Physical Therapy: Restore Strength, Function to Your Shoulder

Physical therapists are an important part of your medical team. For many shoulder conditions, they can help you recover strength and function as well as speed the healing process. If you have surgery, following a physician-supervised physical therapy plan after the procedure is the best way to help the surgery be successful — and speed your return to the activities you love. Physical therapists also work with patients whose shoulder conditions do not require surgery.

Physical therapists:

Work with your orthopaedic specialist (def.) to develop a plan for your postsurgical recovery and rehabilitation.
Take you through techniques that will reduce pain and increase mobility and strength.
Teach you how to do the exercises at home.
In consultation with your doctor, help you decide when you're ready to move on to your favorite activities or back to work.

Physical therapists also work with occupational therapists (def), who may be an important part of your healthcare team in helping return you to everyday activities.

When you've had shoulder surgery

After your surgery, the real work begins. Following your orthopaedic surgeon and physical therapist's plan for rehabilitation can make a positive difference in recovering from your surgery.

Let's be honest. Some discomfort will be involved as you go through rehab. But patients who faithfully comply with the therapies and exercises prescribed by their surgeon and physical therapist have the best possible medical outcomes after surgery, according to the American Academy of Orthopaedic Surgeons. In addition, patients who felt they understood their rehab plan before surgery were most likely to have a good outcome, according to a study presented at the 2006 International Cartilage Repair Society meeting.

Here are the basic types of exercise you may expect:

Range-of-motion exercises

Range of motion is a joint's ability to go through all its normal movements.

Range-of-motion exercises may be passive (your therapist moves your shoulder for you), active-assistive (you need some help), or active (you move your shoulder yourself). These exercises help make the joints and shoulder muscles more mobile and less painful.

Muscle-strengthening exercises

Your physical therapist also may help you strengthen your muscles with resistance exercises. This is typically done with weights or elastic bands.

Electrical stimulation (TENS)

Your physical therapist also may suggest an additional type of therapy called TENS. Transcutaneous electrical nerve stimulation (TENS) is a type of electrical stimulation that can help treat certain kinds of pain. It produces a gentle current that stimulates muscles — and creates a slight tingling feeling.

A TENS device involves the use of small electrodes you attach to your shoulder. The device often can be used at home. It's not known exactly how TENS provides pain relief, but it is thought that it may stimulate production of endorphins (pain-inhibitors) or block nerve impulses that carry pain messages.

Cold therapy (cryotherapy)

Cold therapy may also be beneficial. Collagen is the main protein of connective tissue — helping to form muscles, tendons and ligaments. Normally it acts like a rubber band, stretching and contracting. If stretched too far, however, it can tear. This can allow fluid to escape into the spaces among the muscle fibers. Cold applied to the shoulder area can help decrease the resulting pain and inflammation.

Other therapies

Additional therapies may include iontophoresis, in which medications may be delivered through the skin via an electrical charge, or phonophoresis, which uses ultrasound to deliver medications.

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