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This article was published 27/06/2022 (814 days ago), so information in it may no longer be current.

a Look at Shoulder Pain and Immobility

According to Sport Manitoba Clinic Director and physiotherapist Rickie Walkden, there is a lot of misinformation on shoulder pain and rehabilitation on the internet. Requiring painful rehabilitation for successful shoulder rehabilitation is one of them. Walkden has seen her fair share of shoulder injuries over the years. As a physiotherapist at a sport focused clinic, she treats various injuries, including shoulder pain and immobility. Education, she explains, is a key part of rehabilitation, including assessment and treatment.

Walkden is surprised how many people assume they must live with pain. Many patients wait six months to a year before seeking help, Walkden said. To address shoulder pain and immobility, she recommends seeking assessment sooner rather than later. Shoulder pain does not usually get better on its own. Patients who have pain caused by trauma, such as through a slip or fall, should contact a doctor right away. It may be that an orthopedic surgeon has to reattach a torn tendon, a torn labrum, or manage a fracture or dislocation.  Left untreated, surgery later may have a less successful outcome. Physiotherapy treatment should then follow.

Clinical Assessment

Assessment by a physiotherapist is often a key part of making a diagnosis. Walkden explains that the shoulder is a complicated ball and socket joint. Unlike the hip, which is built for stability, the shoulder sacrifices boney stability for mobility. Stability in the shoulder comes from soft tissues, which can be at risk of being torn, inflamed or injured.

Often patients Walkden treats come with shoulder injuries involving what is called “impingement”. Impingement is a process that happens when there is dysfunction or imbalance in the soft tissues that give our shoulders stability – this may mean tendinosis, bursitis, a cuff tear, posterior capsule tightness, and also a muscle imbalance in the postural muscles in the neck and upper back.  Impingement is essentially caused by inflammation which results in pain. Pain, Walkden explains, “turns off the light switches in the rotator cuff”. In other words, the pain prevents the cuff from firing properly and communicating with other muscles of the shoulder. This results in improper movement of the shoulder and can cause ongoing impingement of the rotator cuff tendons and bursa causing more pain and inflammation. It becomes a vicious cycle that your physiotherapist can help break, Walkden said.

Treatment

People may find that when they rest the pain goes away, but when activity is resumed, it comes back. When treating a patient, Walkden usually advises patients to take, “a hard stop on all activities outside of daily living”. With education, a strengthening regime, and weekly treatment visits, patients can often achieve non-surgical management of pain and restored mobility.

Along with education and treatment, patience is needed. The human body has tremendous capacity to heal, but it often takes place gradually with regular treatments and exercises. In most cases, Walkden said, impingement can take six to eight weeks of rehabilitation with proper management, as physiotherapists need to help manage the underlying cause of the impingement.

There is a lot more that could be said about shoulder pain and immobility, Walkden explained. Shoulder rehabilitation, managed with the intervention and support of a physiotherapist often results in successful outcomes of significant pain reduction and restored mobility. You don’t have to live with pain and immobility.