What makes up the shoulder?
The shoulder is comprised of several bones, which form joints that are held together with ligaments, tendons, and muscles. The manner in which the shoulder is constructed allows the arm to move very freely in order to perform such dynamic activities as washing your back or throwing a ball.
Unfortunately due to the wide range of mobility the shoulder joint has it often leads to increasing problems with instability, impingement, and often tearing of the soft tissue structures in your shoulder which results in pain and dysfunction.
Most causes of shoulder pain can be easily treated if it they are addressed quickly, but more often than not the pain is ignored until it becomes severe at which time an increased amount of damage has occurred and effective treatment becomes more challenging.
What are common causes of shoulder pain?
The most common cause of shoulder pain is inflammation (tendinitis, bursitis, arthritis). But pain can also be due to a torn tendon (attaches muscle to bone), muscle, ligament (attaches bone to bone), or torn cartilage (lining that protects the joint surface). Tears often, but not always, require surgical intervention followed by physical therapy care. Some other less common causes of shoulder pain but very important to be aware of and rule out are nerve impingement, fractures (broken bone), or even tumors.
Can physical therapy help?
Yes physical therapy can absolutely help. What we as Doctors of Physical Therapy do is not only treat the problem, but more importantly we try to identify the cause of the problem so that it does not become a reoccurring issue. We will perform a thorough evaluation to determine a diagnosis as well as determine what may have led to the injury. There are many contributing factors that need to be considered such as poor body mechanics, muscle imbalances, overuse, age, improper athletic equipment (example: too large or heavy a tennis racquet).
Once we appropriately diagnose the injury and hopefully determine what caused it we can then begin to formulate and implement an appropriate physical therapy plan of care that will address these issues.
What would a physical therapy session for shoulder pain consist of?
Our goal in physical therapy is to develop a plan of care that will help decrease pain, inflammation, and swelling, along with increasing range of motion, flexibility, muscle strength, muscle endurance, and muscle balance. This is all done with the goal of returning a patient or athlete back to their maximal functional ability so they can perform at their best in work, sport, or life!
In order to effectively achieve this we utilize a combination of modalities (example: electrical stimulation, ultrasound), therapeutic exercises, and manual therapy (examples: joint mobilization, soft tissue massage, muscle/tendon scrapping, stretching). Based on the patient/athletes specific injury we determine which if not all of the aforementioned treatment tools to incorporate into their treatment protocol.
How long does recovery take?
Recovery could take as little as 2 weeks and as many as 6 months. It is dependent upon the extent of the injury, how long the injury has been present, whether surgery was involved, the age of the person, and most importantly how consistent they are with attending their physical therapy sessions and how well they follow the plan of care developed by their physical therapist.
Do I need to see my Medical Doctor prior to seeing a Doctor of Physical Therapy?
Not necessarily, Arizona is a direct access state which means a Doctor of Physical Therapy can evaluate diagnose and treat without needing a referral from a Medical Doctor*. But that does mean we discourage our patients from seeing their medical doctor first if they so choose. Also, dependent upon the nature of the injury and what our evaluation reveals we often will refer our patients out to orthopedic surgeons, rheumatologist, or neurologists for further evaluation and care.
*Medicare and a few managed care insurance plans still require that individuals receive a prescription from an MD prior to receiving PT care. We will contact your insurance company to see if this is the case prior to you attending your first visit to avoid any confusion.
Rehab Plus of Ahwatukee
4730 E. Warner Rd. #5
Phoenix, AZ 85044
Dr. Keith Pritchette, PT, DPT, AT