Do I Need Physical Therapy For Shoulder Pain in Petaluma?
If you've had shoulder pain for more than a couple of weeks, have pain reaching overhead, lifting weights, throwing, or sleeping, there's a good chance that sports physical therapy is the solution.
The key to good sports injury rehabilitation isn't simply treating the pain, but rather understanding why the pain developed in the first place.
At BaseCamp Performance Co., we see athletes suffering from shoulder pain every single day. From baseball pitchers at Petaluma and Casa Grande, to CrossFit athletes at Sav-Up, to recreational pickleball players and weightlifters, we've helped hundreds of athletes throughout Sonoma County return to the sports they love.
In today's blog, we'll discuss the common causes of shoulder pain, why it happens, and how to determine if you should seek out care for your shoulder pain.
What Causes Shoulder Pain?
When we dive into understanding what causes shoulder pain, we have to first understand what can be hurting. The following are the most common 'diagnoses' that come into our office.
- Rotator Cuff Muscles or Tendons
- Shoulder Impingement
- Labral Injury or irritation
- Biceps tendinitis
- AC Joint irritation
- Frozen Shoulder
- Shoulder instability
- Muscle strains
The diagnosis tells us what tissue hurts, but doesn't explain why that tissue hurts in the first place.
Any of the above injuries or pains may occur for a number of different reasons. Understanding why a pain is happening is critical to understanding how to attack the pain in rehab.
Unfortunately, most of the medical field focuses specifically on what is hurting. This can lead to confusion and frustration.
Why Shoulder Pain Happens (Especially in Active Adults and Athletes)
Gaining an understanding of why your shoulder hurts requires us to understand the demands you're placing on your shoulder.
This isn't unique to the shoulder. We see the exact same pattern in many running injuries, where training loads increase faster than the body can adapt.
For instance, the demands of overhead sports are different than that of weightlifting movements.
Both require overhead mobility, but they require different amounts and different stress to the surrounding muscles.
Most commonly, pain in the shoulder occurs when the demands placed on the shoulder are greater than the body's ability to handle those demands. This could be due to:
- Poor mobility of the shoulder joint
- Weakness in the rotator cuff muscles
- Weakness in the shoulder stabilizers
- Weakness in specific positions (i.e. overhead)
- Previous injury to the shoulder
- Poor recovery
- Rapid increases in training volume
The key to understand here is that there is a mismatch of what you're asking of your shoulder, and what it is currently capable of.
Your shoulder isn't "bad", but rather, the demands you're placing on it have exceeded its current capacity.
This leads to excessive stress to your shoulder, paving the way for painful movement or tissue.
Common Mistakes People With Shoulder Pain Make
Mistake #1: Resting until the pain goes away
Rest is a great strategy for decreasing pain. But it does nothing to address the underlying reason your shoulder hurts in the first place.
As a result, when you return to activity, your shoulder pain often comes back nearly immediately.
Mistake #2: Stretch, stretch, stretch
Mobility can be an underlying cause to shoulder pain. But if you spend your time focused only on stretching, you're unlikely to fully resolve the issue.
The shoulder is a dynamic joint requiring a high degree of strength and stability. Focusing only on flexibility often leads to marginal improvements, at best.
Mistake #3: Continuing to train through pain
This one seems obvious, and yet we see patients every day who push through symptoms.
"It only hurts when I go heavy" - everyone.
Continuing to train, or modifying all of the ways to piss your shoulder off, fails to address the underlying reason your shoulder hurts in the first place.
Want limited progress and continued issues? Try this route.
Mistake #4: It must be inflammation!
Ice, massage guns, and cortisone injections all help to control the inflammatory response. And this can provide powerful relief of symptoms.
Sometimes, they are even necessary components of sports physical therapy. But using these modalities as the sole focus?
You're missing the bigger picture.
Mistake #5: Waiting months before getting evaluated
It's understandable to want to see if something can resolve on its own. Seeking treatment can feel expensive and time consuming.
But, waiting too long presents its own risks. You're very likely to develop compensatory movement patterns, while also losing strength,
These often create longer-term problems, leading to longer recoveries that can often cost more - both financially, and with respect to your time.
Do You Actually Need Physical Therapy?
If you:
- have had pain lasting longer than 2-3 weeks
- have pain when lifting, throwing, sleeping, or reaching overhead
- feel weakness in the arm
- have lost motion or mobility
- have had surgery
- Or are experiencing a recurring bout of shoulder pain
The answer is yes.
Even if you only experience one of the above symptoms, it's worth having your shoulder evaluated before the problem becomes more difficult to treat.
Stop playing pickleball through the pain every day at Lucchesi Park, and get in to see a sports physical therapist.
The above issues suggest that there is an underlying problem leading to your pain, which would benefit greatly from a targeted rehab program.
If it's been 1 week, or the pain is very minimal, you might not need a targeted rehab program at this time.
How Performance Rehabilitation Solves Shoulder Pain
Rest and simple exercises are not the solution to your shoulder pain, especially if you're an athlete or highly active individual.
Performance rehabilitation takes a different approach when addressing your shoulder pain. Here's what that looks like:
Find the True Source
An in-depth evaluation is needed to determine the why behind your shoulder pain. This takes into account your unique mobility, strength, and coordination, but also your training history and sport demands.
Restore Capacity
Above, we discussed that the underlying cause of your shoulder pain is tied to placing too much stress on the tissues.
Decreasing the stress is one strategy for pain-relief.
But the long-term strategy needed is to increase the shoulder's ability to handle stress.
This is done through a progressive program.
Pain-free movement -> Strength -> Power -> Sport-specific movements -> Return to sport.
The muscles and tendons must be challenged to grow. As they do, a sound performance training program continues to adapt to challenge your ability to express strength and control in more challenging positions.
This is how you build capacity.
Return to Performance
Sport requires a higher degree of strength, stability, coordination, and capacity.
Traditional rehab typically ends when you're no longer in pain. A performance rehabilitation program focuses on challenging the shoulder in the exact ways that are required for your sport.
A program for swimmers will look different than one for baseball players.
This is how you build the shoulder back to your sport of choice, and protect yourself along the way.
And better yet, this is how you become a better athlete who can perform better than prior to the injury.
How BaseCamp Performance Co. Treats Shoulder Pain
At BaseCamp, we not only help athletes overcome shoulder pain.
Instead, we build them into more resilient, higher-performing athletes than before.
That's what sports physical therapy is all about.
Here's how we do it:
One-On-One Care
All of our appointments are spent entirely with a physical therapist or sports chiropractor.
No more wondering who's treating you today.
Every appointment is one-on-one with the same expert clinician who knows your goals, your porgress, and exactly what your shoulder needs next.
We don't use aides or technicians, meaning you've got expert eyes and hands on you throughout your entire 60-minute appointment.
Your evaluation is carried out in painstaking detail, and we finish the session by explaining to you why your shoulder pain is occurring, and the exact step-by-step plan we'll take to get you to your goal.
Objective Testing
In our evaluation, and throughout your care, we'll routinely use the highest levels of objective testing to gauge where you're at.
This is exactly how we determine if you're facing a strength, mobility, or power issue.
We use the same technology used in professional sports training rooms across the world.
Instead of guessing whether your shoulder is "strong enough", we measure.
That allows us to make calculated decisions about when it's safe to return to lifting, throwing, or competing.
Collaborative Team
Our team is made up of a team of experts from different disciplines: performance physical therapists, sports chiropractors, and strength & conditioning coaches.
This means that when we look at your shoulder, we're bringing the best from multiple fields.
A baseball pitcher working recovering from a labral injury might begin working with a physical therapist early in rehab, then transition to our strength coach to rebuild power and add velocity.
A swimmer might begin work with a strength coach, only to realize that their performance is limited by mobility deficits, leading them to work with our sports chiropractor to increase their range.
That's what our integrated team specializes in, and what keeps everyone of our clients moving toward their goals.
Individualized Programming
No handouts here.
Every activity we prescribe is built specifically for you.
We battle-test it in your sessions, making sure that it's the right program for you.
We'll tweak your program during each session to ensure you're making quick progress, and not getting stuck on plateaus.
Performance Mindset
Getting rid of pain is just the beginning of our work.
We want you stronger, more durable, and higher performing than before.
This is where our strength & conditioning background truly sets us apart from other clinics.
Expect that you'll throw faster, pull harder, and be able to push yourself further than before when you return to your sport.
That's the BaseCamp difference.
When Should You Seek Professional Help?
Consider an evaluation if you:
- Have pain lasting longer than 2-3 weeks
- Have pain at night while sleeping
- Have experienced weakness or loss of motion
- Feel that your shoulder is unstable
- Have pain that limits your workouts
The sooner you're able to get it addressed, the quicker your rehab will be.
Conclusion
Shoulder pain is common amongst athletes and highly active individuals.
Ignoring it, or treating it with passive modalities or traditional therapies is rarely effective, especially if you're an athlete.
The earlier you're able to understand why your shoulder hurts, the faster you'll be able to get back to doing what you love.
The good news?
Most shoulder injuries respond extremely well when the underlying cause is identified early and addressed with the right rehab plan.
Not sure if you need physical therapy?
If you're dealing with shoulder pain and aren't sure whether physical therapy is the right next step, schedule a free Discovery Call with our team.
We'll discuss:
- Your symptoms
- Your goals
- Whether physical therapy, sports chiropractic, or another healthcare provider is the best next step
Seriously.
That's part of our promise to helping you get the best care possible.
These calls are pressure-free and free of charge.
Just honest guidance to help you make the right decision for you.