Painful Shoulder: Exercise Can Reduce Pain and Improve Mobility and Function
Abstract
Shoulder pain is common, especially as we age. Pain that limits your ability to raise your arm above your head or rotate your shoulder is called “subacromial shoulder pain.” The good news is that most people with subacromial shoulder pain improve with physical therapy. A review of the most up-to-date research published in the March 2020 issue of JOSPT concluded that shoulder exercises are the best way to manage this pain. J Orthop Sports Phys Ther 2020;50(3):142. doi:10.2519/jospt.2020.0501
Shoulder pain is common, especially as we age. Pain that limits your ability to raise your arm above your head or rotate your shoulder is called “subacromial shoulder pain.” Other names you may hear include rotator cuff tendinopathy, subacromial impingement syndrome, or rotator cuff–related shoulder pain. You may feel this type of pain during everyday activities, such as getting dressed.
The good news is that most people with subacromial shoulder pain improve with physical therapy. A review of the most up-to-date research published in the March 2020 issue of JOSPT concluded that shoulder exercises are the best way to manage this pain.
New Insights
The authors of the JOSPT review analyzed 202 systematic reviews published between 2012 and 2018 for quality and relevance. Sixteen reviews were included. The strongest recommendation was for shoulder exercises that were supervised in the clinic or performed at home. Different types of shoulder exercises reduced pain, improved shoulder movement, and increased shoulder function. The most common exercises prescribed included strengthening the muscles around the shoulder and shoulder blade, as well as exercises to improve shoulder mobility or quality of movement.
For patients with persistent shoulder pain, exercise therapy was just as effective as a corticosteroid injection in the short term and shoulder decompression surgery in the long term. In addition to shoulder exercises, manual therapy can help to decrease pain and improve shoulder mobility. The authors also recommended against using laser, ultrasound, extracorporeal shockwave, or pulsed electromagnetic energy therapy to treat subacromial shoulder pain, due to the lack of supporting evidence.
Practical Advice
Shoulder exercises are as effective as shoulder surgery and injections, and are less expensive and unlikely to generate negative side effects. They also offer the general health benefits of exercise.
To help guide your treatment and tailor a program to your needs, your physical therapist will discuss your concerns with you and perform a thorough evaluation. Depending on the findings, you may be prescribed different shoulder-strengthening and/or mobility exercises, which may be combined with manual therapy.
This JOSPT Perspectives for Patients is based on a literature review by Pieters et al titled “An Update of Systematic Reviews Examining the Effectiveness of Conservative Physical Therapy Interventions for Subacromial Shoulder Pain” (J Orthop Sports Phys Ther 2020;50(3):131-141. https://doi.org/10.2519/jospt.2020.8498).
This Perspectives article was written by a team of JOSPT's editorial board and staff. Deydre S. Teyhen, PT, PhD, Editor, and Jeanne Robertson, Illustrator.
For this and more topics, visit JOSPT Perspectives for Patients online at www.jospt.org.
JOSPT PERSPECTIVES FOR PATIENTS is a public service of the Journal of Orthopaedic & Sports Physical Therapy®. The information and recommendations contained here are a summary of the referenced research article and are not a substitute for seeking proper health care to diagnose and treat this condition. For more information on the management of this condition, contact your physical therapist or other health care provider specializing in musculoskeletal disorders. JOSPT Perspectives for Patients may be photocopied noncommercially by physical therapists and other health care providers to share with patients. The official journal of the Academy of Orthopaedic Physical Therapy and the American Academy of Sports Physical Therapy of the American Physical Therapy Association (APTA) and a recognized journal of 35 international partners, JOSPT strives to offer high-quality research, immediately applicable clinical material, and useful supplemental information on musculoskeletal and sports-related health, injury, and rehabilitation. Copyright ©2020 Journal of Orthopaedic & Sports Physical Therapy®
