Often all possibilities of a conservative therapy (without surgery) should be exhausted before an operation is considered. Physiotherapy can often improve shoulder pain and even make it painless. Additional therapies such as physical therapy with heat and massage promote the improvement process.
Physiotherapy instead of surgery
The shoulder joint is a muscle-guided joint and therefore more unstable than, for example, the hip joint. If the responsible muscles and tendons are affected by wear and tear or injuries, the joint can no longer function optimally and the joint head no longer glides as well as before in the socket. Physiotherapy can improve this gliding behaviour, strengthen the muscles and help to centre the head better in the socket again.
In addition, physiotherapy and physical therapy can eliminate muscle tension, which can also lead to shoulder pain and restricted movement. Thus, in many cases an improvement of the symptoms can be achieved without the need for surgery. A reason for surgery is if the patient is young and has a recent injury to a muscle with severe shoulder pain and pronounced symptoms, or if he or she has to perform heavy work with the arm at work (for example, overhead). In some cases, the full functionality of a lesion can only be restored by surgery.
The “lime shoulder” (impingement)
The impingement syndrome is also known as painful arc or painful arc. It manifests itself as shoulder pain when the arm is lifted sideways, especially between 60 and 120 degrees. On the last part, close to the ear, the pain characteristically subsides again.
The impingement syndrome is often caused by a muscle tendon or bursa of the shoulder. When these structures are structurally altered by wear and tear, i.e. “calcified”, they can no longer slide easily over each other and are trapped under the bone of the acromion when the arm is raised. This results in shoulder pain, and can also lead to sensory disturbances in the arm or feelings of numbness.
Impingement syndrome can also be caused by wear and tear (arthrosis) in the cartilage of the acromioclavicular joint. The pain does not necessarily have to be localized where the cause lies. Active sliding of the shoulder downwards (to reduce the pressure on the tendons) Starting position: Sit sideways to the table, the elbow is bent and the elbow and forearm are on the table, the shoulder angled approx. 30 degrees to the side Execution: Imagine a ball in your armpit that you want to roll towards the floor 3 times 15 repetitions, between sets small breaks of approx. 30 seconds
- Starting position: Seat sideways to the table, elbow is bent and elbow and forearm are on the table, shoulder is bent about 30 degrees to the side
- Execution: Imagine a ball in your armpit, which you want to roll towards the floor
- 3 times 15 repetitions, small pauses of about 30 seconds between sets
do not perform this exercise immediately after a fresh lesion, otherwise depending on the pain Starting position: forearm support on a pad, either the knees or the feet touch the floor the rest of the body forms a straight line, the buttocks are not higher than the back and thighs, the shoulder blades are pulled towards the spine if possible, hold for 20-30 seconds, repeat 3 times
- Do not perform this exercise immediately after a fresh lesion, otherwise it is painful
- Starting position: Forearm support on a pad, either the knees or the feet touch the floor
- The rest of the body forms a straight line, the buttocks are not higher than the back and thighs, the shoulder blades are pulled towards the spine
- If possible, hold for 20-30 seconds, repeat 3 times
All articles in this series:
