Shoulder Pain

There are some common conditions that can cause someone to feel pain in the shoulder. This may include a rotator cuff tear, rotator cuff tendinitis, frozen shoulder (adhesive capsulitis), and impingement syndrome. When diagnosing shoulder pain the neck must also be ruled out as a cause because often time and issue in the neck can refer pain into the shoulder. Many shoulder pain conditions can be treated without requiring medications, injections, or surgery.

Rotator Cuff Tear

The rotator cuff muscles are a group of muscles that provide stability to the shoulder as it moves through varying degrees of motion. If an injury occurs to these muscles or the tendons (the connective tissue that attaches the muscle to the bone) then certain movements can become painful.  This pain can be felt in the top back area of our shoulder or even into the outside upper arm region. Rotator cuff tears can keep you from performing normal daily movements, lifting, or participating in your favorite activities pain free.  Some of the more common signs of a rotator cuff tear include:

  1. Pain at night
  2. Pain with raising arm or lowering arm
  3. Weakness in the arm

Rotator cuff tears usually occur in two different ways.  A rotator cuff tear can occur from trauma to the area such as falling on the arm or lifting a heavy object. In this case you will feel immediate pain and likely experience a loss of ability to move your shoulder.  A tear can also occur through overuse of the muscle over time which can cause the muscle and tendon fibers to breakdown gradually. This gradual type of tear usually occurs in the 50 + yr and older population and is treatable without surgery.

What can be done about rotator cuff tear?

Contrary to popular belief surgery is not always necessary for a rotator cuff tear. Each case needs to be examined independently to determine what the best option may be for the patient. Recent research has proven that people who undergo physical therapy alone for rotator cuff tears can have the same outcomes and benefits compared to those who underwent surgery. It is important to consult with a trusted and qualified medical professional to help you make this decision based on your personal goals.

Rotator Cuff Tendinitis

Rotator Cuff tendinitis occurs when the tendons (the fibers that connect the muscle to the bone) are overused and become irritated. This over use can lead to inflammation in the tendon and cause pain with movements especially during and after activities that require more use of the shoulder. This most commonly occurs in weight lifters, athletes, and laborers who perform similar motions repetitively. The key to treating rotator cuff tendinitis is to understand the factors that are causing more stress and load to be placed on the tendon. Once those factors are identified and corrected then normal pain free motion can occur. Some of the common signs of rotator cuff tendinitis include:

  1. Pain during and after activity (which may last until the next day)
  2. A dull ache in the shoulder and upper arm region
  3. Pain that gets better with ice and rest.

Rotator cuff tears usually occur in two different ways.  A rotator cuff tear can occur from trauma to the area such as falling on the arm or lifting a heavy object. In this case you will feel immediate pain and likely experience a loss of ability to move your shoulder.  A tear can also occur through overuse of the muscle over time which can cause the muscle and tendon fibers to breakdown gradually. This gradual type of tear usually occurs in the 50 + yr and older population and is treatable without surgery.

What can be done about rotator cuff tear?

Contrary to popular belief surgery is not always necessary for a rotator cuff tear. Each case needs to be examined independently to determine what the best option may be for the patient. Recent research has proven that people who undergo physical therapy alone for rotator cuff tears can have the same outcomes and benefits compared to those who underwent surgery. It is important to consult with a trusted and qualified medical professional to help you make this decision based on your personal goals.

 What can be done about Rotator Cuff Tendinitis?

Rotator cuff tendinitis is a treatable condition that does not require surgery, medications or injections.  The first step required to successfully treat this condition is to understand which specific movements bring about the pain. After this then a proper load management program must be put in place. Typically with tendinitis it is a case where the tendon has been placed under too much “stress” or “load” which causes it to become painful. Managing the load/stress placed on the tendon is crucial to achieving full recovery. Once these two steps are completed a proper strengthening/stability program can be put in place to make sure that the rotator cuff tendinitis pain does not return. The main point to understand is that this is a treatable condition and you can restore pain free movement with the correct treatment program from a trusted medical professional.

Frozen Shoulder (Adhesive Capsulitis)

Frozen Shoulder which is also known as adhesive capsulitis is a condition in which there is loss of mobility and increased pain in the shoulder. This loss of motion and pain usually occurs gradually over time and can last 12 -18 months. Evidence has shown that this condition mainly affects middle aged women and occurs at increased rates with those who have diabetes or thyroid conditions. People who have frozen shoulder also have an increased risk for it occurring in the opposite shoulder as well. There is still debate on what exactly causes frozen shoulder. It is believed that the condition can be brought about by inflammation to the shoulder joint, an initial shoulder injury that progresses to frozen shoulder, or the body “attacking the shoulder joint” such as would happen in an autoimmune response. Some of the common signs of frozen shoulder include:

  1. Pain in the shoulder and inability to tuck shirt in the back or clasp bra strap
  2. Loss of motion and increase pain when moving shoulder in any direction
  3. Pain when sleeping at night

Frozen Shoulder (Adhesive Capsulitis)

Frozen Shoulder which is also known as adhesive capsulitis is a condition in which there is loss of mobility and increased pain in the shoulder. This loss of motion and pain usually occurs gradually over time and can last 12 -18 months. Evidence has shown that this condition mainly affects middle aged women and occurs at increased rates with those who have diabetes or thyroid conditions. People who have frozen shoulder also have an increased risk for it occurring in the opposite shoulder as well. There is still debate on what exactly causes frozen shoulder. It is believed that the condition can be brought about by inflammation to the shoulder joint, an initial shoulder injury that progresses to frozen shoulder, or the body “attacking the shoulder joint” such as would happen in an autoimmune response. Some of the common signs of frozen shoulder include:

  1. Pain in the shoulder and inability to tuck shirt in the back or clasp bra strap
  2. Loss of motion and increase pain when moving shoulder in any direction
  3. Pain when sleeping at night

What can be done about Frozen Shoulder (Adhesive Capsulitis)

A structured program that includes hands on treatment to loosen up the joint and muscles along with flexibility and strengthening exercises can help alleviate the pain associated with frozen shoulder. There are 4 different stages of frozen shoulder. The stage that you are in will determine what exercises, stretches, or treatment will work best for you. The stages are 1. Pre freezing 2. Freezing 3. Frozen and 4. Thawing.  Once the correct stage is identified you can perform specific flexibility and strengthening exercises to help decrease pain and improve your mobility. Surgery or other invasive procedures are not necessary for this condition as it has a natural course of 12-18 months.