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Shoulder
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Shoulder Bursitis
Shoulder bursitis, rotator cuff tendonitis/tearing, and impingement syndrome are terms used to describe an inflammatory and sometimes degenerative process in the shoulder that may be related to sporting or occupational activities, arthritis/aging, injury or a combination of two or more. The process usually begins with pain in the shoulder or upper arm, especially with overhead activities, and may progress to limitations in motion, weakness, significant nighttime discomfort, inability to perform work or recreational activities or even basic grooming and household activities. Onset of symptoms may be gradual or sudden depending on your specific circumstances.
If the cervical spine is suspected of contributing to your symptoms, an evaluation of the neck may be necessary.
Treatment includes pain relief using anti-inflammatory medications, heat/ice application, and cortisone injection. Exercise is important to full recovery and prevention of recurrence of the syndrome. During treatment, avoidance of activities that aggravate pain is important, such as throwing, swimming, or work activities that involve using or lifting the arms overhead. Surgery may be indicated in those patients who fail to respond to these techniques.
If you have been prescribed anti-inflammatory medications, please take the medication daily for maximum benefit. Continue the medication until you are able to do all of your regular activities without pain.
You will be given a handout of shoulder exercises. To begin with, it is recommended that you only do the pendulum and stretching exercises. You should continue these until the pain in your shoulder begins to improve and then begin the rotator cuff strengthening exercises. You should do the initial exercise 3-5 times daily and the strengthening exercises at least daily, but twice daily is better.
We suggest, as a guideline to return to sports, that you have full range of motion of the shoulder without pain, and that you have normal strength as compared to the uninjured shoulder.
Remember that the longer the symptoms have been present before treatment begins, the longer it may take to achieve full recovery. Repeat injury can be avoided through proper warm-up, stretching, and having an ongoing strengthening program for the shoulder.
APPROACH TO EXERCISE
- Always warm-up for at least 15 minutes prior to stretching and strengthening. A brisk walk is a good choice, but if time is short, application of heat to the shoulder is acceptable.
- Always stretch and work on range of motion first. Hold the stretch for 5-8 counts and repeat 3 times. Don't stretch to the point of pain, but until you feel the muscle pull.
- Pay close attention to form when doing your strengthening exercises. Always try to increase the difficulty of your program by increasing the number of repetitions or sets.
- If you find that you are struggling with the Home Exercise Program, formal Physical Therapy may be indicated. Feel free to ask your Physician or Physician Assistant for a referral.
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