Laurel Office 
14435 Cherry Lane Court Suite 100
Laurel, MD 20707
(301) 776-3665
Hours: Mon–Thurs: 7am to 8pm
Friday - 7am to 4pm

Odenton Office
1360 Blair Drive Suite D 
Odenton, MD 21113
(410) 672-8970
Hours: Mon – Thurs: 7am to 8pm
Friday - 7am to 5pm
Columbia Office
5999 Harper's Farm Road, Suite W100 
Columbia, MD 21144
More Info Coming Soon

Shoulder

The shoulder is the most mobile joint in the body. It consists of three structural joints: the glenohumeral (the ball and socket), the acromioclavicular (where the collarbone meets the shoulder), and the sternoclavicular (where the sternum and the collarbone meet). These three joints work together to allow for motion in all planes. However this mobility also makes the shoulder one of the most unstable joints, leaving it susceptible to injury. To compensate and maintain stability, the cartilage, ligaments, and muscles act as the primary supports. Some shoulder problems arise from disruption of these soft tissues as a result of injury (rotator cuff tear, SLAP tear) or from overuse of the shoulder (tendonitis, bursitis). Other problems arise from a degenerative process in which tissues break down and no longer function normally (arthritis).

Shoulder pain is an extremely common complaint. Often your primary care will recommend physical therapy to diagnose and treat your shoulder pain.

Our shoulder program will consist of the following:

  • A thorough evaluation to diagnose the specific injury/problem
  • A pain relief program and patient education on the shoulder (including its anatomy, risk factors for pain, and ways to manage shoulder pain in the short term at home)
  • Development of home treatment program
  • Manual therapy to normalize range of motion and muscle tone
  • Exercise to improve movement and strength

Some common conditions of the shoulder:

Arthritis: describes the degenerative condition where cartilage within the joint breaks down leading to less cushion and more friction in the joint. Common sites for arthritis of the shoulder are the glenohumeral joint and the acromioclavicular joint.

Symptoms may include:

  • Stiffness/pain in the shoulder that is worse after prolonged periods of rest
  • Grinding/crunching in the shoulder that is also painful
  • A dull ache after prolonged use of the shoulder that ends with increased stiffness

Adhesive Capsulitis (Frozen shoulder): is a condition in which the joint capsule (the tissue closest to the bone that surrounds the joint) becomes inflamed. Shoulder range of motion becomes very limited and extremely painful. Often, the cause of a frozen shoulder is unknown. The condition can appear suddenly, or more gradually over several weeks time and symptoms include pain with motion and a steady loss of motion. Some risk factors for frozen shoulder include: minor traumas, hyperthyroidism, diabetes, post-surgical patients, and prolonged immobilization of the shoulder. The disease is characterized as having “freezing”, “frozen”, and “thawing stages”, and is self-limiting (it goes away on its own). However, it can take two years or more to recover from this condition without treatment. Physical therapy and an exercise program have been shown to increase the speed of recovery.

Impingement: occurs when the tendons, connective tissue, and other internal shoulder structures become irritated and inflamed as they pass through the subacromial space (the passage beneath the tip of the shoulder blade and the top of the arm bone). As the arm is raised, these structures are compressed further leading to significant discomfort with overhead arm motions. This can be caused by a variety of things, but often poor posture and a loss of coordination of the shoulder musculature is the culprit.

Symptoms may include:

  • Pain in the shoulder, specifically during certain ranges of overhead motion
  • Inability to sleep on the affected side
  • Decreased motion and limited strength on the affected side

Tendonitis: is a condition in which the tendons that attach muscle to bone become inflamed/irritated. In the shoulder the most commonly affected tendons are the rotator cuff tendon and the biceps tendon. Tendonitis is an overuse injury, and is common in athletes and those whose activity level has recently increased. Symptoms may include:

  • pain in the shoulder that worsens after prolonged activity
  • an aching sensation in the shoulder at rest
  • decreased motion and limited strength on the affected side

Rotator Cuff Dysfunction/Tear: occurs with trauma to the tendon of the four rotator cuff muscles (supraspinatus, infraspinatus, teres minor, and subscapularis). The rotator cuff muscles help to stabilize the head of the arm bone in the socket both at rest and with movement. Rotator cuff tears tend to occur with a fall/injury in the younger population, and through long-term irritation/a gradual wearing out in the middle-aged population.

Symptoms may include:

  • pain; especially in the back of the shoulder/arm, and with overhead movement
  • decreased motion and limited strength on the affected side
  • in extreme cases, a significant loss of abduction motion (inability to raise the arm out to the side)

Labral tears: The labrum is the cartilage ring that surrounds the shoulder socket (called the glenoid fossa) and makes it deeper. Since the socket is deepened by the labrum, the ball of the arm bone (called the head of the humerus) fits more securely in the joint. Labrum or labral tears are usually associated with trauma, instability of the shoulder, or repetitive motion (such as with throwing in a baseball player). There are two more common types of labral tears. A SLAP lesion, which involves the upper labrum and may involve the biceps tendon, is common with falls. The second, a Bankart tear, involves the lower portion of the labrum.

Symptoms may include:

  • painful clicking or popping
  • instability of the shoulder
  • swelling/radiating pain (if the tear is recent)

Shoulder instability:

Dislocation: occurs when the shoulder moves completely out of socket. This typically is experienced by athletes or with trauma. If a shoulder is dislocated, it will be apparent to the person (joint looks “funny” and is immobile) and emergency medial intervention should be taken. After dislocation, physical therapy is often prescribed to strengthen the joint and prevent recurrence.

Instability: is a recurring condition in which the shoulder joint repeatedly dislocates or relocates (slips temporarily out of joint and then returns on its own). In this case, the ligaments, muscles, and the joint capsule itself may be weak or overstretched. Strengthening and postural education in physical therapy can improve this condition with or without surgical intervention.

Contact Us

captcha