Also known as “frozen shoulder”, can be described as a thickening and retraction of the capsule, which begins to adhere to the humeral head. This pathology is characterized by pain, stiffness and a limited functioning of the articulation. It usually occurs after a shoulder injury or surgery and which can be associated with certain risk factors such as diabetes, a rotator cuff injury, CVA or other cardiovascular diseases that can delay healing.
ROTATOR CUFF TEARS
The rotator cuff is a large tendon comprised of four muscles which combine to form a “cuff” over the upper end of the arm, the head of the humerus. A rotator cuff tear may result from an acute injury such as a fall or may be caused by chronic wear and tear with degeneration of the tendon. Impingement of the front of the scapula, the acromion, on the tendon is believed to be a major cause of cuff tears in individuals older than 40 years. Typically, you will feel pain in the front of your shoulder that radiates down the side of your arm. It may be present with overhead activities such as lifting or reaching. You may feel pain when you try to sleep on the affected side. You may note weakness of your arm and difficulty with routine activities such as combing your hair or reaching behind your back.
How can the physical therapist help?
Physical therapy offers several interventions to accelerate the healing process. The most effective interventions are articular mobilizations and exercises. When performing mobilization techniques, the Physical therapy can execute passive movements of the upper limb and use specific mobilizations to stretch the joint capsule and allow for a better quality of movement. The therapist can also prescribe different exercises meant to increase shoulder movement, stretch the capsule, increase the strength of scapular stabilizers and improve posture. Other methods can be employed, such as the use of TENS or interferential current for pain management and neuro-proprioceptive taping to improve movement quality and reduce pain. In many cases, Physical therapy treatments are also combined with Acupuncture to help stretch capsule fibers and relieve pain. Combining these two methods increases the patient’s chances of having a speedy recovery.
Bicipital tendinitis is an inflammatory process of the long head of the biceps tendon and is a common cause of shoulder pain due to its position and function. Disorders of the biceps tendon can result from impingement or as an isolated inflammatory injury. Other causes are secondary to compensation for rotator cuff disorders, labral tears, and intra-articular pathology.
SUB ACROMIAL BURSITIS
Subacromial bursitis is a condition caused by inflammation of the bursa that separates the superior surface of the supraspinatus tendon (one of the four tendons of the rotator cuff) from the overlying coraco-acromial ligament, acromion, coracoid (the acromial arch) and from the deep surface of the deltoid muscle. Shoulder bursitis symptoms typically include tenderness at the outer shoulder, especially when raising the arm above the head. A person with shoulder bursitis may find it painful to raise the arm, get dressed, or put pressure on the side of the affected shoulder.