What Do I Do About Persistent Shoulder Pain?

Everyone has had joint or muscle pain that steadily disappeared with time.  So what does it mean when the pain doesn’t go away…when the sports cream doesn’t work…when the relief from massage is temporary…when the ice and meds can’t make it disappear…when ” just resting it” just frustrates you further!

Persistent shoulder pain usually persists because there is a much larger issue at hand and a simple fix just isn’t possible.  Shoulder pain can be debilitating and you don’t really understand how much it slows you down until it happens to you.

-Does reaching overhead cause pain?

-Do you wince every time you wash your back or tuck in your shirt?

-Do you brace yourself before reaching for the seatbelt?

-Does it hurt even just lying on your side at night?

The first step in treating persistent shoulder pain is to stop using the internet to diagnose yourself!

If your shoulder pain has lasted for more than a month, limits your range of motion, and impedes upon your ability to function and perform everyday tasks like dressing, bathing, grooming, sleeping or working, it’s time to see a licensed professional.

The shoulder is a complex structure.  For one, there are actually 2 joints that make up what most of us simply refer to as the “shoulder”. The “ball and socket joint” is anatomically referred to as the glenohumeral joint and is made up of the upper arm bone (humerus) and shoulder blade (scapula).  Movements like raising the arm forward, to the sides, behind the back and throwing primarily come from this area. The shoulder complex also includes the scapulothoracic joint where the shoulder blade moves along the rib cage.  It’s responsible for movements such as shrugging.  In actuality, all shoulder movements entail a collective effort from both “shoulder joints”.  Efficient and strenuous shoulder motion requires coordinated and balanced efforts from both areas. Only the eyes of a highly trained professional such as an orthopedic physical therapist can spot these problematic deficiencies.  Poor posture and muscle imbalance can drastically change normal mechanics of the shoulder.  Muscle imbalance can result from weak and/or inhibited muscles(such as rotator cuff,  rhomboids, serratus anterior, lower trapezius etc) , or muscle tightness (subscapularis, pectoralis minor or major, etc).

Whether the injury was due to a fall or impact or came on suddenly “for no reason”, effective treatment of any condition starts with an understanding of the underlying cause of your unique problem.  Arbitrarily treating your own condition based on correlational symptoms is educated guessing at best and can potentially worsen your problem. Whether you have an “impingement syndrome”, rotator cuff strain or tear, “shoulder instability”, labral tear, or scapular dysfunction, there are several treatment interventions that can potentially help.  Pain relief is often the first priority and medical doctors can choose options like non-steroidal anti-inflammatories (NSAIDs) or cortisone injection.  Chau “Joe” Phan is a physical therapist and orthopedic clinical specialist at MVP Sports Center and Physical Therapy and believes, “Physical therapy is a highly effective way to treat persistent shoulder pain. Orthopedic PT’s have the training to identify complex biomechanical deficiencies that can lead to dysfunctional movement patterns of the shoulder.  This can lead to excessive load or strain on muscles and tendons and cause inflammation and pain.  Effective treatment rehab plans start with at least 2 of the following components:

1) A comprehensive evaluation of the shoulder complex that doesn’t just a focus on the area of pain.  “Chasing symptoms” can sometimes lead to missing the underlying mechanism of injury, particularly in cases when the injury wasn’t caused by trauma.

2) Specificity and customization of treatment that is not limited to a pre-set protocol.  What helps one person may not help another.

Physical Therapists can use techniques such as joint mobilization and soft tissue massage, therapeutic exercise, ultra sound, and electrical stimulation to address chronic or persistent shoulder pain.  To know if you may benefit from physical therapy treatment you may want to consult a Physical Therapist.  Clinics like MVP Physical Therapy offer FREE Consultations to assess whether it may be effective for you.

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