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SHOULDER, ELBOW, WRIST, AND HAND PAIN AND CONDITIONS

Shoulder pain
There are many structures in and around the shoulder that can refer pain to the shoulder region. One of the most important roles of the physical therapist is to determine if the shoulder pain is coming from a structure in the joint itself or from another area, most commonly the neck. Once the proper diagnosis is made we can then design a specific treatment plan for your shoulder pain.
How can physical therapy help?
Your physical therapist will evaluate your shoulder, neck and spine to make the correct diagnosis for your shoulder pain. A proper shoulder diagnosis is key to treating this area correctly. Exercises will often include strengthening and stretching of the rotator cuff and scapular muscles as well as education on posture to minimize stress in this area.
Rotator Cuff Injury
A rotary cuff strain is a very common diagnosis, found in more than 20% of patients aged 22 to 80 and 50% of patients older than 661. Older people becoming more and more active makes them even more susceptible to rotary cuff tears2 and have a greater need for managing their movement better.

Good ways to treat rotary cuff pain is through rest, icing, and careful exercises, preferably with a trained physical therapist.
Pinched Nerve in Shoulder Blade
Pinched nerves actually happen in the spine, and are something to look out for when you get older. As we age, the padding between bones get weaker, and sometimes bones can grow while this happens, causing their edges to squeeze our spine’s nerve root3. Depending on where this happens, this can cause a shoulder to feel much harsher pain than the usual sprain.

Pinched nerves are usually diagnosed through X-rays & MRI scans, & can be treated with a neck brace, medicine, & physical therapy.
AC Joint Pain
AC Joints, full name “acromioclavicular joints”, connect the shoulder and neck. They become injured when their ligaments become strained or outright torn. This can happen from a particularly harsh impact while playing sports or falling off a bike4.

In severe cases, you may need surgery to fix an AC joint injury; but in most cases, rest, wearing a sling, and practicing safe AC joint exercises with a physical therapist can help your AC joint gradually heal.
Frozen Shoulder
A frozen shoulder, or adhesive capsulitis, is more commonly seen in women than men and more common in people between 40 and 60 years old5. It often follows a set pattern, which starts with pain and limited mobility for up to 9 months as the shoulder “freezes”. This is when the, normally thin joint capsule, thickens up and tightens down preventing normal joint mechanics.

A good way to treat and prevent frozen shoulders is to practice careful exercises, especially with a certified physical therapist.
More Conditions We Treat

Below is a list of conditions related to the shoulder, elbow, wrist, and hand that we treat including diagnoses for which we provide treatment and links to articles and video transcripts that provide more information regarding each condition.

  • Shoulder Issues and Pain
    • Swimmer’s Shoulder
  • Elbow Issues and Pain
    • Golfer’s Elbow
    • Tennis Elbow
    • Ulnar Nerve Entrapment
  • Wrist and Hand Issues and Pain
    • Carpal Tunnel
    • De Quervain’s Tenosynovitis
    • Trigger Finger or Thumb
    • Wrist Sprain
References
  1. ^ McMonagle, J. S. & Vinson, E. N. “MRI of the shoulder: Rotator cuff”Applied Radiology: The Journal of Pracitcal Medical Imaging and Management, 30 March 2012. Retrieved 27 March 2018.
  2. ^ Elfar, G. C. & Geary, M. B. “Rotator Cuff Tears in the Elderly Patients”Geriatr Orthop Surg Rehabil, September 2015. Retrieved 27 March 2018.
  3. ^ Reviewed by Weatherspoon, D. “Is a Pinched Nerve Causing Your Shoulder Pain?”Healthline, 2 February 2018. Retrieved 27 March 2018.
  4. ^ Miller, J. “AC Joint Injury”PhysioWorks, Retrieved 27 March 2018.
  5. ^ Gillot, C. “Frozen shoulder: What you need to know”Medical News Today, 5 December 2017. Retrieved 27 March 2018.
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Burien WA 98166
Phone: 206.327.9880 | Fax: 206.327.9977
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