Shoulder injuries are a common concern, affecting individuals across various age groups and physical activity levels. Effective management is crucial to restore function, alleviate pain, and prevent recurrence. Two primary approaches that an Osteopath utilises in conservative treatment are manual therapy and exercise-based rehabilitation. Recent research highlights the benefits of integrating these methods for optimal recovery.
Understanding Manual Therapy
Manual therapy involves hands-on techniques performed by trained therapists to mobilize joints, manipulate/massage soft tissues (muscle, tendons, ligaments, fascia), all of which techniques are aimed at reducing musculoskeletal pain. For shoulder injuries, these techniques can enhance joint mobility/range of motion, decrease muscle tension, and improve overall function. A study published in BMC Musculoskeletal Disorders found that combining manual therapy with exercise therapy led to significant improvements in functional capacity, pain reduction, and shoulder range of motion in patients with shoulder impingement syndrome. (Tauqeer et al., 2024)
The Role of Exercise-Based Rehabilitation
Exercise therapy focuses on structured physical activities designed to strengthen muscles, enhance flexibility, and improve joint stability. In the context of shoulder injuries, tailored exercises aim to strengthen the rotator cuff muscles and scapular stabilizers, which are essential for shoulder function. Strengthening these muscles not only aids in recovery but also plays a pivotal role in preventing future injuries. According to Boston Health & Wellness, consistent exercise helps strengthen the muscles around the shoulder, enhancing flexibility and improving range of motion. (Chang, 2024), (Boston, 2019)
Benefits of Combined Manual and Exercise-Based Therapies
Integrating manual therapy with exercise-based rehabilitation offers a comprehensive approach to shoulder injury management. Manual therapy is aimed at and can provide immediate pain relief and increase joint mobility, creating a conducive environment for effective exercise performance. Subsequently, targeted exercises can build on these improvements, leading to long-term functional gains with decreased pain. Research indicates that this combined approach is more effective in reducing pain and enhancing function compared to exercise therapy alone. (Cochrane Lib. 2016)
General Considerations
While the benefits are evident, it's essential to approach rehabilitation under the guidance of qualified healthcare professionals. Individualized assessment ensures that the therapy aligns with the specific nature and severity of the injury. Importantly, adherence to prescribed exercises and active participation in therapy sessions significantly influence outcomes.
Manual therapy and exercise-based rehabilitation are cornerstone interventions in the conservative management of shoulder injuries. Their combined application not only facilitates pain reduction and functional recovery but also aims at empowering individuals to engage in preventive strategies against future injuries. As always, consulting with healthcare providers to develop a personalized treatment plan is paramount to achieving the best possible outcomes. As Osteopaths manual therapy and exercise based management are two of the primary therapies we rely on to assist patients with their shoulder injuries and pain, as well as, the changes in pain and function that accompanies pain and injury.
Reference:
Tauqeer, S., Arooj, A. and Shakeel, H. (2024) Effects of manual therapy in addition to stretching and strengthening exercises to improve scapular range of motion, functional capacity and pain in patients with shoulder impingement syndrome: A randomized controlled trial - BMC musculoskeletal disorders, BioMed Central. Available at: https://bmcmusculoskeletdisord.biomedcentral.com/articles/10.1186/s12891-024-07294-4?utm_source=chatgpt.com (Accessed: 03 April 2025).
Chang, J. (2024) The science behind exercise therapy for shoulder pain, Top Rated PT. Available at: https://holisticarephysicaltherapy.com/exercise-therapy-for-shoulder-pain/ (Accessed: 03 April 2025).
The power of physical therapy, exercise, and manual therapy (no date) Boston Health & Wellness. Available at: https://bostonhealthwellness.com/library_newsfeed_2091?utm_source=chatgpt.com (Accessed: 03 April 2025).
Cochrane reviews | Cochrane Library. Available at: https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD015085.pub2/full (Accessed: 03 April 2025).