Shoulder Impingement Treatment in Visalia – Surgery Is Not Your Only Option

If you have pain in your shoulder, there’s a strong chance shoulder impingement syndrome is responsible

If you look at an x-ray or an MRI of your shoulder, and the doctor tells you that your rotator cuff and bursa are being pinched, you may think that the only shoulder impingement treatment in Visalia is a knife.  Let me share another natural option.

The shoulder is a complex joint consisting of numerous tendons, ligaments and muscles that allow the arm to move in several different directions. These structures help keep the shoulder stable and are crucial for its flexibility, but they also make it vulnerable to a number of injuries. This is one of the main reasons shoulder pain is so common, especially in individuals who perform lots of overhead movements. In most cases, this pain is due to a condition called shoulder impingement syndrome, but the good news is that physical therapy can help, regardless of its cause.

The shoulder is made up of three bones: the upper arm bone (humerus), the shoulder blade (scapula) and the collarbone (clavicle). The humerus and scapula are surrounded and connected by the rotator cuff, which is a group of muscles and tendons that keeps the shoulder stable and allows for the ball-and-socket movements of the joint. There is also a fluid-filled sac called the bursa between the rotator cuff and a bony prominence on the top of the scapula (acromion), and its function is to provide a cushion during movement.

In shoulder impingement syndrome (SIS), the tendons of the rotator cuff become compressed—or “impinged”—as they pass through the narrow space beneath the acromion. Over time, this causes the tendons to become irritated and inflamed, and will lead to bothersome symptoms like swelling and tenderness, loss of strength, restricted shoulder movement and shoulder pain at rest, when moving the shoulder overhead and/or when sleeping.

SIS is most common in individuals that regularly perform lots of overhead activities like golfers, swimmers, and baseball and tennis players, as well as painters and construction workers. If the condition develops, it’s strongly advised to receive physical therapy as soon as possible in order to prevent it from progressing further. Physical therapy for SIS typically consists of the following components:

  • Activity modification/functional training
  • Stretching exercises
  • Strengthening exercises
  • Hands-on (manual) therapy
  • Posture education

A recently published study investigated the effectiveness of eccentric strengthening exercises—a treatment commonly used in physical therapy programs—for patients with SIS, and the results were very encouraging. The conclusion states:

An eccentric program targeting the external rotators was superior to a general exercise program for strength, pain, and function after six months. The findings suggest eccentric training may be efficacious to improve self-report function and strength for those with subacromial pain syndrome (another term for SIS).

Shoulder symptoms from SIS can severely impair your abilities to perform your job or just get through the day without pain, but it doesn’t have to be this way. If your shoulder is bothering you, contact your local physical therapist first and fast, and begin on your path to a pain-free future.

Shoulder Specialist Visalia – About Frozen Shoulder Treatment

Looking for a shoulder specialist in Visalia? We can guide you through every stage of treatment if you adhesive capsulitis

The shoulder is a ball-and-socket joint, with the upper arm bone (humerus) serving as the “ball” and fitting into the “socket” of the shoulder blade (scapula). The bones and other structures of the shoulder are surrounded by a structure called the shoulder capsule, which is made up of strong connective tissue that helps hold the humerus to the scapula. Adhesive capsulitis, or frozen shoulder, occurs when scar tissue forms within the shoulder capsule. Inflammation of the capsule causes severe pain, inflammation, scarring and a tightening of the shoulder joint, which means there is less room to move the shoulder normally.

Although frozen shoulder affects up to 5% of the population, it’s not entirely clear why it develops. In general, it’s believed that not moving the shoulder joint normally for a long period of time is one of the leading factors, as most people who get frozen shoulder have kept their shoulder immobilized due to a recent injury, surgery, pain or some other condition. People between ages 40-60, women and those with arthritis, diabetes, cardiovascular disease and other health conditions are also more likely to develop it.

The Stages of Adhesive Capsulitis Development and Resolution

Frozen shoulder usually develops slowly and gets progressively worse with more pain and loss of motion over time. This is typically broken down into four stages:

  • stage 1 consisting of the onset of symptoms, which gradually get worse over 1-3 months.
  • Stage 2 is the “freezing” stage, which generally occurs 3-9 months after symptoms start and is very painful.
  • Stage 3 is the “frozen” stage in which the shoulder becomes even more stiff and difficult to move.
  • Finally, the “thawing” of stage 4 occurs within 12-15 months, in which pain decreases significantly and range of motion begins to improve.

Conservative Care is the Best First Choice

There are a number of treatment options available for frozen shoulder, but physical therapy is one of the best options because it’s effective for addressing symptoms at every stage. The goal of physical therapy is to control pain and improve strength and flexibility to help patients move their shoulder more easily, and treatment will consist of:

  • Heat and/or ice
  • Stretching exercises
  • Manual therapy
  • Strengthening exercises
  • Specific activity training

The benefits of physical therapy for frozen shoulder can be seen in the findings of a recent study, which evaluated if several commonly used physical therapy interventions were effective for patients with this condition. Here are the results:

Adding a structured rotator cuff strengthening program to TENS and joint mobilization in the treatment of frozen shoulder resulted in improvements in pain, range of motion and function. Reference: https://www.ncbi.nlm.nih.gov/pubmed/27884497

If You Need a Shoulder Expert Here in Visalia, We Provide All Natural Care – No Drugs, Injections, or Surgery

Frozen shoulder is clearly a serious condition that requires a great deal of time to fully recover from, but physical therapy can significantly speed up this process. If you have symptoms of frozen shoulder, contact us for a consultation right away and we can get you started on a treatment program that will safely help you regain your shoulder function.

Hands-on for Shoulder Pain Treatment in Hanford

A 2016 clinical trial confirms what we here at Bacci & Glinn Physical Therapy have been doing for years. If you are in need of shoulder pain treatment in Hanford, then this research may be pertinent to you.  In a study of office workers that suffered with shoulder pain, physical rehabilitation involving hands-on treatment was found to be an important part of a conservative treatment program.

Long-term computer use can lead to muscle dysfunction and disorder

Approximately 90% of white-collar workers use computers for more than four hours per day.  Over time, sitting and working at a computer can lead to a dysfunction of muscle stability and other disorders of the region, which may result in shoulder and neck pain, as well as a decreased threshold for pain.  One of the main reasons for shoulder pain is hyperactivity of an upper back muscle called the upper trapezius, which results in decreased control of two other muscles and instability.  To treat this muscle instability, several physical therapy interventions may be used, including manual therapy.  In manual therapy, the physical therapist performs various manipulations and mobilizations on the painful area in order to bring about tissue changes that will lead to less pain.  Manual therapy may therefore be helpful for office workers with shoulder pain, and to evaluate this possibility, a study was conducted.

Middle-aged office workers with pain serve as the study group

Individuals between the ages of 30-40 who had shoulder pain and worked on a computer for more than eight hours a day were invited to participate in the study and screened to determine if they were eligible.  This process led to 38 individuals who were accepted, and then randomly assigned to either the manual therapy group or the shoulder stabilization exercise group.  Both groups underwent treatment during two 40-minute sessions per week for six weeks.  In the manual therapy group, the therapist applied manipulations and mobilizations to various muscles in the back, chest and neck for three minutes each.  In the shoulder stabilization group, patients were instructed to perform a series of stretching and strengthening exercises for muscles in the same area.  All patients were assessed before and after undergoing treatment for pressure pain threshold (PPT) of certain muscles, which measures the minimum force applied that causes pain.

Manual therapy leads to greater improvements

After completing treatment, participants in both groups experienced significant improvements with an increased PPT of several muscles of the upper back; however, the manual therapy group showed greater PPT improvements in these muscles than the shoulder stabilization group.  This is likely due to the pain-relieving properties of manual therapy, as it increases blood flow and decreases the activity of muscles in such a way that it changes the length of tissues and results in less pain.

Here’s an excerpt from the abstract published on Pubmed.org:

The manual therapy group showed greater improvements than did the shoulder stabilization exercise group in the splenius capitis on both sides, left upper trapezius, middle trapezius on both sides, and right lower trapezius. [Conclusion] The results of this study suggest that manual therapy for shoulder pain is feasible and suitable for office workers and may be useful in clinical rehabilitation.
Reference: https://www.ncbi.nlm.nih.gov/pubmed/27799661

These results show that while both shoulder strengthening exercises and manual therapy appear to be effective for office workers with shoulder pain, manual therapy is even more beneficial for improving their threshold for pain.  Individuals currently dealing with this type of pain should therefore seek out the services of a physical therapist for appropriate treatment.

Diagnoses we’ve successfully treated – Check our medical library

There are a number of shoulder conditions that we regularly treat.  Here’s a link to our medical library where you can learn more about physical therapy for shoulder pain that we provide here in Hanford (and Visalia as well).

If you have questions about your shoulder pain, just give us a call.  Chances are we can help.   Click here to visit our contact page for more information.

-As reported in the September ’16 issue of  The Journal of Physical Therapy Science

 

Frozen Shoulder Treatment in Visalia

Recovering from frozen shoulder often takes a while, but if you are looking for frozen shoulder treatment in Visalia, our physical therapy treatment can help every step of the way.

The shoulder is a ball-and-socket joint, with the upper arm bone (humerus) serving as the “ball” and fitting into the “socket” of the shoulder blade (scapula).  The bones and other structures of the shoulder are surrounded by a structure called the shoulder capsule, which is made up of strong connective tissue that keeps the shoulder stable.  Adhesive capsulitis, or frozen shoulder, occurs when scar tissue forms within the shoulder.  This causes the shoulder capsule to thicken and tighten around the shoulder joint, which means there is less room to move the shoulder normally.

Frozen shoulder affects up to 5% of the population, but it’s not clear why it develops.  In general, it’s believed that one of the leading factors is not moving the shoulder normally for a long period of time.  People between the ages of 40-60, women and those with arthritis, diabetes, cardiovascular disease and other health conditions are also more likely to develop it.

Frozen shoulder usually develops slowly and gets progressively worse with more pain and loss of motion over time.  This is typically broken down into the following stages:

  • Stage 1 (pre-freezing): symptoms start and gradually get worse over 1-3 months
  • Stage 2 (freezing): generally occurs 3-9 months after the start of symptoms; any movement of the shoulder causes pain, which is even worse at night
  • Stage 3 (frozen): occurs within 9-14 months; the shoulder becomes more stiff, making it more difficult to move and rotate it
  • Stage 4 (thawing): occurs within 12-15 months; pain decreases significantly, especially at night, range of motion begins to improve, making it easier to move

This shows that frozen shoulder follows a long course of development and eventual recovery, but following a physical therapy treatment program can expedite this process.

The goal of physical therapy is to control pain and increase strength and flexibility, and physical therapists have specific treatments that are designed to help patients improve at each stage of frozen shoulder.  In general, treatment consists of stretching exercises, manual (hands-on therapy), strengthening exercises and returning to daily activities.

The following findings from a 2007 study clearly identify the value of physical therapy for treating patients with frozen shoulder:

With supervised treatment, most patients with adhesive capsulitis will experience resolution with nonoperative measures in a relatively short period. Only a small percentage of patients eventually require operative treatment.

Dealing with frozen shoulder can be a long, drawn-out and frustrating process, but in seeing a physical therapist, you will be certain to increase your chances of easing the burden of your condition and having a successful, faster recovery.
For more information about our practice locations, click here for details about our Visalia & Hanford offices.