The shoulder goes through a lot in a single day. It is comprised of an intricate network of ligaments and muscles, with the rotator cuff taking the bulk of the movement and exertion. Not only is it the most flexible joint in the human body, but it is also one of the most unstable. Among athletes, shoulder injuries are quite common, causing more injuries than almost all other parts of the body.
Here at PA Pain, we know the shoulder is particularly vulnerable due to its unique construction. Other joints in the body, such as the ankle or elbow, have a somewhat limited range of motion. A wide range of motion allows it to be a freely moving joint. This leaves the shoulder susceptible to stress, injury, and pain.
The various soft tissues within the shoulder muscles, tendons, and ligaments can be injured from overuse, excessive strain, falls, and improper motion. Treating shoulder pain can be a challenge because it is used so often in the course of daily life. A chiropractor can help relieve shoulder pain and speed healing.
Shoulder pain can be caused by a number of conditions. Injury to the rotator cuff is the most common cause and can be a result of a fall, car accident, or work injury. Any activity that involves repetitive shoulder movement can also cause injury. People who work in an environment that requires repetitive motion or strenuous upper bodywork are also at risk, such as construction workers, truck drivers, and assembly line workers.
How We Treat Shoulder Pain in Philadelphia, PA
Consultation and Exam
At PA Pain & Rehab, every new patient is cared for the same way regardless of what brought them in. Every single patient undergoes a thorough consultation and examination. In preparation for the chiropractic consultation, the patient will be asked to fill out forms that provide background information about their symptoms and condition. Typical questions include:
- When and how did the pain start?
- Where is the pain felt?
- Describe the pain—is it sharp, dull, searing/burning, or throbbing? Does it come and go, or is it continual?
- Did the pain start as a result of an injury?
- What activities/circumstances make it better or worse?
Patients are usually asked to provide information on family medical history, any pre-existing medical conditions or prior injuries, and previous and current treatments provided by other health professionals.
A thorough chiropractic exam includes general tests such as specific orthopedic and neurological tests to assess the range of motion of the spine and shoulder, muscle tone, muscle strength, and neurological integrity. Further chiropractic tests may be necessary to assess the affected area, such as having the patient move in a specific manner, posture analysis, or assessing the motion of the spine.
Findings from the patient’s history, physical examination, and diagnostic tests usually help the chiropractor to arrive at a specific diagnosis. Once the diagnosis is established, we can determine if the condition will respond to chiropractic care.
Specific Chiropractic Care in Philadelphia
Chiropractic care can be very beneficial for the patient with an injury or pain in the shoulder. It helps to reduce and relieve pain, improve range of motion, increase flexibility, and restore function – not only to the neck where part of the problem may stem from but to the shoulder as well. Depending on the type of injury, a variety of chiropractic techniques can be used for treatment. At PA Pain & Rehab, our doctors will assess the patient’s shoulder to determine the best course of action.
Most people think that chiropractic only focuses on adjustments to the neck and back but shoulder pain is the #3 most common complaint coming to the chiropractor, behind low back and neck pain. At PA Pain & Rehab, we can perform adjustments to your shoulder to help increase its range of motion, decrease pain, and increase the overall function of the complex shoulder joint.
Myofascial release is a hands-on approach to managing pain and alleviating physical discomfort. As a therapeutic technique, it focuses on smoothing out the body’s connective soft tissue, aka fascia, to help alleviate pain that may be associated with stiff or tight areas within your musculature.
Myofascial release therapy is based on the idea that poor posture and physical injury can throw the body out of alignment and cause its intricate web of soft tissue to become taut and constricted. When the soft tissue associated with any of the joints of the body becomes restricted, the joint itself will also lose its natural range of motion which can lead to pain and dysfunction. At PA Pain & Rehab, we incorporate a variety of different soft tissue techniques to help aid in the recovery of a shoulder injury.
Custom Therapeutic Exercise Program
We use custom therapeutic exercises to support the shoulder joint adjustments and healthy spinal structure. This will also address muscle weakness and imbalance – tightness in one area and weakness in another. Strengthening exercises will also help to correct forward head posture and upper cross syndrome helping to find the right balance between stability and mobility. Too much of either can lead to more severe problems and compensation in other areas. At PA Pain & Rehab, we’ll design a customized plan from a functional perspective with exercises to do in the office with one of our doctors or at home.
Common Causes of Shoulder Pain in Philadelphia
Bursae are small, fluid-filled sacs that are located in joints throughout the body, including the shoulder. They act as cushions between bones and the overlying soft tissues and help reduce friction between the gliding muscles and the bone.
Sometimes, excessive use of the shoulder leads to inflammation and swelling of the bursa between the rotator cuff and part of the shoulder blade known as the acromion. The result is a condition known as subacromial bursitis.
Bursitis often occurs in association with rotator cuff tendinitis. The many tissues in the shoulder can become inflamed and painful. Many daily activities, such as combing your hair or getting dressed, may become difficult.
Our tendons connect muscle to bone. Most tendinitis is a result of inflammation in the tendon. Generally, tendinitis is one of two types: acute tendinitis, from excessive ball throwing or other overhead activities during work or sport; and chronic tendinitis, due to degenerative diseases like arthritis or repetitive wear and tear due to age.
The most commonly affected tendons in the shoulder are the four rotator cuff tendons and one of the bicep tendons. The rotator cuff is made up of four small muscles and their tendons that cover the head of your upper arm bone and keep it in the shoulder socket. Your rotator cuff helps provide shoulder motion and stability.
Shoulder impingement occurs when the top of the shoulder blade (acromion) puts pressure on the underlying soft tissues when the arm is lifted away from the body. As the arm is lifted, the acromion rubs, or “impinges” on, the rotator cuff tendons and bursa. This can lead to bursitis and tendinitis, causing pain and limiting movement.
Shoulder pain can also result from arthritis. There are many types of arthritis. The most common type of arthritis in the shoulder is osteoarthritis, also known as “wear and tear” arthritis. Symptoms such as swelling, pain, and stiffness typically begin during middle age. Osteoarthritis develops slowly and the pain it causes worsens over time.
Osteoarthritis may be related to sports or work injuries or chronic wear and tear. Other types of arthritis can be related to rotator cuff tears, infection, or an inflammation of the joint lining.
Often people will avoid shoulder movements in an attempt to lessen arthritis pain. This sometimes leads to a tightening or stiffening of the soft tissue parts of the joint, resulting in a painful restriction of motion.
Rotator Cuff Tear
Your rotator cuff is the group of muscles and tendons in your shoulder that hold your arm in place and let you lift your arm overhead. You can damage it through overuse or in a fall. It also begins to show wear and tear as you age. Your shoulder may hurt at night and when you try to lift things. You might hear a crackling sound when you move it.
This condition limits how much your joint will move. Abnormal bands of tissue (adhesions) build up in the joint and keep your shoulder from moving freely. Your shoulder might “freeze” because pain or surgery has made you use it less, allowing the adhesions to build up.
Frequently Asked Questions
Should I see a chiropractor or doctor for shoulder pain?
Initially, we should always try to be as proactive and conservative as possible with our care. That’s why we think it’s best to seek out a chiropractor first to make sure the biomechanics of the shoulder are correct, proper shoulder mobility and the thoracic and cervical spine are in the correct alignment. If you’re dealing with a more severe issue, such as a tear or dislocation, you may want to go with a traditional medical consult.
What are the common signs something is wrong with my shoulder?
A dull or sharp pain, stiffness, swelling, and decreased range of motion are surefire signs of trouble. Some patients are unable to perform simple tasks such as combing their hair, buttoning their shirt, or reaching overhead. Numbness, tingling, or weakness may occur if the pain is linked to a pinched nerve in the neck.
How should I sleep with shoulder pain?
We usually recommend that patients with shoulder pain sleep on their back or on the opposite side of the pain. You should use a pillow to support your shoulder.
Why is my shoulder pain not going away?
We use our shoulders all day long for a variety of different reasons. It can get unbelievably frustrating dealing with pain on a regular basis with no end in sight. When your daily routine and quality of life have been affected due to pain it takes a toll. If the problem has existed for a while, it can take time for treatment to work and for healing to occur. Sometimes it’s hard to be a patient but this is advice we often give.