Shoulder pain is a larger group of problems, about which we specifically write a little bit lower in this article. It usually affects people in a productive age between 40-50 years. The pain contains infliction of one or more soft tissues around the shoulder joint (muscles, tendons, bursae, ligaments, joint capsules,…).
- Adhesive capsulitis of shoulder (also known as frozen shoulder) is characteristic by a typical sharp and restrictive pain during the movement motion. Very intensive pain can wake you up from the sleep, it is restricting you or it doesn’t allow you to move your shoulder at all, especially in the external rotation direction and abduction in the shoulder joint, which limits people in daily life activities. The movement in the shoulder joint can be completely impossible, such people then wear arm sling fixing their arm close the their abdomen. X-ray images then usually show calcification in the tendons and bursae area.
- Shoulder impingement syndrome is characterized by sharp pain which is typical during internal rotation of the shoulder and abduction of the arm in 60-120 degrees.
- Blocked sternoclavicular joint is typically manifested by pain when you place your shoulder is in flexion position.
CONSERVATIVE TREATMENT OF THE SHOULDER PAIN
Its consists of complete immobilization (prescribed arm sling) and application of steroid or non steroid based antirheumatcs and analgesics. Rehabilitation is oriented on applying laser or electromagnetic therapy and ultrasound, which has no significant effects. The exercise goal to completely regain the moving ability is painful and has minimal effects as well. Such therapy can take up to few months and even a year. After unsuccessful conservative therapy, doctors usually decide to operate the patient.
MODERN PHYSIOTHERAPY AND SHOULDER PAIN
- Physiotherapist is choosing methods on neurophysiological base, so the coordination between single muscles and muscle groups (either in immediate vicinity to the shoulder joint or more in distant but functionally related areas) would be effective. University educated physiotherapist is conscious about the functional “chains” which transfer the cause of the pain to a further area (for example: frequently dislocated ankle has influence on the function of the shoulder joint).
- Combination of soft tissue techniques and mobilization is ideal in the whole arm area, cervical and thoracic spine as well as ribs.
- Stiffness (restriction) in movement is relieved very well after applying warmth and heat (be careful it’s inflammation in the shoulder joint).
- In case you are diagnosed with frozen shoulder, there’s a great combination between manual physiotherapy with modern shockwave therapy. We may state that today the treatment of the frozen shoulder can not be done without the shockwave therapy.
INSTRUCTIONAL VIDEOS SHOWING PHYSIOTHERAPEUTIC METHODS AND TECHNIQUES
Author: Mgr. Iva Bílková, FYZIOklinka physiotherapy Ltd., Prague, Czech Republic