Physical Therapy For Shoulder Pain - Wall 2 Wall Sports Rehab

Physical Therapy For Shoulder Pain

Frozen Shoulder

Frozen shoulder is a condition characterized by stiffness, pain, and a gradual loss of shoulder mobility due to inflammation and thickening of the joint capsule.

Causes

Post-surgical or post-injury immobility
Diabetes or metabolic disorders
Autoimmune or inflammatory conditions
Unknown (idiopathic cases)

Diagnosis

Physical exam – assessing range of motion and pain
X-rays – to rule out arthritis or fractures
MRI or ultrasound – to evaluate joint capsule thickening

Treatment

Passive and active stretching to restore mobility
Joint mobilizations to improve movement
Manual therapy to reduce stiffness
Strengthening exercises to restore function
Pain management using heat or ice

Recovery

Typically lasts 12-18 months in three stages (freezing, frozen, thawing)
PT significantly improves recovery, especially if started early

Rotator Cuff Tear

A rotator cuff tear occurs when the tendons of the rotator cuff partially or completely tear, causing weakness and pain with shoulder movement.

Causes

Overuse, aging, trauma, or degenerative changes leading to tendon fraying or rupture.

Diagnosis

Special tests (Drop Arm, Empty Can, Lift-Off)
Ultrasound or MRI to confirm tear extent.

Treatment

Strengthening of rotator cuff and scapular stabilizers
Mobility exercises, postural retraining, joint mobilization, and activity modification
Post-surgical rehab includes early passive range of motion followed by strengthening.

Recovery

Average Treatment Time: 6–12 weeks for partial tears
Post-surgical recovery takes 4–6 months.

Shoulder Instability

Shoulder instability occurs when the humeral head moves excessively within the socket, leading to pain, weakness, and frequent subluxations or dislocations.

Causes

Repetitive overhead movements, trauma, genetic ligament laxity (e.g., Ehlers-Danlos Syndrome), or previous dislocations.

Diagnosis

Clinical exams (Apprehension Test, Relocation Test, Sulcus Sign)
MRI for labral involvement
Patient history of instability episodes

Treatment

Scapular and rotator cuff strengthening
Neuromuscular control exercises, proprioceptive training, and bracing if needed
Post-surgical rehab involves progressive strengthening and return-to-sport protocols

Recovery

Average Treatment Time: 8–12 weeks conservatively
Post-surgical recovery is 4–6 months

Shoulder Labral Tear

A labral tear is damage to the cartilage surrounding the shoulder socket, leading to pain, instability, and difficulty with overhead movements. SLAP (Superior Labrum Anterior to Posterior) tears are common in athletes.

Causes

Trauma (fall on an outstretched hand)
Repetitive overhead use (throwing, swimming)
Dislocation injuries

Diagnosis

MRI with contrast
Clinical tests (O’Brien’s Test, Biceps Load Test)
Patient-reported clicking or locking sensations.

Treatment

Rotator cuff and scapular stabilization exercises, postural correction, activity modification, and progressive strengthening
Post-surgical rehab follows a structured protocol with restricted movements initially

Recovery

Average Treatment Time: 12+ weeks
Post-surgical recovery is 4–6 months

Little League Shoulder

Little League Shoulder is a stress injury to the growth plate in young overhead athletes, leading to pain, weakness, and difficulty throwing.

Causes

Repetitive throwing with improper mechanics, excessive pitch counts, and early sports specialization.

Diagnosis

X-ray or MRI for growth plate widening
Clinical evaluation of throwing pain

Treatment

Rest from throwing, scapular and core stabilization
Gradual return-to-throwing program
Biomechanical retraining.

Recovery

Average Treatment Time: 6–12 weeks, depending on severity

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