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How to Assess and Treat Chronic Shoulder Pain


Early diagnosis and intervention for shoulder pain is important to prevent further injury to your rotator cuff.

Shoulder pain greater than 2 weeks that has not resolved should be looked at to prevent a long term problem and an increased risk of rotator cuff damage and even a tear from happening. Most rotator cuff tears start with a chronic mechanical problem with chronic inflammation, pain and swelling that tears doing a routine activity. You are doing the same exercise that you have done in the past or reached behind your car seat to grab your purse and you have sudden pain. Your shoulder problem started before this event.


Here is the process of evaluation and treatment through Jason's story, a personal trainer one year after rotator cuff surgery suffering from shoulder pain with exercise and with sleeping.





If the shoulder diagnostic ultrasound shows inflammation, swelling and even thickening of tendons and bursae, then there is a biomechanics shoulder problem and restoring normal motion through this process will have the greatest chance of success.




Treat the joint limitations that can exist in the glenohumeral joint, shoulder blade or scapula, rib cage and even the spine including the neck. We do this through specific joint manipulation techniques.




There can be trigger points or muscle knots in the shoulder complex, trapezius, rotator cuff and back muscles. Here are some of the treatments that are used to restore normal shoulder muscle mobility and reduce adhesions and restricted and tight connective tissue, even scar tissue.


  • Trigger Point Dry Needling
  • Myofascial Release Technique or Manipulation
  • Active Release type treatment or Functional Techniques
  • Deep Tissue Massage


We recommend dry needling as it speeds up the healing process and will get you better faster.




The next is to work on normal movement and mechanics of the shoulder. This is where you become an integral part of treatment through a home program of using the gained mobility that has occurred through the first two steps. It is important to use the movement that you have been given. Your Physical Therapist will assist you with your technique.




Looking at your posture and postural habits as well as behaviors that may cause a re-injury of your shoulder is important to keep your new shoulder motion and reduced pain from returning. Sleeping posture changes and how you work will be addressed in this part of care.


This is the program that we use to successfully treat chronic shoulder problems. Treatment is usually once a week after your evaluation for 4 visits.





Most shoulder problems can be treated in 4 treatment sessions following this shoulder program. The Shoulder Screening Evaluation helps us determine if the Fast Track Shoulder Program is the right treatment approach for your shoulder.






Pain with sleeping on your shoulder

Painful Arc of motion, pain as you raise your arm

Weakness of the shoulder and sometimes grip

Upper back pain and tension

Neck tension that goes into the shoulder

Pinching sensation of the shoulder

Pain with lifting weights or working out


What's Next?


Shoulder screening to determine the right direction for your shoulder problem. If your shoulder problem is 


Early diagnosis and intervention for shoulder pain is important to prevent further injury to your rotator cuff.


Treatment through the 4 step program has the highest success in resolving chronic shoulder pain and preventing further injury.


Connect with Cornerstone Physical Therapy at 719-596-5000, text us at 719-249-5850, or email at


How to Assess and Treat Chronic Shoulder Pain