People who experience shoulder pain upon reaching overhead often seem to be divided into two groups. Either their job (e.g., painting, carpentry work) or one of their favorite activities (e.g., tennis, baseball) includes many instances of overhead motions, or they’re a person whose daily activities provide very few opportunities for this type of motion. It’s only when the latter group reaches for an item high on a grocery shelf, or perhaps extracts an item from the top shelf of a cupboard, that they experience notable levels of pain.
Regardless of whether a person has a good idea as to which activities are causing their pain, or if they remain puzzled as to the cause, it’s important for anyone suffering from reoccurring shoulder pain to obtain a proper diagnosis. Those that repeatedly ignore bouts of shoulder pain put themselves at risk for further injury.
The shoulder joint is often referred to as a ball and socket joint. It is one of the most complex joints in the body. The top of the upper arm bone (humerus) consists of a rounded end, which nestles within the shoulder blade (scapula). The clavicle or collarbone is also considered part of the shoulder. It forms a bridge between the outer portion of the shoulder blade and the breastbone.
Surrounding the shoulder area is the rotator cuff. This is a collection of tendons and muscles that provide support for the shoulder. These same tendons and muscles that comprise the rotator cuff, also allow the shoulder joint to perform a wide range of motions including
- Flexion (forward movement of the arms from a neutral position, up to 180°).
- Extension (reaching toward the back of the body).
- Abduction (raising the arm to the sides).
- External rotation (neutral upper arms, lower half of arms rotating out to the side.
- Internal rotation (neutral upper arms, arms beyond elbow rotating inward toward the body).
The movements most engaged in reaching overhead include shoulder flexion (reaching to the front and continuing to 180°) and abduction (raising arms to the side, then upward to 180°).
The rotator cuff is heavily involved in overhead motion. So an injury in this cuff is one of the most common reasons for a person to experience shoulder pain when reaching overhead. The tendons that make up the rotator cuff may have become inflamed and developed into tendonitis. Another issue that can occur is when a rotator cuff tendon pulls (tears) away from the arm bone.
Other common issues that can result in shoulder pain upon reaching overhead include advanced arthritis and frozen shoulder (adhesive capsulitis). The latter condition can occur when the connective tissue that makes up part of the shoulder capsule begins to thicken. As this connective tissue thickens, it leads to a restriction in shoulder movement.
Another medical condition that can cause shoulder pain is shoulder bursitis. This occurs when the small sacs of fluid (bursa) that rest over the rotator cuff tendons become irritated and inflamed.
Physical Therapy for Shoulder Pain
Whether a person is experiencing pain in their shoulder from tendonitis, shoulder bursitis, a rotator cuff tear, or a frozen shoulder, surgery is not necessarily the first solution their physician will recommend. Many times you can resolve these conditions through a series of physical therapy treatments. Steroid injections in the shoulder area can also help reduce inflammation.
A physical therapist’s first goal when working with a patient is to reduce their pain levels. This may involve employing ultrasound treatments, applying heat and/or ice packs, along with gentle manipulation of tight muscles and other tissues. When ready, a physical therapist will have their patient take part in simple stretching exercises. These exercises increase a patient’s range of motion. As a patient’s condition continues to improve, they will eventually take part in exercises designed to strengthen the injured area, along with adjacent supporting muscles.
If you or someone you know is experiencing shoulder pain, we can help! Please contact Cawley Physical Therapy & Rehab today.