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Painful shoulder exercises–are they safe?

Wednesday, January 9th, 2013 | Shoulder

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 Paramus, NJ provides orthopedic and sports physical therapy services for the greater Ridgewood, Paramus, 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.

Tags: Apex Orthopedic Rehabilitation, arm pain, eccentric strengthening, infraspinatus, neck pain, pain eccentric strengthening, Paramus Physical Therapist, paramus physical therapy, scapula stabilizer, Shoulder Impingement, shoulder pain, shoulder pain paramus, shoulder pain ridgewood, supraspinatus

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