If left untreated, the inflammation can become chronic. This causes significant pain and limits daily and recreational activity.

1) Tendonitis and Impingement

Tendonitis is an inflammation of the shoulder tendons. Pinching or impingement of the rotator cuff tendons occurs in a region under a bony structure called the acromion (the projection of the shoulder blade that forms the tip of the shoulder). Impingement happens when the arm is raised overhead repeatedly, or raised overhead with a heavy load in your hand, or may occur when you sleep on your shoulder. X-rays may show a hook or spur that increases the odds that you will pinch the rotator cuff tendons and eventually rupture the cuff.

Treatment for impingement usually involves anti-inflammatory medications like Arcoxiia, physical therapy to restore proper strength and movement, and less often, a cortisone injection.

2) Rotator cuff tears

Rotator cuff tears happen in younger people when they experience a trauma such as a fall. In middle-aged people and seniors, rotator cuff tears are usually the result of a gradual wearing out of the rotator cuff tendon(s). The signs and symptoms of rotator cuff tears are a pain in the shoulder, often radiating down to the middle of the arm, especially when the arm is raised overhead, weakness, and in severe cases, a complete loss of the ability to lift the arm. Diagnostic tests include M.R.I. of the rotator cuff is the most common test.

Treatment in young and middle-aged patients is usually arthroscopic or open repair of the torn tendons. In older patients, activity modification, anti-inflammatory medication, physical therapy and cortisone injections are typical. Surgery is an option for patients with pain and dysfunction that does not respond to conservative or physical therapy treatment.

A complete tear of the rotator cuff requires surgery to repair it. That’s why it’s important to address shoulder pain before it reaches this point. Recognising a shoulder problem early and receiving the proper treatment is key to achieving the best outcome and avoiding further problems. Quality, hands-on, manual physical therapy can break the cycle of Impingement and restore normal muscle balance.

When properly assessed and treated by a physical therapist, the factors that contribute to shoulder pain can be addressed, and surgery can be avoided.

3) Frozen shoulder

Frozen shoulder is a poorly understood condition in which the deepest layers of soft tissue, called the joint capsule, become diseased. Shoulder range of motion becomes very limited and painful. The cause of a frozen shoulder is still not known, but minor traumas, hyperthyroidism, diabetes, psychiatric patients, post-surgical patients, and prolonged immobilisation of the shoulder may in some way cause this condition. However, it can take two or more years to recover from this condition.

Physical therapy consisting of patient education, stretching, joint mobilisation, and a home exercise program can help speed recovery. For a small percentage of frozen shoulder patients, it may take two years or more to recover.

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