Shoulder Problems

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Shoulder Instability

Shoulder instability occurs when the muscles and tendons that hold the shoulder in place are not as tight as they should be, which can cause repeated shoulder dislocations. Traumatic onset instability is the result of a traumatic injury, while atraumatic onset instability is not. The shoulder is the most likely joint in the body to experience dislocation, which is usually caused by sudden impact and can result in shoulder pain and immobility. Sometimes, you can also visually determine that the shoulder is out of place. Physical therapy can help patients increase stability and avoid injuries down the road.

If you are experiencing numbness, discoloration, or a sense of cold in your arm or hand following a dislocation, seek emergency medical attention immediately. These symptoms could indicate nerve or blood vessel damage.

Multidirectional Instability

Atraumatic onset shoulder instability, also called multidirectional instability, is a condition described as the general looseness of the shoulder joint in multiple directions. This condition can be present at birth or develop over time, but either way, it presents with more frequent shoulder dislocations. Physical therapy restores strength, decreases shoulder pain, and increases the stability of the shoulder.

Posterior Dislocation

Most shoulder dislocations are anterior, meaning the shoulder pops out of the front of the shoulder socket. Posterior dislocations, where the shoulder pops out of the back of the socket, are far less common and much more severe. This injury may require surgery for treatment, but some cases can be treated with physical therapy. Treatment focuses on the strengthening of the rotator cuff and retraining movements.

Recurring Dislocations

If you have already experienced a shoulder dislocation, you are at a higher risk of reinjury. Repeated dislocations can result in multidirectional instability and other detrimental conditions. To reduce this risk, consult with your doctor and physical therapist to decide when you should return to full activity. You need to allow your shoulder time to heal completely.

Labral Tears – The glenoid labrum is the ring of cartilage that surrounds the base of the shoulder joint. When this is damaged, it is referred to as a labral tear. Whether traumatic (caused by a single-incident injury) or nontraumatic (caused by repetitive motion), these injuries can be painful and immobilizing. Your physical therapy plan will likely include exercises that will improve your shoulder stability, helping you recover from the current problem and preventing further injury.

Shoulder Tendinitis + Impingement

Impingement occurs when the rotator cuff tendons in the shoulder rub against each other, causing discomfort and stiffness. Tendinitis and impingement are common injuries for those who repeatedly use their arm in an overhead motion, such as in manual labor, swimming, baseball, golf, or tennis. These conditions can also be caused by injury, bony abnormalities, osteoarthritis, or poor muscle strength. If left untreated, impingement can lead to rotator cuff tears.

Your physical therapist will help you increase your range of motion, strength, and stability while also assisting with pain management. As your symptoms improve, your therapy will grow to include specific functional movements so that you can return to your best quality of life.

Adhesive Capsulitis – Also known as frozen shoulder, adhesive capsulitis is the stiffening of the shoulder due to a buildup of scar tissue. This usually takes place after an injury or surgery, where the shoulder has been intentionally immobilized for a period of time. This condition can be painful, but with multiple stages of physical therapy and exercises, your therapist will help you return to normal function.

Shoulder Arthroscopy

Using a small camera called an arthroscope, a surgeon can examine, diagnose, and treat a variety of conditions inside a patient’s shoulder joint and around their rotator cuff. This outpatient surgical option has reduced scarring, quicker recovery, and fewer risks. Physical therapy ensures healthy recovery and helps to maintain good range of motion.

Rotator Cuff

The rotator cuff is the group of muscles and tendons that keep the shoulder in place. Injuries can result from overuse or traumatic incident, and when left untreated, can cause severe shoulder pain and discomfort. Full-thickness tears extend from the top to the bottom of a rotator cuff muscle or tendon, while partial-thickness tears do not extend all the way through. Acute rotator cuff tears occur suddenly, while chronic tears develop over time. Patients with this condition have often experienced shoulder impingement in the past, as well.

Physical therapy differs for acute tears, chronic tears, and post-surgery recovery (if surgery was necessary for the repair), and recovery can take a long time, but it is imperative not to reinjure the shoulder while it is healing. The details of your treatment plan will depend on the severity of the injury, the extent of surgical repair, and your general health and activity level.

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