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Physical therapy for shoulder pain.

Shoulder problems are common. Sometimes shoulder pain is also a recurring injury. Possible causes of shoulder pain are heavy physical work or sports. The complaints are often triggered by moving the arm upward. There may be radiation toward the upper arm or toward the shoulder blades. Sleeping on the injured shoulder is often difficult. Especially in the first period after the onset of shoulder pain, it is difficult to carry out your daily activities. Grocery shopping, heavy lifting or sports where you use your arms a lot is often difficult and painful.

The shoulder joint consists of the humerus(upper arm bone), scapula(shoulder blade) and clavicle(collarbone). The joint between the upper arm and shoulder blade is called the glenohumeral joint. The clavicle with the shoulder blade is the acromioclavicular joint. Another joint of the shoulder area is the scapulothoracic joint. This is the joint between the shoulder blade and the ribs. These joints allow the shoulder to move in many different directions. The shoulder contains many different muscles and tendons. The function of these muscles is to move and stabilize the shoulder during various daily movements. There are smaller muscles that are closer to the joint as well as larger muscles that have a more powerful function. Anatomically, a distinction is made between a local muscle system and a global muscle system. Functionally, however, they largely have the same function. 


Physiotherapy for Shoulder Pain

Causes of shoulder pain

We can divide shoulder pain into 3 types:

  1. Under the roof of the shoulder blade, certain anatomical structures can become irritated. You usually feel this when you move the arm up sideways. You should think here of bursitis or tendonitis of one of the shoulder muscles. But also complaints resulting from a fall or aging tendon tissue.
  2. Complaints related to structures between the head and socket of the shoulder. For example, one of the most common complaints here is a frozen shoulder or osteoarthritis of the shoulder joint.
  3. It is also possible to have shoulder pain as a result of neck pain. It may be that symptoms you feel in the shoulder have another cause. Usually then a nerve from the neck is responsible for this pain. Other small joints around the shoulder can also be the cause of shoulder pain. The joint with the clavicle or the joint with sternum may be responsible for shoulder pain.

Common Shoulder Problems

Frozen Shoulder

This condition, also known as adhesive capsulitis, causes pain and limited range of motion in the shoulder, which can make daily activities difficult. It mostly affects women and people between the ages of 40-59, with a higher risk for those with diabetes or autoimmune diseases. A frozen shoulder can pass on its own, with a duration ranging from 4 months to 3 years, and goes through three stages: freezing, frozen, and thawing. Treatment may include pain relief and exercises to restore mobility.

For more information, visit our page on Frozen Shoulder.

Deltoid Tendinopathy

This condition is characterized by pain and stiffness in the shoulder caused by over- or underuse of the tendon tissue. It often leads to movement restrictions and can affect both young and old people. Diagnosis is based on symptoms, physical examination, and possibly additional imaging such as ultrasound or MRI. Treatment focuses on restoring the balance between strain and load on the tendon, with a combination of exercise therapy and appropriate advice for daily activities.

For more details, see Deltoid Tendinopathy.

Shoulder luxation

This condition occurs when the shoulder head dislocates, often due to a fall or direct impact, leading to acute pain and restriction of motion. Diagnosis occurs via X-ray examination, and initial treatment includes reinsertion of the shoulder head. Rehabilitation is crucial to restore shoulder stability and prevent future luxations, with physical therapy playing a key role in strengthening the muscles around the shoulder.

For more information, visit our page on Shoulder luxation.

biceps tendon rupture

A biceps tendon rupture occurs with excessive stress on the biceps, often in older men or due to sports injuries. This can frequently lead to pain near the shoulder. Symptoms include an audible pop, sharp pain, and a visible bulge at the arm. Treatment ranges from physical therapy to surgery, depending on activity level and severity of the rupture. Physical therapy focuses on restoring mobility and strength.

For more details, visit Biceps tendon rupture.

Subacromial Pain Syndrome (SAPS).

This is characterized by pain when lifting the arm or lying on the shoulder. The cause is often irritation of the tendons or bursa in the shoulder. Treatment through physical therapy focuses on reducing pain and improving mobility and muscle strength.

For more information, see Subacromial Pain Syndrome (SAPS)..

Rotator Cuff Rupture

This involves a (partial) tear in one of the four shoulder muscles, often caused by aging or acute injury during sports. Symptoms include pain, loss of strength and restriction of movement. Treatment ranges from physical therapy to surgery, aimed at pain relief and restoration of function, with a recovery period of four to six months.

For more information, visit Rotator Cuff Rupture.

Musculus Pectoralis Minor

Complaints to this muscle, often seen in strength athletes, include pain in the chest and front of the shoulder. Treatment focuses on relative rest, exercise therapy, and if necessary, adjusting posture and strengthening the muscle.

For more information, visit The Musculus Pectoralis Minor.

AC instability

These are injuries to the AC ligament, usually caused by a hard blow or fall, resulting in stretching or tearing. Depending on severity, classified as Tossy 1 to 3, treatment ranges from rest and physical therapy to possible surgical intervention. Symptoms include pain, swelling, and a visibly raised clavicle in severe cases.

For in-depth information, see AC Instability.

Physical therapy for shoulder pain

During the examination, the possible cause of your shoulder pain is examined. Based on the examination, a clear treatment plan will be drawn up. Continued movement with shoulder problems is very important to maintain the mobility in the shoulder. Besides specific advice, the treatment can consist of: restoring mobility through manual therapy, dry needling, various muscle techniques and training the muscles of the upper back and shoulder through exercise therapy.

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