The shoulder is a unique joint because it has a great range of motion. Unfortunately, that benefit is negatively balanced with poor stability. This is likely why between 20-25% of the population is afflicted with shoulder pain at some point in life.
One of the greatest challenges in managing shoulder pain of musculoskeletal origin (it can also be a referred pain from a visceral organ like the gall bladder or from the heart) is its slow recovery rate. Some studies show that only about 50% of all new episodes of shoulder complaints have a complete recovery within six months. Add in the aging process, conditions that can slow recovery (like diabetes), and hobbies and jobs that increase the risk of re-injury and it’s understandable why it may not be possible for some patients to make a full recovery.
So, what can doctors of chiropractic do to help those with shoulder pain? The use of manipulation, mobilization, and modalities such as class IIIb and class IV laser (and others) can help a lot. But most importantly, exercise training is the KEY to a successful outcome.
Because of the slow recovery time for shoulder injuries, it is IMPORTANT to gradually introduce exercises at the correct time. In the initial acute stage, the following are appropriate:
Pendulum exercises: Like the pendulum of a clock, let the arm hang freely and gently swing while grasping a light weight (2.5-5 pounds, or 1.13-2.27 kg) – DO NOT try to lift the weight!
Finger walks up a wall: Face a wall and slowly walk your fingers up the wall but STOP at the point of pain. Remember, the first goal is to restore pain-free motion.
Once pain levels have improved and range of motion has been restored, resistance exercises are necessary to regain full function. TheraTube or TheraBand exercises are very practical, as you can travel with these and perform them anywhere. Here is a sample protocol: https://youtu.be/HKdm-2WYxDQ
Start with only three repetitions for each of these movements and SLOWLY release the tubing to help build coordination. If the protocol is too difficult, move toward the anchor point/door to reduce the tension on the tube. Be patient with your progress. It’s a slow but a consistent routine that will get you to your desired goals.
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