What do we need to Focus on When Treating Shoulder Pain
Shoulder Pain is commonly diagnosed as either a Rotator Cuff tendon issue such as Tendonitis or Bursitis of the Shoulder. More recently research has suggested that we need to focus on the cause of the problem in order to successfully reduce pain and achieve progressive healing. The focus is now about assessing if temporarily adjusting the angle and position of the shoulder blade, the shoulder joint or spine helps reduce painful movement of the shoulder. Hence examination focuses on these adjustments in the shoulder movement position that causes most pain.
Humeral Head Adjustment
If a patient has pain lifting the hand upwards, the problem may arise from poor positioning of the Shoulder head in its socket. We can use shoulder belts that can gently hold the ball of the shoulder more centrally in its socket from the front or back of the shoulder whilst the patient performs the aggravating shoulder movement. If it gives relief from pain, then it is our Treatment Tool. Likewise adding in exercise contraction with the aid of a resistance band during a pain movement can help alter the normal pattern of Tendons contracting around the shoulder joint abd thus help reduce painful symptoms.
Changing Shoulder Blade Position
Scapula (Shoulder Blade) Dysfunction or poor movement patterns during shoulder movement can cause or contribute to Shoulder Pain. In testing to see if poor Scapula position is implicated in Shoulder Pain, the Arm is elvated into its painful movement with the Physical therapist manually fixing or biasing the scapula into an elevated, depressed, forward tilting or backward tilting position to examine if improved movement and pain reduction is achieved. If it is found that by manually tilting the scapula backwards to correct a dysfunctional scapula, helps reduce pain, well this is then our treatment of choice. The use of Taping can help achieve this permanent exercises coupled with an exercise to reinforce this correct pattern of scapula movement.
Affect of Curvature of Thoracic Spine
Excess Curvature (Kyphosis) of the middle (thoracic) spine can influence the position of the shoulder blade and hence the muscle loading of the tendons of the shoulders. The examination needs to assess if reduction in thoracic spine kyphosis reduces shoulder pain. If this is successful, then exercise and taping techniques that focus thoracic curvature reduction are needed in the treatment plan.
Tomás Ryan is a Registered Physical Therapist with The Irish Association of Physical Therapy and is based in Thurles. Contact Number: 0504 26672