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Shoulder Pathology - What is Causing Your Shoulder Pain and How You Can Remedy It!

By Koren Lavi - October 16, 2020

What is causing your shoulder pain and how you can remedy it!

Many types of shoulder pathologies are contributed to by decreased subacromial space. Thats the space between your arm bone (humerus) and shoulder-blade bone (scapula). The soft tissue of our body can get impinged or "pinched" between these bones causing irritation. The soft tissue that most frequently get impinged is the biceps tendon, the supraspinatus (a rotator cuff muscle), and the subacromial bursa (a fluid filled sac that acts as a cushion). Very commonly, when there is an issue with the shoulder joint, our patients often complain of aching or sharp pain in the shoulder joint. Often times these symptoms occur during overhead reaching, forward reaching, and reaching behind the back. 

Seeking timely medical attention from your orthopedic doctor or physical therapist is critical to prevent permanent damage of these soft tissue structures. Additionally, lack of timely treatment may cause secondary issues such as stiffness, weakness, and instability of the shoulder. A lot of the time, pain and inflammation after an initial injury persists with lack of shoulder motion. 

With these kinds of injuries the old "no pain no gain" adage DOES NOT APPLY.

First, the goal is to reduce inflammation through a combination of anti-inflammatory medications and pain-free motion. Initially physical therapy should include soft tissue mobilization to relax tight or "guarded" muscles. PT should also start by including exercises such as pendulum or Codman's exercises to temporarily increase the subacromial space (check out this post for those exercises).

During this time it is crucial to work on range of motion to combat stiffness. After inflammation and stiffness begin to subside, it is important to work on strengthening (pain-free!) to begin regaining stability in the shoulder joint.

To seek a more specific plan of care tailored to your specific needs, come in and get an evaluation from one of our licensed doctors of physical therapy!