some ways to prevent tedonopathies include:
  • Proper work and sleep ergonomics
  • Frequent rest breaks during any strenous and/or repetitive activities
  • Proper warmup and cooldown prior to any strenous or repetitive physical activity
  • Exercises (including resistance and flexibility) for the muscle
  • General postural exercises
Is shoulder therapy painful?
Generally, no. But it depends on the injury as well as the stage of healing at time of therapy. For example, treatment techniques for tendonopathies, which include manual therapy (soft tissue tehcniques, mobilization, etc), modalities (ultrasound, laser, acupuncture/dry needling, etc) and individualized exercises, are typically not painful. However, mobilizations for Frozen Shoulder, which has been shown to be quite effective, can be uncomfortable. Prior to beginning any treatment technique, your physiotherapist will inform you of the benefits, contraindication, risk and alternative methods of treatment.
Can stress cause shoulder pain?
Yes! When under stress, our body enters a "fight or flight" state which increases heart rate, respiratory rate, blood pressure and causes muscles to contract/tense. If muscles are constantly contracted or tensed, they may become painful, weak, tight, develop trigger points and not function properly. Whereby increasing ones risk of developing shoulder pathologies. Stress has also been linked with mental health problems, cardiovascular disease, gastrointestinal, mental health and more. Luckily there are many ways to manage stress including but not limited to meditation, exercise and help from healthcare professionals.
Is hot or cold good for shoulder pain?
It depends. There's a lot of mixed literature out there between hot and/or cold therapy. Ultimately, it will depend on the type of injury you are dealing with as well as what stage of healing you are in. Generally, if you are dealing with acute pain and notice that there is inflammation, ice would be your best bet. If you are dealing with chronic pain and stiffness, heat would be most likely be recommended. However, consult with your physiotherapist and they will be able to help determine what would be the most beneficial for you.