Shoulders

Rotator cuff tendinitis occurs when the tendons of the shoulder become inflamed, usually due to overuse, repetitive movements, or poor posture. The rotator cuff is a group of muscles and tendons that stabilize and move the shoulder, so irritation can make even simple motions painful. Without early treatment, tendinitis can progress to partial or complete tears. Physical therapy focuses on reducing inflammation, correcting movement patterns, and restoring strength and flexibility to the shoulder. Addressing rotator cuff issues early often leads to faster recovery and prevents chronic dysfunction.

Symptoms may include:

• Aching pain in the shoulder, especially at rest
• Pain that worsens with lifting or reaching
• Tenderness around the shoulder joint
• Limited shoulder motion
• Weakness in the arm

Shoulder impingement occurs when the tendons of the rotator cuff or bursa become compressed during shoulder movements. This often results from poor shoulder mechanics, muscle imbalances, or repetitive overhead activities. Over time, impingement can lead to tendon inflammation or even tearing if not addressed. Therapy focuses on improving scapular stability, restoring full range of motion, and reducing irritation under the acromion. Correcting impingement early can prevent progression to more serious shoulder injuries.

Symptoms may include:

• Pain when lifting the arm overhead
• Sharp pain at the front or side of the shoulder
• Weakness in the arm
• Limited range of motion
• Tenderness at the tip of the shoulder

Frozen shoulder, or adhesive capsulitis, is a condition where the shoulder capsule thickens and tightens, severely limiting movement. It often develops after periods of immobility, injury, or surgery, and can take months to years to resolve without treatment. Frozen shoulder progresses through stages: freezing, frozen, and thawing. Physical therapy plays a critical role in each phase by preserving as much motion as possible and gradually restoring strength and flexibility. Early treatment can shorten recovery time and reduce stiffness.

Symptoms may include:

• Stiffness and inability to move the shoulder normally
• Dull or aching pain deep in the joint
• Pain that worsens at night
• Difficulty reaching overhead or behind the back
• Gradual loss of shoulder movement

Shoulder instability occurs when the structures that hold the shoulder joint in place become too loose, allowing the ball of the joint to partially slip out (subluxation) or completely dislocate. Instability can result from a traumatic injury or develop over time from repetitive strain. Left untreated, it can lead to repeated dislocations, joint damage, and chronic pain. Therapy focuses on strengthening the muscles around the shoulder and improving neuromuscular control to restore stability and prevent future episodes.

Symptoms may include:

• Feeling that the shoulder is “loose” or “giving out”
• Recurrent dislocations or subluxations
• Pain during certain arm movements
• Weakness in the shoulder
• Clicking or popping sensations

Bursitis occurs when the fluid-filled sacs (bursa) that cushion the shoulder joint become inflamed, usually from repetitive overhead motions, direct trauma, or chronic pressure. Inflamed bursae can cause swelling, sharp pain, and difficulty moving the shoulder. Early intervention helps control inflammation and restore normal movement. Physical therapy focuses on offloading the irritated bursa, reducing swelling, and correcting any underlying movement dysfunction that may have contributed to the problem.

Symptoms may include:

• Sharp or aching shoulder pain
• Swelling or warmth over the joint
• Pain when lying on the affected side
• Pain when lifting the arm
• Limited shoulder movement

The labrum is a ring of cartilage that surrounds the shoulder socket, helping to stabilize the joint. A labral tear can result from trauma (like a fall or dislocation) or from repetitive overuse, especially in athletes or workers who perform overhead activities. Labral tears can lead to instability, weakness, and clicking or catching sensations in the shoulder. Physical therapy can help improve stability, strengthen surrounding muscles, and minimize symptoms without requiring surgery in many cases.

Symptoms may include:

• Deep, aching pain in the shoulder
• Clicking, popping, or grinding sensations
• Feeling of instability in the shoulder
• Decreased strength
• Pain with overhead activities

Arthritis in the shoulder occurs when the cartilage that cushions the bones wears down over time. Osteoarthritis is the most common form, but rheumatoid arthritis can also affect the shoulder joints. Arthritis leads to stiffness, swelling, and pain, especially with movement. Physical therapy helps improve joint mobility, maintain strength, and reduce pain so patients can continue doing the activities they enjoy.

Symptoms may include:

• Persistent shoulder pain
• Stiffness and reduced range of motion
• Grinding or clicking sounds with movement
• Swelling around the joint
• Weakness in the arm

Postural shoulder dysfunction refers to abnormal positioning of the shoulders, often due to forward head posture, rounded shoulders, or muscle imbalances. Poor posture places extra strain on the muscles and joints, leading to pain and dysfunction over time. Therapy focuses on correcting posture, strengthening weak muscles, and teaching ergonomic habits to relieve strain and prevent future injuries.

Symptoms may include:

• Shoulder pain that worsens with prolonged sitting
• Tightness across the chest
• Weakness in the upper back muscles
• Rounded shoulder appearance
• Fatigue or discomfort after computer use

An AC (acromioclavicular) joint sprain happens when the ligaments connecting the collarbone to the shoulder blade are stretched or torn. It often occurs from falls onto the shoulder or direct blows, especially in sports. Mild sprains may cause temporary pain, while severe injuries can lead to noticeable bumps and significant shoulder dysfunction. Therapy helps control inflammation, rebuild shoulder strength, and improve joint stability.

Symptoms may include:

• Pain at the top of the shoulder
• Swelling or bruising over the AC joint
• Pain with overhead or cross-body arm movements
• A visible bump at the top of the shoulder
• Decreased shoulder strength