Best Physiotherapy Methods for Treating Shoulder Pain

Shoulder pain is a common ailment — affecting 18% to 26% of adults — but that doesn’t mean it’s ever convenient. The shoulder has the most range of motion of all our joints, so it’s not surprising that shoulder pain and injuries are both common and incredibly uncomfortable.

The shoulder joint is made up of three main parts:

  • Humerus (the upper-arm bone)
  • Clavicle (the collarbone)
  • Scapula (the shoulder blade)
Physical Therapy for Shoulder Pain

Common Injuries that Lead to Shoulder Pain 

Knowing why you’re experiencing shoulder pain is the first step to treating it, and shoulders can be injured by a variety of activities, including seemingly harmless ones, like sitting at your desk at work. The types of shoulder injuries can be neatly divided into two main categories: sudden injuries and injuries born from overuse.

Sudden Injuries

Also known as acute injuries, these can be the result of anything from tripping and landing on your shoulder to twisting the shoulder in an unnatural way. Sudden injuries can include:

  • Bruises
  • Injured tendons, which connect the muscle to the bone
  • Injured ligaments, which help keep the shoulder joint stable
  • Injured nerves
  • Torn rotator cuff, which happens when any of the four tendons that cover the shoulder joint is damaged
  • Strained muscles
  • Broken bones
  • Dislocation

After an acute shoulder injury, you’ll likely see bruising or swelling straight away, and you may feel tingling or numbness if the injury resulted in a pinched nerve or damaged blood vessel.

Shoulder Pain

Overuse Injuries

Overuse injuries can be more sinister than acute injuries since they can develop slowly over time as a result of your everyday activities. They’re the result of the shoulder joint or the surrounding tissue facing excess stress, and you may not even realize anything’s wrong until you suddenly find yourself with an annoying shoulder pain to deal with. Overuse injuries can include:

  • Bursitis, which is when the fluid sac cushioning and lubricating the shoulder joint becomes inflamed.
  • Tendinitis, which is when the tendons become inflamed.
  • Muscle strain.
  • Frozen shoulder, which “freezes” your shoulder’s range of movement.
  • Impingement syndrome, which is when overhead arm movements force the tendons to rub against a part of the shoulder blade, which can lead the rotator cuff tendons to become inflamed.

While acute and overuse injuries are the most common reason for shoulder pain, there are a handful of less-common injuries that can also affect your shoulder, including:

Physical Therapy Treatments for Shoulder Pain

Depending on the specifics of your injury, the shoulder therapy that your physical therapist will prescribe will likely include one or more of the following types of treatment:

Ice therapy

Ice and Cold Therapy

The RICE (Rest, Ice, Compression Elevation) modal encourages icing injured spots for acute injuries. It helps reduce inflammation and swelling, which, in turn, helps reduce pain, as well.

Heat therapy

In contrast to ice therapy, which used within the first hours of the injury, heat therapy is best used after 72 hours have passed. Like ice therapy, it’s also a painkiller and allows muscles to relax.

Hands-on therapy

Hands-on-Therapy

As the name implies, hands-on therapy requires the physical therapist’s help to relax the injured shoulder. With their hands, the physical therapist uses direction-specific pressure on the tissue to help it regain some of its natural mobility.

Stretching

Streching

Stretching is a common type of therapy for shoulder pain since it’s designed to gently push your muscles further and further until you regain your range of motion. The physical therapist will likely incorporate varying levels of stretches that may target the parts of the shoulder as well as the neck and spine, depending on the injury.

Strengthening

Strengthening is essentially another way of saying exercise since the physical therapist may recommend you practice specific strengthening exercises to reduce the pain at the injury site while also strengthening other muscles, like your core. The goal is to leave you stronger than before the injury in an attempt to prevent its reoccurrence.

Joint mobilization

Another type of therapy in which the physical therapist’s help is necessary, joint mobilization aims to increase the injured shoulder’s mobility by stretching the joint capsule. Because it requires a thorough understanding of anatomy, it’s only performed by a trained, professional physical therapist.

Ultrasound

USD

A therapeutic ultrasound — not to be confused with a diagnostic ultrasound — is a type of physical therapy for shoulder pain in which the muscles, tendons and other soft tissue are treated to a session of deep heating. The heat improves the circulation in the tissue, which both alleviates pain and assists in healing the injury. Therapeutic ultrasounds also help increase the elasticity of muscles, especially in cases of frozen shoulder, in order to allow the muscles to stretch more easily and, thus, increase the range of mobility.

Electrical stimulation

One way to strengthen the muscles of the injured shoulder is to stimulate the nerves. Sometimes, it’s used to contract muscles or reduce inflammation, but it can also be used as a way to administer medication.

Athletic taping

Your physical therapist may opt to use athletic tape as part of your shoulder physical therapy in conjunction with other methods of therapy, such as exercises.

Taping

Kinesiology taping

 While athletic taping aims to limit movement, kinesiology taping encourages movement in a safe and secure way while increasing circulation. Depending on the type of shoulder injury you’re suffering, the physical therapist may use one of these taping methods or neither.

Kinesiology taping encourages movement in a safe and secure way while increasing circulation

Activity modification

To reduce the likelihood of your shoulder injury returning, your physical therapist will provide you with ways in which to modify the way you perform everyday activities, so your shoulders are properly supported. For example, if you’re dealing with a frozen shoulder, the physical therapist may suggest you avoid excessive rest for your shoulder.

Workplace ergonomics

 In this day and age, it’s almost impossible for some people to not be sitting at their computer desk for upwards of eight hours a day. Ergonomics is something your physical therapist will likely discuss with you — its aim is to find ways to ensure your body is getting the proper support it needs. This could be anything from doing specific exercises at your desk or investing in a new office chair.

Home exercise program

The shoulder physical therapy exercises you do with your physical therapist will likely need to be maintained to some extent once your sessions are complete. The physical therapist will curate a set of at-home exercises to help maintain the progress you’ve made. They’ll practice the exercises with you during sessions, so you can be confident in how to do them when you get home.

Physical Therapy Exercises for Shoulder Pain

While specialized exercises are best prescribed by your physical therapist to target your specific shoulder injury, for everyday shoulder pain, there are certain exercises that you can do at home. These exercises may be part of the physical therapy treatment plan, but they’re also a good way to loosen up any tightness or tension in your shoulder and potentially help prevent an injury from occurring.

As with any exercise, it’s important to know your limits and not push yourself too hard and risk another potential injury.

Across the Chest

Across the chest

Bring one arm across your chest and hold it in place with your other hand. Release your arm and repeat with the opposite arm.

This is one of the easiest physical therapy shoulder exercises out there. It’s great to do while sitting at your desk at work, while watching TV or even as part of your daily morning stretches. It’s designed to help the shoulder joint and its muscles maintain or improve flexibility and range of motion.

Pendulum

Pendulum

With one hand resting on the back of a chair, allow your other arm to hang loosely and circle it a few times both clockwise and counter-clockwise. Then release and repeat on the opposite side. Doing this exercise a few times a day will help increase flexibility, and it’s also great for warming up your joints before a workout.

Doorway Stretch

Doorway Strech

Stand in any doorway with both elbows forming right angles. Step one foot forward while pressing your palms into the doorway and lean forward slightly, using your core muscles to remain steady. Repeat the move with the other foot and complete a handful of repetitions to let your chest and shoulders stretch and strengthen.

Downward Dog

Downward Dog

Better known as a popular yoga pose, Downward Dog is great for stretching and strengthening the muscles in your shoulders as well as your back. Start on your hands and knees, then press into your mat with your palms to lift your hips up. Keep your knees a little bent if you need and distribute your weight among your palms and feet. Your spine should be straight, with your head pulled towards your feet, allowing your shoulders and back to properly stretch out above your head.

Neck Release

Neck Release

To give our neck and shoulder muscles a little relief, gently dip your head until your chin is touching your chest and feel the stretch in the back of your neck. Then, gently lift your head a little and tilt it to one side to allow the opposite shoulder to stretch. Then, repeat the tilt on the opposite side.

Chest Expansion

Chest Expansion

Standing with your arms behind you holding an exercise strap or towel, gently move your shoulder blades toward each other, opening up your chest. Lift your chin to look up. Deepen the stretch by bringing your hands closer together on the strap or towel.

This stretch is great for encouraging flexibility as well as improving your shoulders’ range of motion.

Seated Twist

Seated Twist

If you practice yoga regularly, you’ll recognize the seated twist. If you’re not familiar with yoga, you can do this twist while seated on a chair. Make sure your hips are facing forward throughout the stretch and allow the stretch to begin in your lower back. Your knees should be in line with your ankles, and as you twist to one side, bring the opposite hand to rest on your thigh. Hold the stretch before gently turning to repeat it on the opposite side.

When to Start Shoulder Physical Therapy

It can be tricky to identify when your shoulder pain is bad enough to warrant professional medical attention, but a good rule of thumb is to see your doctor as soon as your shoulder pain is noticeable, especially if it begins to prevent you from doing everyday activities. Your doctor may recommend you see a physical therapist, but you don’t have to wait for their recommendation. If you feel you could benefit from professional physical therapy, you won’t be doing any harm by at least meeting with one, so they can examine the extent of the injury.

Ideally, sooner is better when it comes to seeing a physical therapist and beginning physical therapy for your shoulder pain. This is especially crucial if you suspect you may be suffering from an overuse injury, which often doesn’t become noticeable until the injury is more serious. The longer you leave a potential shoulder injury without adequate treatment, the worst it is likely to get. Prevention is often better than the cure, but in the case of shoulder injuries, getting physical therapy sooner rather than later can both prevent your injury from getting worse and reduce the chances that you may need surgery.

Leaving the injury too long always may end up costing you more money in the long run since a more severe injury will require more treatment. Plus, seeing a professional physical therapist who is well-versed in human anatomy is an excellent way to help you fix any problematic activities or habits you may have, allowing you to both heal and successfully prevent future injuries.

So, as soon as you suspect you may be dealing with shoulder pain or a shoulder injury, it’s a good idea to seek medical advice.

Dr Rohit Bhaskar, Physio
Dr Rohit Bhaskar, Physio Dr. Rohit Bhaskar, Physio is Founder of Bhaskar Health and Physiotherapy and is also a consulting physiotherapist. He completed his Graduation in Physiotherapy from Uttar Pradesh University of Medical Sciences. His clinical interests are in Chest Physiotherapy, stroke rehab, parkinson’s and head injury rehab. Bhaskar Health is dedicated to readers, doctors, physiotherapists, nurses, paramedics, pharmacists and other healthcare professionals. Bhaskar Health audience is the reason I feel so passionate about this project, so thanks for reading and sharing Bhaskar Health.

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