Physical Therapy for Shoulder Pain
The rotator cuff is a group of muscles that are located in the shoulder and a common injury we treat in Physical therapy Durham NC . Their primary function is to stabilize the shoulder while carrying weight and performing overhead activities (not so much to rotate, despite the name).
When there is an injury to this muscle group it can have a massive impact not only on sports-related activities but also with activities of daily living including washing your hair, brushing your teeth, and reaching for objects in front or above your head.
While medication and surgical interventions are common options for the treatment of rotator cuff injuries, orthopedic physical therapy, and specifically, dry needling may be another option.
This article will highlight how rotator cuff injuries occur, common shoulder injuries, what dry needling is, and how it can be beneficial for patients looking to recover from a rotator cuff injury.
How Do Injuries to the Rotator Cuff Occur?
When looking at the mechanism of rotator cuff injuries they can be broken down into two groups; traumatic injuries and chronic degeneration injuries.
Traumatic Shoulder Injuries: This type of injury is defined by sudden events that have a particular trigger and result in intense pain or weakness in the affected shoulder. Examples of movements that can cause traumatic rotator cuff injuries include lifting heavy weights, reaching for something overhead, or having your arm pulled suddenly. Additionally falls on outstretched arms and dislocations of the shoulder can also lead to traumatic rotator cuff injuries.
Chronic Degeneration Injuries: This type occurs over time and does not have a particular inciting event. According to the Cleveland Clinic, there are multiple reasons this type of rotator cuff injury occurs, ranging from decreased blood flow as we age, the development of bone spurs in the shoulder joint, and overuse with repetitive motions. This type of injury is most common in lifetime athletes and certain professions like carpenters, painters, and mechanics.
Common Rotator Cuff Injuries
Rotator Cuff Tendinopathy: Tendinopathies are strains to the tendons, or the connective tissue anchoring muscle to bone. In the rotator cuff irritation to the tendons is known to cause pain with shoulder movements and result in tightness of the rotator cuff muscles.
Rotator Cuff Impingement: Impingement occurs when the space the rotator cuff passes through in the shoulder between the humeral head (i.e. the top of your arm bone) and the acromion process of the shoulder blade decreases (the acromion process is the bony part on top of your shoulder). This can cause compression on the rotator cuff muscles, resulting in painful limitations to overhead motion, and can cause tendinopathy of the rotator cuff to occur.
Subacromial Bursitis: The bursa is a small fluid-filled sac that sits between the tendons of the rotator cuff and the bony surface of the shoulder which is meant to decrease friction and improve the movement of the tendons. If the bursa becomes inflamed it can put increased pressure on the rotator cuff similar to impingement.
Rotator Cuff Tear: As the name implies, a rotator cuff tear is physical damage to muscles or tendons of the rotator cuff resulting in significant pain and loss of motion in the shoulder. The severity can range from a partial thickness tear where you can move but with difficulty or pain to a complete tear where movements of the shoulder are impossible due to weakness or pain.
How Dry Needling Can Help
Dry needling is a minimally invasion treatment that offers various benefits for helping recovery from rotator cuff injuries. It targets trigger points, or tense areas in muscles, tendons, or ligaments. Additionally, dry needling can improve circulation which is key for tissue healing, according to the Mayo Clinic. Dry needling has the added advantage of stimulating the parasympathetic nervous system, promoting overall relaxation. All of these benefits can not only improve comfort and decrease pain but also shorten recovery time and get you back to doing what you love faster.
Benefits of Dry Needling for Rotator Cuff Injuries
Dry needling can be a powerful tool in recovering from a rotator cuff injury. When incorporated into a rehabilitation program that includes stretching and strengthening exercises, research by Saylor Pavkovich et al has shown that dry needling can be a practical, non-invasive, and drug-free solution for managing pain and accelerating recovery time in patients with rotator cuff injuries. Below are several examples of exercises that can be utilized with dry needling to help kickstart your recovery.
Exercises for Shoulder Pain
Internal and External Rotation Isometrics
Internal Rotation: stand in a doorway with your arm at side, hand out in front of you with palm on door frame (internal rotation). Push into the frame with as much pressure as you can tolerate. Repeat 5-10 times as tolerated.
External Rotation: stand in a doorway with your arm at side, back of hand on door frame (external rotation). Push into the frame with as much pressure as you can tolerate. Repeat 5-10 times as tolerated.
Wall Slide
Stand facing a wall with both forearms resting on the wall. Slowing slide your forearms up the wall as high as you can, making sure not to wing elbows out to the side. Repeat 10-15 times as tolerated
Shoulder C.A.R.
Start standing with the affected shoulder closer to a wall. Slowly bring arm forward and overhead with your thumb pointing up. As you reach the highest point of your rotation gradually rotate your shoulder so your thumb now points in the opposite direction and continue behind you until you complete a circle. Repeat 5-10 times as tolerated.
While these exercises are a good starting point and can help with some pain you may be experiencing, it is important to have a customized plan of care to achieve long-term relief. If these exercises cause more pain, then it is likely best to rest your shoulder and focus on very gentle movement in a pain free range until you can see a physical therapist.
If you are tired of your shoulder pain interferring with your life, Contact us today to see if we’ll be a good fit to help relieve your shoulder pain!
Sources:
