Shoulder Pain & Treatment
What to expect
When experiencing shoulder pain, a history and physical examination by either a doctor or physical therapist is a good start. Depending on the diagnosis, your physician may order some tests like an xray, ultrasound or MRI. The most common injuries involve the rotator cuff mechanism (either inflammation or a tear), instability, labral injuries, a frozen shoulder, or arthritis.
The majority of shoulder issues can be treated without surgery. This non-operative approach often involves physiotherapy. Physiotherapy will work to restore, maintain and maximize function and pain free movement through stretching and strengthening exercises to “recenter the ball on the socket.” Modalities can also be used to help relieve pain. Treating shoulder problems can be a lengthy and challenging procedure dependent upon how early treatment intervention is received and the compliance of the patient.
About the shoulder
The shoulder is a complex joint that is actually comprised of 3 separate joints. These are the scapulothoracic joint (shoulder blade on rib cage), the AC joint (collar bone at acromion) and the glenohumeral joint (main shoulder ball and socket joint). This ball and socket joint is designed like a golf ball on a golf tee so it is inherently unstable. The ball is balanced on the socket like a TV tower is balanced on the ground with various guide wires. These guide wires in the shoulder consist of static stabilizers such as the labrum, capsule and ligaments. There are also dynamic stabilizers which are the various muscles around the shoulder (particularly the 4 rotator cuff muscles). If these “guide wires” are too loose, too tight, too weak or too strong on one side compared to other sides, the ball is not centered on the socket and this can lead to shoulder pain.
Surgical Care
In situations where surgery is required, post operative physiotherapy is essential in a successful outcome. Our physiotherapists follow the postop guidelines and protocol as determined by our shoulder surgeon at Wellington Ortho & Rehab. Expect the postop rehab program to last around 3 months with a few visits per week. A home exercise program monitored by your physiotherapist is also very important and can last for months as well.
Please make sure you arrange the following a few weeks prior to surgery:
- Post operative physiotherapy appointments
- Any recommended slings or physical aids
- Game Ready ® (cold and compression therapy) for passive control of pain and swelling
Referrals
Shoulder rehab doesn’t require a referral. Please check your insurance provider for coverage details. You will receive a referral for Physiotherapy from your doctor prior to your operation.
Fees & Payments
WSIB may cover up to 4 week of Game Ready® rental upon approval.
The Wellington Ortho & Rehab clinic is a private clinic and fees are not covered under OHIP.
The fee for an assessment by a physiotherapist is $100. Each subsequent treatment has a fee of $60.
Physiotherapy services are covered by most extended health care benefit plans. Direct billing is available for a number of extended health care plans.
We accept payment by cash, cheque, debit, mastercard or visa
Unsure of what to do next or where to start?
Avoiding narcotics and pain medication
Game Ready® Post-op Recovery
The combination of cold and compression therapies allow you to reduce swelling and pain without narcotics or prescriptions. Game Ready® has unique shoulder fitting wraps in multiple sizes to fit all body types. These shoulder cryotherapy wraps make recovering at home more manageable.
The application for Game Ready® is easy and can be completed in under 10 minutes.
Recovery
Post operation
The first visit after your operation can take between 30 and 60 minutes. During the appointment we will make an assessment of your unique condition. If you are not wearing a shoulder sling we will properly fit you with one of our recommended options. Our practitioners will go through the do’s and don’ts based on your abilities, and will provide guidelines on exercises.
A recommended course of treatment will be developed and a schedule for your future appointments will be created.
Course of treatment’s are built custom for you, based on your budget, time and lifestyle. Recommendations will be made and we encourage you to discuss your restrictions.
Next Steps
At home recovery
Continuing your treatment at home is important to achieve a successful recovery. Additional instructions and exercises will be sent to you via email. During your next appointment our practitioners will update you on your progress, address how you are feeling, and discuss how the exercises are performing.
Our physiotherapists will monitor your progress and you are encouraged to maintain your appointments until we can discharge you from care.
Appointments are available based on our clinic hours.
