As we explained in our last post, there are several steps you can take to reduce your risk for shoulder pain, but even if you follow these measures to a T, pain may still develop for reasons that are partially out of your control. If you do begin noticing pain in your shoulder or start struggling to perform certain overhead activities, you might be wondering what to do next.
For frequent episodes of pain that interfere with how you function in daily life, we strongly recommend taking a proactive approach and seeing a physical therapist as soon as possible. Physical therapists are movement experts whose goal is to guide patients back to full strength and function with a multifaceted, evidence–based approach. Rather than wait and see if the pain progresses or improves on its own, physical therapists teach patients how to modify their movements and engage in behaviors that reduce strain on the shoulder right away, which will ultimately reduce their pain levels.
Typical physical therapy treatment programs for common shoulder conditions
Most treatment programs will involve some combination of pain–relieving interventions, flexibility and strengthening exercises, manual (hands–on) techniques administered by the physical therapist, and education on how to avoid future shoulder issues. The specific approach used will vary depending on what condition is present, its severity, and the patient’s abilities and goals, but most treatment plans for shoulder pain share several features in common. Below are a some of the more frequently used interventions for various shoulder conditions:
- Rotator cuff/shoulder tendinitis
- Stretching and strengthening exercises, including external and internal rotation, forward flexion shoulder raises, pendulum exercises, and scapular squeezes
- Education on how to improve posture and avoid habits that will further aggravate the shoulder
- Rotator cuff tear
- Passive treatment like ice, heat, and ultrasound to alleviate pain
- Strengthening exercises that target the pectoral and upper back muscles
- Education on how to avoid positions and movements that can further aggravate the shoulder, like sleeping on the side and carrying heavy loads
- Shoulder impingement syndrome
- Stretching and strengthening exercises that target the rotator cuff and scapular muscles
- Manual (hands–on) therapy, which typically includes soft–tissue massage
- Shoulder bursitis
- Stretching exercises like Codman’s pendulum swings and active range of motion exercises
- Strengthening exercises that target the scapular and core muscles
- Ultrasound and other pain–relieving modalities
- Posture education
- Frozen shoulder
- Treatment for frozen shoulder depends on the current stage of the condition, from stage 1 (pre–freezing) to stage 2 (freezing), stage 3 (frozen), and stage 4 (thawing)
- The bulk of treatment consists of manual therapy and stretching and strengthening exercises, which increase in
- intensity with further stages of the condition; activity–specific training is usually added at stage 4
There is an abundance of research showing that these interventions are effective for many shoulder conditions. For example, a recent review of studies called a systematic review found that stretching exercises, strengthening exercises, mobilization, and several other physical therapy techniques were found to reduce pain and improve range of motion and functional status in patients with frozen shoulder. A 2018 systematic review identified moderately strong evidence to support the use of exercise therapy for full–thickness rotator cuff tears, while a 2015 systematic review and meta–analysis concluded that surgery was no more effective than conservative treatment for shoulder impingement. Similarly, a 2019 guideline recommended that patients with a shoulder condition shoulder impingement avoid surgery and instead pursue nonsurgical treatments like physical therapy.
So if you’re dealing with a new case of shoulder pain or a lingering problem that just won’t seem to improve, physical therapy may be your best bet for a safe and successful outcome. Contact us today to learn more or schedule an appointment.