Shoulder Therapy Made Easy

If you are experiencing general shoulder pain and want to work out the kinks and reduce your shoulder soreness, this article is for you. Rather than address any one specific injury or diagnosis, I’m excited to share my general philosophy for shoulder treatment along with exercises that may save you thousands of dollars in medical bills.

With that said, it’s important to stress that I believe you’re always better off turning to your healthcare providers before implementing any therapy plan, and I encourage you to do so. More specifically, I want to enlighten you with tips and knowledge to help you ask better questions to help strengthen these meetings with your wonderful sports medicine specialists as you, quite literally, place your shoulder in their hands.

Now, back to your treatment…So you have a sore, stiff, cranky, catching, aching and/or unhappy shoulder? And you want to learn what to do and what to avoid as you work to get your shoulders, upper back and chest stronger, more flexible and symptom free—right?

A smart starting point is to first understand your anatomy:

Your shoulder girdle involves three main bones, four articulations or joints, 20+ muscles and plenty of miscellaneous “stuff.” The humerus is better known as the upper arm bone, the clavicle the collar bone, and the scapula the shoulder blade.

The shoulder, or glenohumeral, joint is located where the upper arm bone connects to the scapula. Structurally, this is a mechanically weak area and a common source of stability issues and sequential shoulder pain. Most shoulder joint therapy is focused on increasing range of motion (ROM) and improving muscle strength.

The acromioclavicular (AC) joint is where the clavicle and scapula come together. This is located at the side or “tip” of the shoulder and rests directly above the shoulder joint. AC joint injuries, common when someone lands on the side of his/her shoulder, are sometimes more painfully debilitating than seen with a sprain or “shoulder separation” (addressed in this article) [Insert link to article].

Lastly, the sternoclavicular, or SC, joint is located in the upper and inner chest region where the clavicle and sternum merge. An SC sprain is not common and rarely requires surgery. However, when this injury does occur, it is not quick to heal. Limited motion typically persists due to this impairment.

Shoulder Exercise Dos & Don’ts

One of my goals as a physical therapist is to ensure an athlete returns to the field or court safely. Those I train of course have the same goal. The following tips are the same rules I use with my professional athletes and can help you, too, get back in the game quickly and safely.

Shoulder Therapy Dos:

DO perform a 5-to-10 minute warmup of the four joints and countless shoulder girdle muscles prior to any exercise or shoulder treatment.
DO focus on strengthening the rotator cuff, especially if the injured shoulder is not as strong as its partner.
DO listen to your shoulder and follow its lead. If your shoulder exercises tell you that a specific exercise worsens your symptoms, discontinue or adjust the plan. This may sound too simple, but trust your instincts and your insight. I always tell both my athletes and myself: “Work with your body, not against it!”
DO work hard to increase the pain-free range of motion for your shoulder joint and shoulder girdle.

Shoulder Therapy Don’ts:

DON’T sleep on the injured shoulder.
DON’T engage in shoulder exercises with the thumb pointed downward, which has a tendency to create rotator cuff impingement syndrome.
DON’T perform high-intensity shoulder exercises above the shoulders unless it’s a functional position your sport. Comfortable stretching of this area is great, but aggressive strengthening is usually too risky.

Ask the Right Questions Like a Pro

Prior to exercising your shoulder, mirror what professional athletes with shoulder pain do to ensure a safe return to sport: ask their sports medicine specialist the following questions:

1. Is my rotator cuff damaged, and if torn, is it partial or full thickness?

2. What specific shoulder exercises or motions should I avoid in my shoulder therapy?

3. What can I expect with this injury over the next 2-6 weeks?

4. When testing the external rotation (ER) strength for both shoulders, what would you grade the percentage strength on my injured side versus my healthy one?

5. Do you think I presently have or am at risk for impingement syndrome?

Sports Medicine Tips for the Best Results

Know Your Priorities – Ask yourself: “What do I really need from this shoulder?” If the answer is “less stiffness,” focus on stretching. If it’s “better function,” focus on strength. “Less aching and pain?” Prioritize pain-free motion and icing.
Seek Stability – Your shoulder is not a stable joint, so avoid any position that risks furthering the injury in an unstable manner.
Ice is Your Friend – Ligaments, bursas, and muscles…oh my! With so much “stuff” around the shoulder joint and shoulder girdle, ice is a high priority. Its chill may sting, but ice is exactly what the doctor orders for almost every shoulder injury. The pros will tell you that ice is their best teammate, so stop complaining and do what you know you need….ICE and lots of it.
Hands on the Ground – Add a new wrinkle to your shoulder treatment that will open a new door for your stretches, stability exercises and strengthening. Put your hands on the ground and use your body weight to engage the muscles that surround the shoulder girdle. It’s very safe for most shoulder injuries as well as a fun change. I know it sounds kind of yoga-ish, so channel your inner yogi and give it a try.
Long in the Front & Short in the Back – Improving the resting position of the shoulder girdle is a key part of almost every shoulder therapy program. In today’s busy lifestyle that sometimes includes staring at a computer all day, rounded shoulders are a common problem. Thereby, it is important to lengthen the front of the shoulders (stretching the chest and internal rotators) while shortening the back of the shoulders (strengthening the upper and middle back and external rotators).