At Global Physiotherapy, we frequently evaluate patients with shoulder pain. We see everything from hockey players who have had repeated dislocations to avid golfers with a diagnosed rotator cuff tear. Shoulder pain is also associated with chronic neck and posture problems and can result from an injury caused by overreaching or falling.
Unfortunately, the incidence of rotator cuff strains and tendinitis increases as we age. The small tendons that attach to the ball of the upper arm bone (the humerus) become more fragile and blood supply to the shoulder muscles is weaker than in other areas of the body, such as the hands.
A Global Physiotherapy Upper Quadrant Assessment
Our experienced physiotherapists dedicate approximately an hour of one-to-one time to complete a detailed posture exam and evaluate your neck, shoulder, and lower arm. We feel that it is important to get a complete picture of the contributing factors to your pain. Often, we find issues on the opposite side of the body to your pain. These need to be addressed during your shoulder physiotherapy to resolve the condition.
How Does My Neck Cause Shoulder Pain?
The nerves that supply the muscles and tissues of the shoulder come from the neck. Many people are in the habit of keeping their head forward in front of the shoulders. A crease in the skin low on the neck is a sign of this chronic posture habit. Unfortunately, this same place has a nerve heading to the shoulder and arm. Chronic narrowing of the space where the nerves exit results in impaired blood supply to the nerves. The spinal nerves become irritated and, in turn, provide low-grade stimulation to the structures they supply. This results in muscles with a lower threshold to stimulation that can be vulnerable to strain or overuse with everyday activities. Combine this with age-related changes to the tendons, and a partial tear or tendinitis can develop.
The Muscle Puzzle of Shoulder Pain
The shoulder is a confusing area of the body because the cause of pain is not necessarily the area of pain. For instance, the rotator cuff muscles near the front of the shoulder can cause symptoms in the back of the shoulder. Furthermore, people often experience pain down the arm, which can also benefit from shoulder physiotherapy. An experienced physiotherapist will decode the muscle puzzle, explain where your injury is, and outline how global physiotherapy treatments can resolve your shoulder pain.
If you injured your shoulder one to four weeks earlier, the rotator cuff tendons may still be inflamed. This type of shoulder pain improves with ice and anti-inflammatory medicines or creams. However, if the pain keeps returning, you need help to improve the cell chemistry required for healing.
Laser and Regenerative Photon Therapy™ (RPT) is a state of the art solution that will help your muscles heal. The technology works with the cell messengers in your body to improve oxygen in the tissue, decrease swelling, increase the energy source for healing, decrease inflammation, and bring the repair cells through an increased blood supply. This technology works differently from ultrasound used in traditional physiotherapy practice. It has the capacity to treat more than one injured tendon effectively and results in quicker recovery.
Rotator Cuff Tendinosis
If your symptoms have been present for longer than a month or if you have injured your shoulder before, it is likely you have tissue changes in the tendon. This is called tendinosis. The challenge is to replace the abnormal tissue with healthy tendon tissue.
At Global Physiotherapy, our experienced physiotherapists target the tendons with manual techniques as well as with laser and RPT chronic treatment strategies. Often, clients with rotator cuff tendinosis will have reduced nerve flexibility and fascia tightness patterns combined with poor posture habits.
Frozen shoulder, or capsulitis, usually develops after trauma. Typically, patients suffer from a period of tendinitis that progresses to tendinosis. Persistent pain leads to the individual limiting the use of their shoulder to decrease pain. The condition is more common in the non-dominant arm.
The experienced physiotherapists at Global Physiotherapy have numerous treatments to assist in resolving frozen shoulder. We may include some of the following types of physiotherapy for shoulder pain to assist you in regaining functional motion:
- Manual therapy
- Laser and RPT
- Medical acupuncture
- IMS (intramuscular stimulation)
Post-Surgical Shoulder Rehabilitation
Global Physiotherapy staff are experienced with post-operative protocols to help you recuperate from a rotator cuff repair. For more information, please contact us.