Hey Team!

This week is an update on Shoulder Mobility injuries.  Often time individuals will arrive at the clinic looking for help to regain motion to the shoulder.  We can lose mobility to the shoulder for many reasons, so let’s investigate a few.  

Reasons We Lose Shoulder Mobility

• Frozen Shoulder:  this condition is known also as adhesive capsulitis and is unique in presentation.  The mechanism, or the why, this injury occurs is not fully understood, but there are some associations.  We do know your risk increases if you're recovering from a medical condition or procedure that prevents you from moving your arm — such as a stroke or a mastectomy. Individuals with diabetes can have an increase association as well. This condition creates consistent tightening to the capsule of the shoulder and limits mobility overall.  This loss of motion is progressive and continues to restrict the shoulder.

• Rotator Cuff Injury:  an injury to the rotator cuff, a strain or tear, will ultimately limit your ability to reach overhead or to the side.  With pain being a limiting factor… you will not use the shoulder as much.  Overtime, this limitation to the shoulder will create adaptive shortening to the capsule.  This is the classic “you use it or you lose it”

• Shoulder Impingement:  this condition occurs when the rotator cuff tendon is pinched between two bones. Impingement (or pinching) occurs when the humerus (long bone of upper arm) of the shoulder and the acromion (top of the shoulder) do not create enough space for the tendons of the shoulder to move freely. This creates a pinch effect creating considerable pain… especially lifting overhead.  Many causes can create this pain, and a restricted shoulder capsule is only one reason. 

• Arthritis:  Shoulder arthritis is a degenerative process to the joint. It is a result of damage to the cartilage of the involved bones creating pain, but it also creates limited mobility.  Our bodies attempt to protect the joint from continued arthritis, but this effect limits our shoulder function.  Loss of motion in many directions of movement is a classic sign of degenerative shoulder arthritis, but is similar in presentation to frozen shoulder as mentioned earlier. 

So what do we do?

• Tip #1:  Start ROM Early.  “ROM” stands for range of motion and is similar to stretching or flexibility.  Many of these ailments begin as we stop using our shoulders full available motion.  We don’t know we are losing this ROM until we have lost too much and is noticeable in our daily life.

• Tip #2:  Use the “Goldie Locks” Rule:  How hard or light should you stretch?  Well… the Goldie Locks rule is to not stretch too hard or too light… but just right.  How do you know it is just right.  First, we do not want to create pain.  We want to feel a firm stretch with a dull pressure to the joint, however this should never create sharp pain.  Also, if aching is occurring to the joint after stretching greater than 20 minutes… you are stretching too aggressively!  Alternatively, if you never feel pressure in the joint… you are not going to gain motion. 

• Tip #3:  Start PT on Time!  The ailments listed above are related to a loss of shoulder motion.  Often times patients have waited too long to begin treatment for their loss of shoulder mobility or pain, thus requiring a more extensive physical therapy plan of care.  Starting physical therapy sooner means you will not lose as much motion and our treatment plan is shorter.  

Can’t tuck in your shirt or reach behind your back!  

CLICK HERE is a link to a video on how to improve ROM.  

Take Home Message

Shoulder motion can be lost for many reasons related to some known factors and some unknown factors.  Maintaining full range of shoulder motion consistently is important for preventing a loss in movement, but also in identifying when early restriction is occurring.  Severity of shoulder loss can be improved with early intervention.  Starting physical therapy early will assist in reducing the disability associated with these injuries.  

As always, if you have any specific questions, that I can help you with, feel free to send me a quick email or give me a call at the clinic.  I’m happy to help!

Ok Team… that’s all for today.   

-Keep Moving 

Rob 

• The author, Rob Sumner, is a Doctor of Physical Therapy and owner of Sumner Specialized Physical Therapy. He's happy to answer any questions about this article, wellness, fitness, or physical therapy overall by phone at (509) 684-5621 or by email at Rob@SumnerPT.com

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