Shoulder pain is a very common condition that, in fact, places second to low back pain for the most prevalent musculoskeletal reports in primary care offices. Shoulder pain accounts for 16% of all musculoskeletal complaints, and its by no coincidence. One of the most common locations of severe inflamation in the shoulder is the Rotator Cuff, which is a group of 4 muscles and their tendons that is largely responsible for the rotating motion required to throw an object. The shoulder is a complex joint consisting of bones, tendons, ligaments, muscles and cartilage.
What makes the shoulder unique is that it offers a great deal of motion, unlike many other joints in the body. But while the shoulder has the ability to move in many directions and planes of motion, it lacks inherent stability. It is best described as a golf ball that sits on a tee – essentially having a large convex surface on a shallow concave surface.
The body attempts to stabilize the joint by enhancing the cavity by way of a cartilage called the labrum, and is equipped with ligamentous material that statically holds the ball in the socket. While the shoulder moves, a group of four muscles, commonly referred as the rotator cuff, works dynamically to secure the ball as the arm engages in various motions and directions. As we age and as the arm is taxed repeatedly, the shoulder starts to break down and undergo degenerative changes. Chronic shoulder pain is defined by pain lasting at least 6 months.
Age also plays an important role in the possible causes of shoulder pain. Among patients younger than 40 years, shoulder instability and mild rotator cuff disease are more common, whereas adhesive capsulitis, glenohumeral osteoarthritis and more advanced rotator cuff disease are more common among older adults.
There are multiple variables that can cause musculoskeletal shoulder pain, even while not considering the myriad of other non-musculoskeletal conditions like angina or a pancoast tumor, which could manifest itself in the shoulder. Nevertheless, if you are examined and it is determined that the pain is of a musculoskeletal origin, the best course of actions generally includes conservative measures including pain and anti-inflammatory medications, physical therapy and education.
As the body heals, it moves through several phases of healing that should be facilitated with a sound physical therapy program. Pain control and anti-inflammatory modalities like non-thermal ultrasound, ionotphoresis, cold laser, ice and electrical stimulation all play a critical role initially. As the acute stage passes to the next phase, the proliferative phase, thermal modalities can be introduced in efforts to promote blood flow and increase local metabolism, while being coupled with passive and active therapies designed to maintain or restore strength and motion.
Lastly and most importantly, the shoulder while healing should not be subjected to the stresses that injured it in the first place. If you’re a painter, a pitcher, or a mother of 4 children, you may want to adjust your lifestyle as much as possible in order to remove additional stress. This will allow for healing to take place expeditiously and without morecompromise to the injured joint.
Executive Park Physical Therapy in Westchester County offers a holistic plan for treatment of Injuries to the Shoulder, Rotator Cuff, and general pain in your shoulder. To get your neck and shoulders back to full strength, schedule your appointment today or click here to view our modalities and services.
Yonkers – 914.509.4640 | Elmsford 914.909.5130