Shoulder
Shoulder Conditions
Frozen Shoulder (Adhesive Capsulitis)
What is Frozen Shoulder?
Frozen shoulder, also known as adhesive capsulitis, is a condition characterized by pain, stiffness, and gradual loss of motion in the shoulder joint. It occurs when the connective tissue surrounding the shoulder joint becomes inflamed and thickened, leading to restricted movement and discomfort. Frozen shoulder typically develops in stages and can significantly interfere with daily activities that require reaching, lifting, or overhead motion.
It is most common in adults between the ages of 40 and 60 and may develop after an injury, surgery, or period of shoulder immobility.
Causes of Frozen Shoulder
Shoulder immobilization following injury or surgery
Rotator cuff injury or inflammation
Diabetes or other metabolic conditions
Thyroid disorders
Autoimmune conditions
Unknown causes in some cases (idiopathic frozen shoulder)
Signs and Symptoms
Gradual onset of shoulder stiffness and limited range of motion
Dull or aching pain in the outer shoulder or upper arm
Increased pain with movement, especially at night
Difficulty with activities such as dressing, reaching, or lifting
Shoulder “freezing,” followed by a plateau phase, and then gradual “thawing” over time
Symptoms lasting several months to over a year without treatment
How We Help You Recover
At Hand Rehabilitation Specialists, our skilled Occupational and Physical Therapists—including Certified Hand Therapists—create individualized treatment plans to reduce pain, restore shoulder motion, and improve overall function. We guide patients through each stage of recovery with gentle, effective therapy.
Treatment may include:
Targeted stretching and range-of-motion exercises
Manual therapy to reduce joint stiffness and improve mobility
Postural training and shoulder mechanics education
Strengthening exercises for the shoulder and upper back
Pain relief strategies including heat, cold, and other modalities
Home exercise programs and activity modification guidance
Rotator Cuff Tendonopathy
What is Rotator Cuff Tendinopathy?
Rotator cuff tendinopathy is a condition involving irritation, degeneration, or inflammation of the tendons that make up the rotator cuff in the shoulder. The rotator cuff is a group of muscles and tendons that stabilize the shoulder joint and allow for overhead and rotational arm movements. When these tendons are overused or stressed, they can become painful and limit mobility, especially during lifting or reaching.
Rotator cuff tendinopathy is often caused by repetitive use, poor posture, or age-related changes to the tendons.
Causes of Rotator Cuff Tendinopathy
Repetitive overhead movements or lifting
Shoulder impingement or poor shoulder mechanics
Age-related tendon degeneration
Weakness or muscle imbalance in the shoulder
Poor posture or scapular instability
Acute injuries or overuse from work or sports
Signs and Symptoms
Pain in the front or side of the shoulder, especially with lifting or overhead use
Weakness or fatigue in the shoulder
Pain at night or difficulty sleeping on the affected side
Limited range of motion or shoulder stiffness
Aching or sharp pain during repetitive arm movements
Increased discomfort with reaching behind the back or head
How We Help You Recover
At Hand Rehabilitation Specialists, our experienced Occupational and Physical Therapists—including Certified Hand Therapists—offer comprehensive treatment for rotator cuff tendinopathy. We focus on restoring strength, flexibility, and shoulder function through individualized, evidence-based care.
Treatment may include:
Therapeutic exercises to strengthen the rotator cuff and surrounding muscles
Manual therapy to reduce tightness and improve joint mobility
Postural correction and movement retraining
Activity modification and ergonomic education
Pain management using modalities like ice, heat, or ultrasound
Progressive return-to-activity programs for work or sports
Rotator Cuff Tears
What is a Rotator Cuff Tear?
A rotator cuff tear is a partial or complete tear in one or more of the tendons that make up the rotator cuff in the shoulder. These tendons connect the shoulder muscles to the bone and help lift and rotate the arm. Tears can result from sudden injury or develop gradually due to tendon wear and degeneration. Rotator cuff tears can significantly limit shoulder strength, range of motion, and overall function.
Tears are classified as partial (incomplete) or full-thickness (complete) and may affect daily tasks such as reaching, lifting, or sleeping on the affected side.
Causes of Rotator Cuff Tears
Acute trauma such as falling on an outstretched arm or lifting something heavy
Repetitive overhead activities or sports (e.g., swimming, baseball, tennis)
Degenerative changes due to aging
Poor posture or shoulder mechanics
Chronic impingement or tendon wear over time
Previous shoulder injuries
Signs and Symptoms
Shoulder pain, especially with lifting or overhead movements
Weakness in the shoulder or arm
Pain at night or while lying on the affected shoulder
Limited range of motion
Difficulty performing daily activities like dressing or reaching
A popping or clicking sensation during movement
How We Help You Recover
At Hand Rehabilitation Specialists, our experienced Occupational and Physical Therapists—including Certified Hand Therapists—specialize in conservative and post-surgical rehabilitation for rotator cuff tears. Whether you’re recovering from an injury or surgery, we design a therapy program to help restore strength, flexibility, and function.
Treatment may include:
Custom exercise programs to improve strength and mobility
Manual therapy to reduce stiffness and promote healing
Postural correction and shoulder mechanics retraining
Pain management strategies including ice, heat, or electrical stimulation
Activity modification and return-to-work or sport planning
Post-operative rehabilitation to protect repair and regain shoulder use
Shoulder Instability
What is Shoulder Instability?
Shoulder instability occurs when the structures that support the shoulder joint—such as ligaments, muscles, and the joint capsule—are too loose or damaged, allowing the head of the upper arm bone (humerus) to move excessively or slip out of the shoulder socket (glenoid). This can cause pain, weakness, and a sensation that the shoulder may “give out” during certain movements.
Shoulder instability can be caused by trauma (such as dislocation), repetitive overhead activity, or general joint laxity. It can lead to chronic discomfort and limit participation in sports, work, or daily activities if not properly addressed.
Causes of Shoulder Instability
Traumatic injury such as a shoulder dislocation
Repetitive overhead motions (common in sports like swimming, baseball, or tennis)
Loose or stretched ligaments due to overuse or hypermobility
Poor posture or muscular imbalances
Previous shoulder injuries that were not fully rehabilitated
Signs and Symptoms
A feeling that the shoulder is loose or may “slip out” of place
Pain during overhead or throwing motions
Weakness or fatigue in the shoulder muscles
Clicking, popping, or catching sensations
Limited performance in sports or functional activities
Recurring shoulder dislocations or subluxations (partial dislocations)
How We Help You Recover
At Hand Rehabilitation Specialists, our team of experienced Occupational and Physical Therapists—including Certified Hand Therapists—offers customized rehabilitation programs to restore shoulder stability and strength. Whether your instability is related to a past injury or repetitive strain, we develop a plan that targets the root cause and promotes long-term shoulder health.
Treatment may include:
Strengthening exercises for the rotator cuff and scapular stabilizers
Manual therapy to improve joint mechanics and reduce tightness
Postural training and correction of movement patterns
Proprioceptive and neuromuscular control exercises
Education on activity modification and injury prevention
Post-operative rehabilitation for surgical stabilization procedures
SLAP tear
What is a SLAP Tear?
A SLAP tear is an injury to the labrum, the ring of cartilage that surrounds the socket of the shoulder joint. SLAP stands for “Superior Labrum Anterior to Posterior,” meaning the tear occurs at the top (superior) part of the labrum, where the biceps tendon attaches. This type of injury can result from trauma, repetitive overhead activity, or degenerative changes and often causes pain, clicking, or instability in the shoulder.
SLAP tears are common in athletes who perform frequent overhead motions, such as baseball players, swimmers, and tennis players, but can affect anyone following a fall or sudden pulling injury.
Causes of SLAP Tears
Falling onto an outstretched arm
Lifting heavy objects or sudden pulling movements
Repetitive overhead motions (throwing, swimming, etc.)
Degenerative wear and tear with age
Trauma or dislocation of the shoulder
Signs and Symptoms
Deep, aching shoulder pain, especially with overhead activity
Clicking, popping, or catching in the shoulder
Shoulder weakness or fatigue
Decreased performance in throwing or lifting activities
Pain when lying on the affected shoulder
A sensation of instability or “dead arm”
How We Help You Recover
At Hand Rehabilitation Specialists, our expert team of Occupational and Physical Therapists—including Certified Hand Therapists—provides comprehensive therapy for SLAP tears. Whether treated conservatively or following surgery, we develop a personalized rehabilitation program focused on restoring shoulder stability, strength, and function.
Treatment may include:
Manual therapy to improve joint mobility and reduce stiffness
Strengthening exercises for the rotator cuff and scapular stabilizers
Postural training and movement pattern correction
Pain management strategies such as ice, heat, or electrical stimulation
Activity modification and education to protect the joint
Post-operative rehabilitation following arthroscopic repair
Bursitis
What is Shoulder Bursitis?
Shoulder bursitis is a condition that occurs when the bursa—a small, fluid-filled sac that reduces friction between tissues—becomes inflamed. In the shoulder, the most commonly affected bursa is located beneath the deltoid muscle and above the rotator cuff tendons. When inflamed, the bursa can cause pain and restrict shoulder movement, especially during overhead activities.
Bursitis can result from overuse, direct trauma, poor posture, or as a secondary issue alongside rotator cuff tendinopathy or impingement syndrome.
Causes of Shoulder Bursitis
Repetitive overhead movements
Prolonged pressure or overuse of the shoulder
Poor posture or shoulder mechanics
Acute trauma or direct impact to the shoulder
Underlying rotator cuff injury or tendinopathy
Degenerative changes with age
Signs and Symptoms
Pain on the outside or top of the shoulder
Increased discomfort with overhead or reaching movements
Tenderness when pressing on the outer shoulder
Swelling or warmth around the joint
Pain that may disturb sleep, especially when lying on the affected side
Limited range of motion and stiffness
How We Help You Recover
At Hand Rehabilitation Specialists, our experienced Occupational and Physical Therapists—including Certified Hand Therapists—develop customized treatment plans for shoulder bursitis to reduce pain, restore motion, and prevent recurrence. Our goal is to help you return to your daily activities without discomfort or limitation.
Treatment may include:
Manual therapy to reduce inflammation and improve joint mobility
Therapeutic exercises to strengthen the rotator cuff and shoulder stabilizers
Postural training and ergonomic education
Activity modification to avoid aggravating movements
Pain relief strategies using heat, ice, or other modalities
Gradual return-to-activity and sport-specific training
Fractures of the Shoulder
What are Shoulder Fractures?
Shoulder fractures refer to breaks in any of the bones that form the shoulder joint—most commonly the clavicle (collarbone), scapula (shoulder blade), or the proximal humerus (upper arm bone). These fractures can result from falls, trauma, sports injuries, or motor vehicle accidents. Depending on the severity and location of the fracture, movement and function of the shoulder can be significantly impaired.
Timely rehabilitation is essential to regain shoulder strength, mobility, and full function—whether treated with or without surgery.
Causes of Shoulder Fractures
Falls onto the shoulder or outstretched arm
Direct trauma from sports or car accidents
Osteoporosis or weakened bones
High-impact collisions or blunt force injuries
Twisting or overloading injuries in the elderly
Signs and Symptoms
Severe pain in the shoulder or upper arm
Swelling, bruising, or tenderness over the affected area
Limited ability to move the arm or shoulder
Visible deformity or sagging of the shoulder
Grinding or popping sensations with movement
Difficulty lifting the arm or performing daily tasks
How We Help You Recover
At Hand Rehabilitation Specialists, our team of expert Occupational and Physical Therapists—including Certified Hand Therapists—develops personalized rehabilitation programs for patients recovering from shoulder fractures. Whether your fracture was treated conservatively with immobilization or surgically with fixation, we guide you through a safe and structured recovery.
Treatment may include:
Custom splinting or sling use guidance during the healing phase
Range-of-motion exercises to prevent stiffness
Manual therapy to restore joint and soft tissue mobility
Progressive strengthening exercises to rebuild stability and control
Scar management and post-operative care
Education on safe movements and return-to-activity strategies
Osteoarthritis of the Shoulder
What is Shoulder Osteoarthritis?
Osteoarthritis of the shoulder is a degenerative joint condition that occurs when the cartilage covering the surfaces of the shoulder joint wears down over time. This leads to pain, stiffness, swelling, and reduced mobility in the shoulder. The condition most commonly affects the glenohumeral joint (where the upper arm bone meets the shoulder socket) but can also affect the acromioclavicular (AC) joint near the top of the shoulder.
As the cartilage deteriorates, bones may rub against each other, causing inflammation, joint damage, and reduced function. Shoulder osteoarthritis can develop gradually with age or as a result of previous injury or overuse.
Causes of Shoulder Osteoarthritis
Age-related wear and tear
Previous shoulder injury or dislocation
Repetitive overhead use or heavy lifting
Inflammatory conditions like rheumatoid arthritis
Post-surgical changes or joint degeneration
Genetic predisposition or structural abnormalities
Signs and Symptoms
Pain in the shoulder, especially with movement or activity
Stiffness or loss of range of motion
Grinding, clicking, or popping sounds with movement
Swelling or tenderness around the joint
Pain at night or difficulty sleeping on the affected side
Weakness or difficulty with lifting, reaching, or overhead tasks
How We Help You Manage Shoulder Osteoarthritis
At Hand Rehabilitation Specialists, our experienced Occupational and Physical Therapists—including Certified Hand Therapists—create personalized, non-surgical treatment plans for managing shoulder osteoarthritis. Our goal is to reduce pain, improve mobility, and help you remain active and independent.
Shoulder Dislocation
What is a Shoulder Dislocation?
A shoulder dislocation occurs when the head of the upper arm bone (humerus) is forced out of its normal position in the shoulder socket (glenoid). Because the shoulder is the most mobile joint in the body, it is also the most commonly dislocated. Dislocations can happen in any direction, though anterior (forward) dislocations are the most common. A shoulder dislocation can damage surrounding ligaments, tendons, cartilage, and nerves, often leading to instability or recurrent dislocations if not properly treated.
Causes of Shoulder Dislocation
Falls onto an outstretched arm
Direct trauma to the shoulder
Sports injuries involving impact or forceful arm movement
Motor vehicle accidents
Loose ligaments or prior history of shoulder instability
Signs and Symptoms
Severe pain in the shoulder and upper arm
Visible deformity or a squared-off appearance of the shoulder
Inability to move the shoulder or arm
Swelling, bruising, and tenderness around the joint
Numbness, tingling, or weakness in the arm or hand
Recurrent episodes of the shoulder “slipping out” after initial dislocation
How We Help You Recover
At Hand Rehabilitation Specialists, our team of Occupational and Physical Therapists—including Certified Hand Therapists—provides expert rehabilitation for patients recovering from shoulder dislocation. Whether treated non-surgically or with surgery, we develop a personalized plan to restore strength, stability, and full function.
Treatment may include:
Range-of-motion exercises to restore mobility after immobilization
Strengthening exercises for the rotator cuff and shoulder stabilizers
Manual therapy to improve joint flexibility and soft tissue mobility
Neuromuscular retraining and proprioceptive exercises
Education on activity modification and injury prevention
Post-operative rehab following surgical stabilization
Impingement Syndrome
What is Impingement Syndrome?
Impingement syndrome occurs when the tendons or bursa in the shoulder become compressed or “impinged” between the bones of the shoulder joint, particularly during lifting or overhead movements. This compression causes pain, inflammation, and limited mobility. The condition often involves the rotator cuff tendons and the subacromial bursa, which can become irritated over time with repetitive use.
If left untreated, impingement syndrome can lead to tendon damage, bursitis, or even rotator cuff tears.
Causes of Impingement Syndrome
Repetitive overhead activity (sports, lifting, or work tasks)
Poor posture or altered shoulder mechanics
Shoulder instability or muscular imbalances
Bony abnormalities (e.g., bone spurs) in the shoulder
Previous shoulder injuries
Rotator cuff weakness or fatigue
Signs and Symptoms
Pain in the front or side of the shoulder, especially with lifting the arm
Discomfort during overhead or reaching motions
Pain that may worsen at night or when lying on the affected side
Weakness in the shoulder and arm
Stiffness or limited shoulder mobility
A catching, clicking, or grinding sensation during movement
How We Help You Recover
At Hand Rehabilitation Specialists, our skilled Occupational and Physical Therapists—including Certified Hand Therapists—provide personalized treatment plans to relieve pain, restore movement, and prevent further shoulder damage caused by impingement syndrome.
Treatment may include:
Manual therapy to improve joint and soft tissue mobility
Postural training and correction of movement mechanics
Strengthening exercises for the rotator cuff and scapular stabilizers
Stretching to improve flexibility and relieve pressure on impinged structures
Activity modification and ergonomic education
Pain management techniques including heat, ice, or other therapeutic modalities