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Painful shoulder exercises–are they safe?

Tom Willemann |

The exercises your physical therapist prescribed are causing pain. Could that be recommended practice?
Recent studies suggest it may be. Eccentric strengthening in the moderately painful range may blunt pain fibers’ signals to the brain leaving you with decreasing pain as the muscles strengthen. Such strengthening may also assist in stimulating improved tissue repair.
Evaluation of an exercise concept focusing on eccentric strength training of the rotator cuff for patients with subacromial impingement syndrome Journal of Clinical Rehabilitation 25 (2011):69-78) looked at painful eccentric strengthening for patients with shoulder pain.  A purpose of the study was to determine if exercising into the painful range was a necessary component of treatment.
Participants in the study performed prescribed exercises twice a day for 12 weeks.  Participants were instructed to exercise into pain levels around 5 on a pain scale of 0-10 (10= severe pain and 0=absence of pain).  Exercises included rotator cuff strengthening of the supraspinatus and infraspinatus muscles. Conditions excluded from the study included complete tendon rupture, radiating neck pain, history of  chronic rheumatic or inflammatory disease, previous surgery, shoulder instability, osteoarthritis of shoulder ac joint, adhesive capsulitis (frozen shoulder) and/or corticosteroid administration in last three months
Eight of 10 participants had significantly less pain and improved function after exercising into pain for 12 weeks!
While this study supports the treatment of shoulder impingement syndrome using painful eccentric strengthening of the supraspinatus and infraspinatus muscles paired with scapula stabilizing exercises including shoulder shrugs and shoulder retractions, additional randomized controlled double blind studies with larger sample sizes are required before this treatment method can become standard.
If a physical therapist does prescribe this treatment approach for your shoulder pain, be sure your therapist  has done a thorough evaluation to ensure you don’t cause further injury to your shoulder with this approach. Be sure you have been educated thoroughly on how to perform the exercises.
At Apex Orthopedic Rehabilitation my patients have responded well to incorporation of this treatment method for patella and achilles tendinopathy (both mid portion and insertional).
Apex Orthopedic Rehabilitation in Wyckoff, NJ provides orthopedic and sports physical therapy services for the greater Ridgewood, Wyckoff, and Bergen County region.  This blog is intended for informational purposes only and should not be used for diagnostic or prescriptive purposes. The views expressed here are the author’s views and should be taken as suggestions. Always consult your doctor, physical therapist or healthcare practitioner before engaging in a physical therapy or rehabilitative program.

Tom Willemann

Tom Willemann

Tom Willemann is a premier physical therapist based out of Bergen County, New Jersey. He holds an MS in physical therapy from the University of Miami, is credentialed in the world-renowned McKenzie Method of Mechanical Diagnosis and Therapy (MDT), and holds an OCS (Orthopedic Clinical Specialist) certification. As of 2018, there are approximately 14,000 ABPTS certified specialists in the nation and less than 400 of them are located in the state of New Jersey. Tom is the owner and director of Apex Orthopedic Rehabilitation in Paramus. He opened the clinic, which specializes in spine and sports injury prevention, in 2004 after many years of experience in the field. Tom’s caring interest in others and his strong belief in continuity of care, combined with his clinic’s ability to find solutions for the most difficult orthopedic problems, have earned Apex Orthopedic Rehabilitation its excellent reputation with patients and medical professionals in northeastern New Jersey and beyond. A true “family man,” Tom takes pride in his clinic’s warm and welcoming environment.
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