Shoulder function is essential for the majority of routine tasks, from stretching up to the top shelf of the kitchen cabinet to engaging in a competitive sports match. Unfortunately, there are vast numbers of individuals with shoulder mobility problems as a result of injury, overuse, or the degeneration that comes with aging. Such problems can seriously interfere with life quality: they cause pain and reduce the chances of making movements. Physical therapy exercises can be massively effective in relation to restoration of shoulder function and enhancement in mobility, which is a unique, noninvasive type of management.
Understanding Shoulder Function
The joint that we mostly call the glenohumeral joint is actually one of the human body’s complex joints and most flexible. This is a ball-and-socket-type joint where the round humerus, or upper arm bone, fits into the socket of the scapula (AKA shoulder blade). Unlike the hip joint, for example, the socket of the shoulder joint is actually extremely shallow, being more of a slightly concave surface rather than a true “socket.” This affords a wide range of motion but also makes the shoulder susceptible to instability and injury.
In most cases, shoulders do not inherently lack mobility. Usually if there is a lack of mobility, it stems back to irritation in the joint. Ironically, this irritation actually stems from lack of stability, not mobility. This is why stretching it may result in short term improvements in mobility, but are more likely to result in increased pain. Common causes of limitation in shoulder mobility are:
- Impingement: Excessive movement of the ball within the socket resulting in soft tissues being “impinged” in narrow spaces between the moving bones.
- Frozen shoulder (adhesive capsulitis): Pain and stiffness with limited motion. This can be EXTREMELY painful, is much less common than rotator cuff injuries, but is absolutely treatable.
- Arthritis: Degeneration of the shoulder joint over time, creating the classic “bone on bone” scenario we have all heard about.
- Bursitis: This is an inflammation in the fluid-filled cushioning sacs, also known as bursae.
- Tendinitis: General inflammation of the rotator cuff tendons. Symptoms from restricted mobility at this area may range from a mild resistance to movement to intense pain, which inhibits normal functional movements. This typically arises as a result of regular impingement.
- Injuries to the rotator cuff: Shearing and tearing in the group of muscles and tendons that function in stabilizing the shoulder.
- Labrum tears: Damage to the cup like cartilaginous structure surrounding the edge of the socket.
Will Physical Therapy Actually Work for My Shoulder?
Many people have been lead to believe that their shoulder pain cannot be solved without surgery. They may have been told that they have a rotator cuff tear by a surgeon, or they know they have arthritis, just like their parents did. However, did you know that you can have tears and injuries in your shoulder, yet still function at an entirely high-level, pain-free way? A study in 2016 showed that in 53 people without pain between age 45-60, 69% had labral tears? Another study in 2020 of olympic level volleyball players again without pain showed that 65% of them had rotator cuff tears.
Long story short- you can have tears, but still feel and perform GREAT!
Advantages of Physical Therapy in Shoulder Function
Physical therapy offers several benefits for individuals with problems related to shoulder mobility:
Non-invasive treatment: It is an extremely low risk alternative to the surgical process.
Individual treatment plan: A physical therapist creates an individualized treatment plan for a patient based on his or her unique condition and needs to provide focused and efficient care. In order to really have success, exercises MUST be specific to the body and injury of the person. A generic list of exercises should never be prescribed.
Long-term health and mobility: Physical therapy addresses not only immediate pain and mobility issues but also works on preventing the appearance of future problems by working on the strengthening of the shoulder and improvement of its overall function. The person will also learn so much during the process that they are empowered in understanding the keys to long term success.
Physical therapists use a wide array of techniques for enhancing shoulder function.
Rotator cuff strengthening exercises: These targets should focus on shoulder extension rotator cuff — internal rotation resistive exercises or shoulder retraction external rotation resistive exercises.
Scapular strengthening exercises: Making the scapular muscles strong helps in providing support to the joint and improves mobility. Exercises such as serratus anterior presses, rows, “Ts” and external rotations are often included.
Manual therapy techniques include hands-on techniques to reduce pain and increase mobility, such as joint mobilization, dry needling and instrument-assisted soft tissue massage.
Treatment of the spine is also absolutely vital to success, as any irritation in the upper back and/or neck will interfere with the shoulder’s ability to fire properly and heal well.
It is quite important that a good physical therapy program dealing with shoulder function contains a few major basics:
Evaluation and diagnosis: The physical therapist will perform a Total Body Diagnostic to identify the cause and extent of the problem.
Setting Personal Goals: Based on the assessment and a deep understanding of the patient’s priorities in life, the therapist and patient set achievable goals for recovery.
Prescribe an individualized treatment plan: A therapist designs a program that includes specific exercises and techniques according to the patient’s needs. The monitoring is constant, and the changes are made at EVERY visit to ensure that the treatments and exercises are up to date with the patient’s current state.
Success Stories and Testimonials
Most patients have shown remarkable improvement in shoulder function and pain from this approach. For example, Sarah, aged 45 and a teacher, has been able to recover full movement in the shoulder since the first time she heard about a frozen shoulder diagnosis, and thus, she went back to her normal active life. The other one is John, a retired athlete with chronic rotator cuff pain, who is now enjoying his favorite sport ,pickleball, without pain.
Ways to make shoulders more mobile
Shoulder function needs to be continuously worked upon and sustained by observing the recommended practices as follows:
Consistency: Scheduled exercises should be performed and appointment sessions for therapy kept with regularity to ensure recovery.
At-home exercises: Gentle shoulder exercises can be done during daily activities to maintain flexibility and strength.
Bullet-proofing: When you make improvements, you must build upon what you have done so that the problem really stays away. Future problems can be avoided by keeping a few simple exercises in your routine. Secondly, strengthening often leads to more mobility gains than stretching, which surprises people. Oftentimes however it is pain that restricts motion in the shoulder rather than true tissue tightness. By strengthening, you can improve the ability of the ball to stay in the socket cleanly, reduce irritation, and then the shoulder will just naturally move better without being restricted by pain or impingement.
Physical therapy forms an integral part in re-establishing the functions of the shoulder and getting it to be more mobile. This form of non-invasive, individualized procedure helps restore movements while reducing pain for individuals experiencing shoulder-related problems. The consultation with a professional physical therapist may serve as an effective first step on the road to a pain-free and dynamic life for individuals suffering from shoulder-related problems. The proper health of the shoulder for long-term mobility is always assured with consistent exercise and preventive measures.