Manual Therapy for Shoulder Pain: What to Expect During Treatment

Shoulder pain is a common complaint that millions of people worldwide may have at some point in their lives. This condition may be caused by overuse injuries, poor posture, traumatic events, or underlying musculoskeletal conditions, such as bursitis, rotator cuff injuries, tendinitis, etc. Regardless of the cause of shoulder pain, this condition limits physical function and mobility, making it difficult to perform daily activities comfortably and independently. Chronic shoulder pain may also affect your mental health, leading to stress, depression, insomnia, etc. Therefore, if shoulder pain is left untreated for a long time, it may reduce your overall quality of life. 

Manual therapy is one of the most effective treatment options for managing shoulder pain. This approach involves a hands-on technique that requires a skilled therapist to manipulate and mobilize the joints and other soft tissues for pain relief and restoration of physical function. Manual therapy is a non-invasive procedure that aims to treat the root cause of shoulder pain alongside its symptoms. Hence, it is considered a very effective treatment method compared to pain-relieving medications and surgery. Therefore, this article will guide you through what you should expect if you decide to undergo manual therapy for shoulder pain treatment at Summit Physical Therapy. 

Causes of Shoulder Pain

The shoulder joint is a very mobile but complex joint. Its high mobility puts it at constant risk of injury and dysfunction that lead to pain. Mechanical or structural factors may cause shoulder injuries or dysfunction. Some of the most common causes of shoulder pain include:

• Rotator cuff injuries: The rotator cuff is a group of four muscles (supraspinatus, infraspinatus, teres minor, and subscapularis) and their tendons that attach to the shoulder blade and upper arm bone, stabilizing the shoulder joint and allowing for a wide range of movements. These muscles and their tendons may become damaged or injured due to trauma, age-related degeneration, repetitive use, etc. Rotator cuff injuries cause severe pain that worsens with certain activities, weakness in the shoulder, reduced range of motion, and limited physical function. 

• Frozen shoulder (Adhesive Capsulitis): The shoulder has a fibrous sheath, known as the capsule, that connects the humerus (upper arm bone) to the scapula (shoulder blade), surrounding and protecting the joint. While the shoulder capsule is relatively loose and lax, adhesive capsulitis causes the capsule to thicken and tighten, leading to pain and stiffness in the shoulder joint. 

• Shoulder impingement: This condition occurs when a tendon in the shoulder joint or rotator cuff becomes pinched or compressed due to certain shoulder movements (e.g, tendons rubbing against the bone or other soft tissues) when the arm is lifted. These shoulder movements lead to inflammation, which will subsequently cause shoulder pain. Common causes of shoulder impingement include repetitive overhead motion, poor posture, muscle imbalances, inflammation, improper form, etc. 

• Arthritis: Osteoarthritis is one of the most common types of arthritis that affects the shoulder and causes shoulder pain. This type of arthritis is caused by the wear and tear of the shoulder joint cartilage that cushions the tissues, due to overuse, injuries, and age-related degeneration. Osteoarthritis causes stiffness, chronic shoulder pain, and limits physical function. 

• Tendinitis and Bursitis: Tendinitis refers to the inflammation of the tendons in the shoulder joint, while bursitis refers to the inflammation of the bursae, a fluid-filled sac that cushions the shoulder joint. Both conditions are commonly caused by overuse injuries and they lead to severe shoulder pain, tenderness, and even swelling. 

• Postural defects: Poor posture, due to bad ergonomics, lifestyle habits, and improper body mechanics, can cause muscle imbalances and abnormal joint movements. Over time, keeping a poor posture can strain your shoulder joint and its surrounding structures, leading to severe pain and loss of function. 

Symptoms of Shoulder Pain

Several signs and symptoms may accompany shoulder pain, alerting you to the need to seek appropriate treatment. Some of these symptoms may include:

• Stiffness in the shoulder
• Limited range of motion
• Clicking or popping sensation in the shoulder
• Weakness of the shoulder muscles
• Sharp or dull pain that may worsen at various intervals or with specific movements
• Swelling and tenderness in the shoulder
• Muscle tightness
• Restricted mobility and physical function

These symptoms and more are signs that you may need to seek medical attention early to avoid further complications. 

What Does Manual Therapy Entail?

Manual therapy is a specialized form of physical therapy that employs hands-on techniques to assess, diagnose, and treat musculoskeletal pain and dysfunction. The skilled hands of a physical therapist are the primary instrument during manual therapy, unlike other treatment methods that may require specialized equipment or machines. Physical therapists are highly skilled in mobilizing joints, stretching muscles, manipulating the soft tissues, and using other manual therapy techniques to reduce pain, relieve muscle tension, improve joint alignment, and enhance blood circulation to promote healing. 

Manual therapy is a unique and effective treatment method because it approaches every case individually, considering each patient’s symptoms and treatment needs and goals. Some of the most common components of manual therapy that you should expect during manual therapy for shoulder pain treatment include:

Initial Assessment

This is the first step to treatment and recovery with manual therapy. Before administering any manual therapy technique, your therapist will evaluate your situation comprehensively to determine the severity of your condition and the best approach to treatment. Some of the components of an initial assessment during manual therapy include symptoms evaluation, medical history review, range of motion testing, physical examination, etc. 

Individualized Treatment Plan

After the initial assessment, your physical therapist can design personalized treatment plan with the useful information gathered during the evaluation. Typically, treatment plans contain the specific techniques and other modalities that your physical therapist intends to use during treatment to relieve pain, restore movement, and improve your function and ability to perform your daily activities comfortably and independently. Manual therapy may be combined with other non-invasive interventions, such as therapeutic exercises, movement retraining, postural training, and education, etc, to ensure effectiveness.

A manual therapy session can last anywhere from 45 to 60 minutes, with various non-invasive techniques being administered. It is normal to feel mild discomfort during the procedure; however, you should tell your therapist if you feel intense pain during manual therapy. During the period of treatment, physical therapists adjust their techniques based on patient feedback to reflect the progress they have made. 

Manual Therapy Techniques for Shoulder Pain

Manual therapy consists of several non-invasive techniques. Each of these techniques is designed to treat and address specific problems in the joints and other connective tissues. The following are some common manual therapy techniques that can relieve shoulder pain and restore mobility and physical function:

• Soft tissue mobilization: This manual therapy technique involves applying pressure and stretching to the muscles, ligaments, fascia, and other soft tissues through kneading, stroking, and friction to break down adhesions, reduce pain and inflammation, improve blood circulation, and improve overall function. Soft tissue mobilization is commonly used to relieve muscle tightness and pain, improving flexibility and range of motion.

• Joint mobilization and manipulation: These techniques involve controlled movements of the shoulder joint to restore normal joint alignment and range of motion. Joint mobilization employs passive movements to relieve pain, reduce stiffness, and improve joint function and range of motion. This technique can help relieve conditions that cause shoulder pain, such as frozen shoulder, overuse injuries, etc. Joint manipulation, on the other hand, involves applying more forceful but controlled movements to the joint to realign it, reduce pain, and restore proper joint function. 

• Myofascial release: This manual therapy technique focuses on releasing muscle tension and tightness by targeting the fascia, the connective tissue that surrounds the joint, muscles, organs, and nerves. During myofascial release, the physical therapist applies gentle pressure to the area where the fascia is restricted to release muscle tension, relieve pain, and improve physical function. 

• Trigger point therapy: A trigger point is a hyperirritable spot in the skeletal muscle that can cause localized or referred pain when stimulated. Therefore, a trigger point in the shoulder can cause shoulder pain. During trigger point therapy, your physical therapist will first locate trigger points in the shoulder and then apply pressure to these areas to relieve pain and muscle tension and promote healing. 

• Muscle energy techniques (METs): This is a form of manual therapy that uses a patient’s muscle contractions against a therapist’s resistance to lengthen and relax the muscles, leading to pain relief, joint realignment, and improvement of joint function and range of motion. 

• Passive stretching: As the name implies, all you have to do during this manual therapy technique is to stay in one position for a set time. During passive stretching for shoulder pain, an external force (your physical therapist) will actively move your hand into a stretch without you having to do anything. This manual therapy technique can help to lengthen the muscles, improve flexibility, and relieve shoulder pain.

These and many more are manual therapy techniques that physical therapists employ to deliver effective treatment.

How Does Manual Therapy Help With Shoulder Pain?

The following are some of the benefits of undergoing manual therapy for shoulder pain in Merrick, NY:

• Pain relief: This is the primary reason why people undergo manual therapy for shoulder pain. Manual therapy can relieve both acute and chronic shoulder pain without pain-relieving medications or surgery by releasing tight muscles, breaking up adhesions, decreasing nerve irritation, reducing inflammation, and correcting muscle imbalances. You may feel some immediate relief after manual therapy sessions while experiencing increased comfort while performing your daily activities.

• Improved mobility and function: You may be unable to move your shoulder or perform actions that require you to move your shoulder because of shoulder pain and damage from shoulder injuries. However, manual therapy can help to relieve shoulder pain and treat and manage shoulder injuries to repair and undo damage. 

• Enhanced blood circulation and faster healing: Manual therapy is a hands-on technique that can improve blood flow and circulation, ensuring that nutrients and oxygen get to the injured soft tissues in the shoulder and removing metabolic wastes from the body. This encourages faster healing of the injured structures of the shoulder, leading to faster recovery. 

• Prevention of future injuries: Manual therapy can correct biomechanical dysfunction, such as poor posture, improper joint mechanics, and repetitive stress. It also corrects muscle imbalance and realigns the shoulder joint, ensuring that every structure are in their normal position and in perfect shape. As a result, the shoulder becomes more stable, making it less prone to strain and injury in the future. 

These and many more are the benefits of manual therapy for shoulder pain. 

Conclusion

Shoulder pain is a debilitating condition that causes severe discomfort, affecting physical and mental health. This condition limits your mobility and physical function, making it difficult to move around and perform your daily activities comfortably and independently. Shoulder pain may also affect your sleep quality, causing anxiety, depression, and other mental health issues. However, you do not have to endure the devastating effects of shoulder pain forever. If you suffer from shoulder pain, consider undergoing manual therapy at Summit Physical Therapy for effective treatment.