SHOULDER PAIN TREATMENT in MISSISSAUGA & ETOBICOKE

Shoulder pain can happen to people of all ages from children to the elderly. Pain from the shoulder can be very intense and cause a lot of limitations with many of our day-to-day activities.

What the most common signs and symptoms of a shoulder injury?

Pain in and around the shoulder
Swelling
Restricted range of motion
Weakness
Sensation of shoulder “popping” out.
Bony deformities

Areas of injury in the Shoulder

Although we commonly think of the shoulder as one joint, it is made up of 4 separate joints. However, despite the number of joints that make up the shoulder complex, the shoulder does not have a lot of bony protection to keep it stable. This basically means that majority of our shoulder joint is held together by soft tissues. This also means that there are a lot of soft tissue structures that can get injured and produce shoulder pain. Below is a list of the most injured structures of the shoulder joint.

Soft tissue structure	How does injury occur?
Ligaments	Ligaments are commonly injured with trauma, such as a sudden overstretching or direct impact Examples of trauma include collisions in sports or motor vehicle accidents
Muscles & Tendons	Muscles and tendons of the shoulder are usually injured with overuse or repetitive activities Sudden traumas, such as a fall or sudden wrenching movement of the arm, can also result in injury to these structures
Joint Capsule	The joint capsule is a support structure that can become a source of pain if inflamed Inflammation of the capsule can happen with overuse, repetitive activities, or previous injury to the shoulder
Bursae	Bursae can get inflamed and produce pain with overuse or repetitive activities of the shoulder
Labrum	The labrum can get injured or torn with sudden trauma such as a direct blow or a sudden fall onto an outstretched arm Overloading the shoulder with excessive weights can also cause injury to the labrum

What are the most common reasons for shoulder pain?

Rotator Cuff Tendonitis
- The Rotator Cuff is made up of 4 different muscles, which work together to stabilize the shoulder.
- The Rotator Cuff tendons are commonly injured due to over-load or repetitive activities that reduce the structural integrity of the tendons over time.
- The most affected tendon of the rotator cuff is the supraspinatus tendon.
Rotator Cuff Tears
- The tendons of the rotator cuff can also get torn with prolonged or sustained overuse activities.
- Tears can also happen through traumas such as falls or sudden jarring motions of the shoulder.
- The tears may be either partial or complete in nature.
- The most torn tendon of the rotator cuff is the supraspinatus tendon.
Frozen Shoulder
- The medical term for frozen shoulder is Adhesive Capsulitis.
- This condition results in a severe loss of movement and function in the shoulder and is caused by inflammation of the joint capsule.
- Trauma to the shoulder can also lead to the development of frozen shoulder if the shoulder joint is not moved through its range due to pain.
- Frozen shoulder tends to occur more frequently in women and in people with Diabetes.
Bursitis
- Bursitis refers to the inflammation for the bursa in and around the shoulder.
- There are 6 bursae around the shoulder, and all are located where there may be a high level of friction between the tissues.
- Bursitis commonly develops because of mechanical faults in the joints or tissues of the shoulder.
Labral Tears
- Tears of the labrum can usually happen with trauma to the shoulder.
- There are different types of labral tears and they can all produce pain and instability in the shoulder.
- Severe tears of the labrum that limit movement and function may require surgery.
Dislocations
- A shoulder dislocation means that the ball of the joint has come out of the socket that holds it in place.
- Shoulder dislocations occur with trauma to the shoulder such as sudden blows to the joint or a fall onto an outstretched arm.
- It is possible to have either complete or partial dislocations and both can produce pain and instability through the shoulder.
Fractures
- Fractures of the shoulder can also happen with trauma, such as falls or motor vehicle accidents.
- The most fractured bones of the shoulder complex are the humerus (long bone of the upper arm) and the clavicle (collar bone).
Post-surgical shoulder
- Most shoulder surgeries are done for tendon repair and most commonly for complete tears of the rotator cuff tendons.
- Other examples of shoulder surgeries include labral tear repairs and shoulder replacements.
- The surgery will repair the damaged structures, but physiotherapy is required after the surgery to regain movement, strength, and function.

Will physiotherapy help with my shoulder pain?

Physiotherapy treatment can help you manage shoulder pain. A Registered Physiotherapist at PhysioNow will do a thorough assessment of your shoulder to understand the nature of your pain or injury.

The physiotherapist will use the information from the assessment to develop a treatment plan that will address the signs and symptoms of your shoulder pain. The specific treatment will depend on the nature of your shoulder pain.

Shoulder pain physiotherapy treatment may include:

Patient Education
- Explanation of the injury and possible timelines for recovery
- Tools for self management of the condition
Manual Therapy
- Soft tissue work
- Joint mobilizations
- Passive stretching
Therapeutic Exercise
- Exercises to improve flexibility, strength and function of the shoulder and surrounding areas.
Adjunct treatments
- Electrotherapies may be used to assist with reducing inflammation and promoting soft tissue healing.
- Examples include ultrasound, laser and interferential current therapy.
- Acupuncture can also help reduce pain and inflammation.

Don’t let your shoulder pain affect your quality of life! We have 4 locations across the communities of Mississauga and Etobicoke to help you manage your pain. Contact PhysioNow to book your appointment and get started today!

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COMMON QUESTIONS ABOUT SHOULDER PAIN TREATMENT

Who is most affected by severe shoulder pains?

Anybody can be affected by shoulder pains. Common causes are injuries to the rotator cuff muscles. Injuries can happen due to trauma or from wear and tear over time.

How are shoulder injuries treated?

We treat shoulder injuries with modalities such as ultrasound and electrotherapy. These are very comfortable treatments to receive. We also do hands on mobilizations for your shoulder to release the tightness. Lastly, we give you very specific exercises that can speed up your recovery.

Will I need surgery for my shoulder pains?

Most people will not need surgery for shoulder pain. Conservative care, such as Physiotherapy is the treatment of choice. The only time that surgery is considered is if you are a major league pitcher or if there is a full tear to one of your shoulder muscles and Physiotherapy has ‘failed’.

What are some warning signs or symptoms of shoulder pain?

Warning signs include: you are having trouble reaching overhead, reaching behind your back or putting your arm into your coat.

What risks are involved with a torn rotator cuff?

Most people can recover well even if they have a full tear to the rotator cuff. We have other muscles that can help even if one is not doing its job. Physiotherapy is very effective in helping you to recover from a full tear. It is often less painful than if you have a partial tear or tendonitis.

What causes shoulder pain to be worse at night?

There are a few reasons why shoulder pain is worse at night. Firstly, during the day you are moving around and doing your day to day tasks. This keeps the shoulder a little more mobile and pain is not as noticeable. However at night, you are not moving around as much and this causes the shoulder to stiffen up more. Secondly, at the end of the day, it is likely that there are less distractions than during the day which makes you more aware of the pain.

I have a popping noise when I rotate my arm. Is their something wrong with my shoulder?

Some noise from joints like popping or clickins is perfectly normal. If those noises are associated with pain or other symptoms then there may be a mechanical reason why it’s occuring. If there is discomfort then it would be a good idea to see a physiotherapist so that they can assess the shoulder and provide any treatment if there is a problem with the shoulder.

Does sleeping on your side cause shoulder pain?

Not necessarliy! However, if there is a history of shoulder pain or a recent injury to the shoulder, then it may be painful to sleep on that particular side.

Does lifting heavy at the gym cause long term damage to a shoulder?

It depends! Lifting heavy doesn’t automatically mean there is going to be damage to the shoulder. There are safe ways to continue with lifting as long as there is proper posture and technique during the lift. Also, it is important to work up to heavier weights over extended periods of time so that there is enough strength in the shoulder to tolerate the lift. However, like any joint, if there is excessive use and repetitive motions over time, this may negatively affect the shoulder down the line. Therefore, it is important to do a variety of strengthening activities and be aware of any developing limitations so that injuries can be prevented.

Does stretching everyday prevent shoulder pain?

Stretching on a regular daily basis will definitely help prevent injury to the shoulder. A physiotherapist can help prescribe the most appropriate shoulder exercises that you can do at home to help maintain good shoulder movement and function.

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