A shoulder injury is a common cause of decreased function in daily life, affecting activities at home, work, and in the community. Proper diagnosis and management are essential to restore function and prevent further complications. Your physical therapist can use the following considerations to help diagnose, treat, and guide you through recovery.
Key Considerations in Diagnosing Shoulder Injuries
When evaluating your shoulder injury, your physical therapist will examine the following factors:
- Onset and Duration: Is the injury acute, chronic, insidious, or traumatic?
- Source of Pain: Is the source of the shoulder pain or dysfunction musculoskeletal in origin—such as from muscles, tendons, ligaments, or joints?
- Or is it systemic, which could indicate a medical condition requiring attention from a physician?
- Referred Pain: Not all pain felt in the shoulder originates from the shoulder itself. Pain may be referred from the neck, upper back, or even internal organs.
While most shoulder injuries seen in outpatient physical therapy are musculoskeletal, it is important to remain vigilant for signs that may suggest a non-musculoskeletal cause. If your therapist determines that additional medical workup is required, they will assist you with the next steps.
Comprehensive Shoulder Assessment
Once your therapist establishes that the pain is truly originating from the shoulder, a detailed assessment is necessary. This includes evaluation of:
- Global Shoulder Mobility: Assessing overall movement of the shoulder joint and scapula (shoulder blade).
- Glenohumeral Mobility: Your therapist will check how well the ball and socket shoulder joint moves while checking for movement restrictions or excess movement.
- Scapulothoracic Mobility: Your therapist will observe the movement of the shoulder blade on the rib cage, which is essential for full shoulder function.
- Strength: Your therapist will test the strength of the rotator cuff, scapular stabilizers, and surrounding musculature.
- Tissue Tension and Tenderness: Your therapist will touch the soft tissues of your shoulder to identify areas of increased tension, trigger points, or tenderness in the muscles, tendons, or ligaments.
- Posture: Posture is an important factor that can affect shoulder positioning and function. Your therapist will examine posture to identify patterns that may contribute to shoulder dysfunction.
A thorough assessment to identify deficits in these areas helps pinpoint the source of pain and informs the most effective treatment plan.
What Causes Shoulder Dysfunction and Injury?
Shoulder injuries can arise from a variety of sources, including:
- Muscle Imbalances and Weakness: Weakness in the rotator cuff or scapular (shoulder blade) stabilizers can lead to instability and compensatory overuse of larger muscles.
- Joint Instability or Stiffness: Limited mobility or excessive joint laxity can both contribute to pain and dysfunction. Manual therapy techniques may be used to improve joint mobility, while targeted strengthening exercises can enhance stability.
- Poor Movement Patterns: Faulty movement mechanics, often due to pain or previous injury, can perpetuate dysfunction and increase the risk of re-injury.
The Role of Physical Therapy in Shoulder Injury Recovery
Physical therapy offers a conservative (non-invasive), evidence-based (backed by research) approach to managing shoulder injuries. At Rise, our physical therapists are trained to identify the underlying causes of pain and dysfunction, and to develop a personalized plan of care to help eliminate pain and get you back to full activity.
A comprehensive plan of care for shoulder pain or injury includes:
- Manual therapy such as dry needling or joint mobilizations to address joint or soft tissue restrictions.
- Therapeutic exercises to restore strength and mobility.
- Education on posture and movement strategies to prevent recurrence.
How Long Does Physical Therapy for Shoulder Injuries Take?
It is important to recognize that conservative management through physical therapy services requires time and consistency. Recovery timelines can vary depending on factors such as tissue type, severity of injury, and whether the issue is acute or chronic. Adherence to your prescribed home exercise program is essential for optimal outcomes. While tissues have a natural capacity to heal, appropriate interventions during the healing process are critical to ensure efficient and effective recovery, and to reduce the risk of future injury.
Shoulder Healing Timelines
- Tendonitis/Tendinopathy: Between 2 weeks and 6 months depending on severity
- Early treatment is key!
- Post-operative shoulder conditions: 6-12 months for complete recovery
- Muscle strain: 2-8 weeks if mild
- Muscle tear or severe strain: 4 weeks-6+ months
Shoulder injuries can significantly impact your quality of life, but with a comprehensive assessment and a structured rehabilitation plan, recovery is achievable. If you are experiencing shoulder pain or dysfunction, consider consulting a physical therapist at Rise. Our team is dedicated to helping you identify the source of your pain and guiding you on the path to recovery.
Matt Palmer joined Rise Physical Therapy in June of 2023. He is originally from St. Louis, MO. He received his undergraduate Bachelor of Science degree in Health Sciences with an emphasis in Physical Therapy at the University of Central Arkansas before receiving his Doctor of Physical Therapy (DPT) at Missouri State University. Matt enjoys working with patients who present with a variety of musculoskeletal conditions. He values every opportunity in the clinic and strives to create a safe and positive environment as he and the patient work together to achieve the patient’s goals. In his free time, Matt enjoys golfing, fishing, and attending Razorback games during basketball and football season. He and his fiancé also just welcomed their Bernese Mountain Dog, Reece, to their family!
