Shoulder pain

Physical therapy is considered a first-line treatment for various arthritic and tendon related issues. What is interesting are the numbers patient that tell me they have been to physical therapy before and did not find that it helped them significantly. I still refer patients to physical therapy quite often. A recent personal story helps solidify my faith in physical therapy when used appropriately.

I have played tennis since my early teens. I played quite a bit competitively for several years. After starting college I gave up tennis for approximately 16 years. I restarted playing around the same time I started my practice a few years ago. Having restarted playing tennis, and trying to play in a similar manner at the same level I was able to as a teenager, immediately led to a number of interesting issues. First off as expected I suddenly discovered some of the things I was previously able to do, including running for hours on end without getting tired, were no longer possible. In addition I fairly quickly realized what tennis elbow, wrist pain, and rotator cuff tendinitis felt like.

My right shoulder in particular has been an issue. I have pain with serving and overheads. I have checked my own rotator cuff under diagnostic musculoskeletal ultrasound. I discovered that I have a small tear in the supraspinatus tendon, this is in fact the most commonly injured tendon that causes rotator cuff tendinitis and rotator cuff tears. My typical recommendation for patients who present with a history of this sort of injury is to participate in physical therapy first, if that is insufficient consider a cell based biologic treatment such as platelet rich plasma.

Physical therapy benefits include:
#1 helping to diagnose any weakness or muscle imbalance that could be causing functional impairment and pain.
#2 improving range of motion and strengthen appropriate muscle groups around a joint that has been injured or has chronic arthritis/tendinitis.

As in any other field, finding a physical therapist who excels at their profession plays a large role in the outcome of treatment. Specifically in the ability to diagnose functional impairments, and one who is capable of treating those issues as well. In my case, an emphasis on strengthening the upper back muscles has made a significant benefit in regards to my right shoulder pain. As I plan on returning to play tennis, my hope is that this improvement in muscular function results in less or no pain while playing, and improvement in ability.

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