Shoulder Pain Prevention

Shoulder Pain Prevention

Shoulder pain is a common problem that affects millions of Americans each year. In most cases, this discomfort only lasts a short time, and the person is able to resume normal activities quickly. However, in other cases, significant disability can occur, and the patient may require ongoing physical therapy or even surgery to correct the damage. A closer look at shoulder pain can help you to determine the cause of the injury and what you may need to relieve pain and restore full function.

Causes of Shoulder Pain

Severe trauma, such as from an automobile accident or fall, can cause chronic shoulder pain. However, the vast majority of shoulder pain cases are caused by overuse and repetitive motion injuries. Osteoarthritis can also affect shoulder joints, causing chronic pain, swelling and loss of motion. A number of systemic diseases can also cause shoulder pain, including rheumatoid arthritis, lupus, Lyme disease and gout.

Shoulder Joint Structure

The shoulder joint is the most flexible joint in the human body. It is made up of four muscles and five bone groups the function smoothly together to provide a wide range of movement. The main joint, called the glenohumeral joint, is the ball-and-socket combination that allows this range of motion. Overuse can cause damage to any part of this delicate mechanism. Inflammation can affect the small sac of lubricating fluid in the bursa. Bones and cartilage can be damaged by arthritis. A visit to a physician that specializes in joint problems can help to determine the cause of the problem and design an effective treatment program to eliminate pain and increase function.

Treating Shoulder Pain Problems

Shoulder pain problems are diagnosed using x-rays, MRI and CT scans. In some cases, oral anti-inflammatory medications can help to manage pain and reduce inflammation. Physicians often recommend a change in activity level until the injury has resolved. Corticosteroid injections may be necessary to treat inflammation in the joint. In some cases, surgery may be needed.

New Methods of Treatment

New technologies are providing new methods of treatment for many types of muscle and joint injury. Dynamic neuromuscluar stabilization, or DNS, uses reflex stimulation and manually assisted exercise to maximize movement patterns and reduce dysfunction. Extracorporeal shockwave therapy, or ECST, offers a non-invasive technique to increase blood circulation, stimulate the metabolism and enhance tissue regeneration to accelerate the healing process. New York Dynamic Neuromuscular Rehabilitation and Physical Therapy offers both of these therapies to help patients

Shoulder Pain Prevention Strategies

Keeping your shoulder joint healthy can be achieved by taking a number of proactive steps before strenuous activity:

  1. Monitor your posture when standing, walking and sitting to maintain normal shoulder position.
  2. Maintain your overall health and fitness level.
  3. Always do warm-up stretching exercises before engaging in activities that involve rigorous use of the shoulder joint. These exercises should be done for at least 30 seconds before activity.
  4. Do exercises to strengthen the muscles surrounding the shoulder joint to prevent overuse injuries.
  5.  Do self myofascial release before the activity to decrease tension and prevent injury of the shoulder joint. The fascia is connective tissue surrounding the bones, muscles and joints. Trigger points are tight bands of muscle that are vulnerable to injury. The technique of running a foam roller over slightly painful areas within joints can help to relieve minor pain and prevent further injury to the joint.
  6.  Incorporate exercises into the physical activity to ensure that all elements of the shoulder joint are kept in line during movement.
  7. Alternate the use of arms and shoulders during lifting or physical activity to prevent repetitive injuries.
  8.  Avoid holding arms in an overhead position for work duties to prevent shoulder strain.
  9. When using a backpack, ensure the pack has good support that centers on the back, not on the shoulders.
  10. Avoid the use of alcohol or drugs before athletic activities to reduce the risk of injury.

Maintaining strong, healthy shoulder function is a process of preventive actions and monitoring minor problems to prevent more serious injuries. If you experience shoulder pain on an ongoing basis, talk to a specialist to determine the cause of the problem and your options for treatment.


In this instance, an athlete was originally diagnosed with minor quadriceps muscle strain and was treated for four weeks, with unsatisfactory results. When he came to our clinic, the muscle was not healing, and the patients’ muscle tissue had already begun to atrophy.

Upon examination using MSUS, we discovered that he had a full muscle thickness tear that had been overlooked by his previous provider. To mitigate damage and promote healing, surgery should have been performed immediately after the injury occurred. Because of misdiagnosis and inappropriate treatment, the patient now has permanent damage that cannot be corrected.

The most important advantage of Ultrasound over MRI imaging is its ability to zero in on the symptomatic region and obtain imaging, with active participation and feedback from the patient. Using dynamic MSUS, we can see what happens when patients contract their muscles, something that cannot be done with MRI. From a diagnostic perspective, this interaction is invaluable.

Dynamic ultrasonography examination demonstrating
the full thickness tear and already occurring muscle atrophy
due to misdiagnosis and not referring the patient
to proper diagnostic workup

Demonstration of how very small muscle defect is made and revealed
to be a complete tear with muscle contraction
under diagnostic sonography (not possible with MRI)


Complete tear of rectus femoris
with large hematoma (blood)


Separation of muscle ends due to tear elicited
on dynamic sonography examination

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