The shoulder is one of the most complex and joints in the human body. It consists of the scapula, gleno-humeral joint, A-C joint, labrum, and has 17 muscles that attach to it. The shoulder needs to be flexible, but also have stability to prevent injury and allow many different actions and movements. When it's injured we want to figure out what tissues are injured in the shoulder so we then know the best treatment and how to get the best response.
What do we look for in the shoulder joint?
There are 4 rotator cuff muscles in the shoulder that stabilize the shoulder during shoulder movement. The larger muscles that attach are involved with the shoulder such as the trapezius, levator scapula, deltoid, rhomboid, biceps, triceps actually move the shoulder during these motions. With a shoulder injury we want to test the rotator cuff muscles for injury. We also want to see if Shoulder impingment is happening, During shoulder inpingement we will also check for scapular dysfunction. Once we have an idea of what tissues are injured and causing pain we can set up a treatment plan.
What does treatment typically consist of for shoulder injuries?
Depending on the type of injury treatment typically consists of adjustments to the shoulder joints and spine, soft tissue work to the injured muscles, in office and home exercises to decrease pain and improve shoulder function. These exercise typically start with stretching and isometric exercises and then progress into resistance exercises and eccentric exercises with bands and weights to improve the strength, improve their function and return them to their activities that have been affected.
How long do these injuries typically last?
Depending on the type of injury I typically will start patient's at 2 times a week with treatment for 3 weeks. In this time we have a minimum goal of 50%, but often are able to improve 70-80% or more. This does depend on if a patient is completing their home exercises.
What about getting back into my functional activities such as Tennis, Workouts, or Golf?
This is important aspect in recovery from a shoulder injury. Typically a patient has to take their rehab and exercises further than the average person if they want to get fully back into their activities. And it is important they do so because this tells us the shoulder is much healthier and at decreased odds to have further injuries. With a progressive rehab/exercise/treatment program this allows us to continue to increase the activities patients are able to do. With these activities we can also track a patients progress. If in the beginning they are not able to swing a golf club without pain and by the end of their treatment they are not only able to swing a golf club, but play 18 holes of golf, not have pain during or days after, and also hit the ball further and better this is obvious improvement.