Chiropractic & Neurology Testing

Shoulder Pain
Understanding Causes & Treatment

This article will help you to identify some of the most common causes of shoulder pain with tips to help prevent and resolve these potentially disabling conditions.

Shoulder pain may come on suddenly (acute) or may last for weeks or even months. When pain or stiffness persists for more than 3 months it is termed chronic and may indicate permanent damage.

If you have been suffering with shoulder pain, shoulder stiffness or other associated symptoms like numbness or tingling for more than three days you need to consult your health care provider.

Since 1997, Dr. Peter Gastaldi has been helping patients just like you, suffering with shoulder pain related to many different causes.

Gastaldi Chiropractic is easily at 94 McClean Avenue on Staten Island, offer early morning, late evening, and weekend hours, and accept all insurance plans.


Give us a call now to schedule your same-day appointment...

(718) 839-6933
A more in depth discussion of shoulder pain follows:


Anatomy of the Shoulder

Image of shoulder joint to demonstrate shoulder pain treated at Forest Hills Rehabilitation.

The shoulder joint is essentially formed by two large bones, the arm bone or “humerus” and the shoulder blade or “scapula.” The upper portion of your humerus has a large ball shape which sits in a shallow cup of the scapula. A strong cartilaginous ring known as the “labrum” helps to stabilize this union of the two bones, and keeps the large ball seated in the shallow cup.

For additional support a web of tight fibrous bands called “ligaments” form a capsule around the joint. Around that capsule, you have a thick cuff made up of four muscles, aptly named the “rotator cuff” (commonly mispronounced as “rotary cuff, or cup”). The rotator cuff muscles all originate on the shoulder blade and attach at the upper arm, allowing you to rotate your arm in all directions.

To decrease friction caused with rotation you have several strategically placed “bursae” throughout the shoulder. A bursae is a small fluid filled sac – imagine a balloon with just a small amount of water inside – that allows these structures in high friction areas to glide past one another.

One other muscle that should be discussed here is the biceps muscle. The biceps muscle sits on the front part of the upper arm, and is anchored to the shoulder blade by a strong fibrous band called the biceps tendon.

Injury to any one of these delicate structures can result in profound symptoms. Moreover, it may be difficult for you to determine the source of your shoulder pain, since symptoms may be closely related. Even though symptoms from one person to the next may be similar, treatment may be very different depending on the source of the injury. This is why it is so important to have an experienced clinician make the diagnosis.

Whether you're suffering from a stiff shoulder or severe shoulder pain, we can help. There is no need to live with shoulder pain or stiffness any longer.

A more in depth discussion of some of the more common conditions associated with shoulder pain we treat can be found below…


Shoulder Impingement:

Impingement is one of the most common causes of pain in the adult shoulder. As stated in the above mentioned shoulder anatomy discussion, the four main shoulder muscles originate on the shoulder blade in the back, and attach via a tendon on the arm. These tendons pass through and around several structures before the point of insertion. If the space is not adequate, it will become squeezed and thus irritated as you use your shoulder throughout your daily routine.

The space may be obstructed for many reasons...bony obstructions as with arthritic spurs, or post-fracture, swelling as with tendonitis or bursitis, or other anatomical issues.

As you might expect, squeezing these sensitive structures (tendons, bursae, etc) can be quite painful. You may also experience limited movement as a result. Continued pressure and loss of normal active ranges of movement quickly creates degenerative issues.

The good news is that many causes of shoulder impingement can be controlled and reversed with appropriate physical therapy. The bad news is that if left untreated scar tissue begins to form, usually within 72 hours, making full recovery less likely with each passing day.

So simply stated – with prompt attention our queens physical therapy team can get your shoulder pain under control, and get you back to your normal activities quickly. If you are suffering with shoulder pain, please don’t delay. We’re on call seven days a week, so call now...

Call now…(718) 839-6933

It is important to emphasize that since it is often difficult for a patient to differentiate the source of an injury, it is imperative that you get examined by a trained clinician at the first sign of pain. Don’t delay… We’re on call seven days a week. If any immediate concern, give us a call and talk to one of our trained physical therapists or doctors on the phone right now.


Call now…
(718) 839-6933

Torn Labrum / Labral Tear (Shoulder):

As you learned in the earlier description of the shoulder anatomy, the shoulder joint is made up of three bones, the humerus (upper arm bone), the scapula (shoulder blade) and the clavicle (collar bone). The upper part of the arm bone has a large ball, referred to as the “head” of the humerus, which sits in a shallow cup of the scapula called the glenoid.

The glenoid labrum is a fibrous ring that surround the shallow cup to help stabilize the large humeral head. It also serves as an attachment site for several ligaments.

The labrum can be torn or injured following acute trauma such as falling on an outstretched arm, or repetitive stress injuries to the shoulder, common in athletes and throwing injuries.

Typical symptoms of glenoid labrum tear include:
  • deep shoulder when raising your arm overhead
  • clicking, “clunking”, popping in the shoulder
  • shoulder weakness
  • shoulder instability
  • limited shoulder ranges of motion

Shoulder labral tears at the top of the glenoid are called SLAP lesions (superior labrum, anterior to posterior).

Shoulder labral tears below the glenoid are called Bankart lesions.

Shoulder labral tears can be quite serious and may require surgery.

In many cases however symptoms can be controlled through conservative measures, such as physical therapy in combination with pain management.

Since the labrum is cartilagenous it cannot be evaluated by x-ray, and may require alternative diagnostics, such as diagnostic ultrasound, or mri.

In most cases, labral tears can be diagnosed by a trained clinician through manual orthopedic testing.

If you are experiencing symptoms of a labral tear, have suffered a shoulder injury, or just have shoulder pain, let us help you on your road to recovery.

We have lots of experience with shoulder injuries and we are on call seven days a week, so call now...

Call now…(718) 839-6933

It is important to emphasize that since it is often difficult for a patient to differentiate the source of an injury, it is imperative that you get examined by one of our trained medical doctors or physical therapists at the first sign of pain. Don’t delay… We’re on call seven days a week. If any immediate concern, give us a call and talk to one of our trained physical therapists or doctors on the phone right now.



Call now…
(718) 839-6933

Rotator Cuff Injuries:

As I mentioned in the anatomy discussion above, the Rotator Cuff, often mistakenly referred to as the Rotator Cup, or Rotary Cuff, is made up of four muscles that together are responsible for rotating your shoulder in all directions.

Rotator Cuff injuries are often associated with sports injuries, such as throwing. It is true that rotator cuff injuries may result from high velocity activities, but you may experience injury to the rotator cuff muscles through other avenues as well. In fact, we often treat rotator cuff injuries that are related to degenerative issues such as arthritis, and arthritic spurs, poor posture, or simple weakness associated with disuse.

The cause and the nature of the rotator cuff injury of course dictates the appropriate course of therapy or medical treatment.

The good news is that since muscles have a very good blood supply, they often heal quickly with the appropriate course of conservative therapy.

The bad news is that if a rotator cuff injury is left untreated, scar tissue develops which can lead to other more serious conditions (such as frozen shoulder), and can make reversal more difficult.

Often times, rotator cuff injuries are associated with partial or complete tears, which may not respond to conservative therapy.

Since symptoms of partial rotator cuff tears can mimic full thickness tears, arthritis, tendonitis etc, it is important to get evaluated by a trained clinician ASAP. We are specifically trained to diagnose and treat all types of shoulder injuries, but don’t guess if this condition will get better on its own – because it probably won’t!

We have been helping patients just like you recover from serious shoulder injuries, without surgery for more than 14 years.

If you are experiencing symptoms associated with a shoulder injuries, or if you suspect a rotator cuff injury, call our office today to see how our techniques can benefit you.


Call now…
(718) 839-6933

Frozen Shoulder:

As discussed in the shoulder anatomy page above, the shoulder joint is encapsulated by a mesh of fibrous bands called ligaments. When this capsule thickens, it can significantly restrict shoulder movement in all directions, and is thus termed “Frozen Shoulder”. Frozen shoulder is also associated with progressive, often times severe pain.

Frozen shoulder may come on insidiously - meaning we are not really sure why - or it may follow traumatic injury, or can even be associated with underlying systemic conditions such as diabetes.

The cause and the nature of the frozen shoulder of course dictates the appropriate course of therapy or medical treatment.

Since the ligaments have a very poor blood supply, healing times are prolonged and will definitely require an appropriate course of conservative therapy.

Deferring therapy or medical consult for even a couple of days may severely lengthen recovery times if at all.

Since a frozen shoulder may stem from other underlying conditions like diabetes it is imperative to get evaluated by a trained clinician ASAP. We are specifically trained to diagnose and treat all types of shoulder injuries, but don’t guess if this condition will get better on its own – because it probably won’t!

We have been helping patients just like you recover from serious shoulder injuries, without surgery for more than 14 years.

If you are experiencing symptoms associated with a shoulder injuries, or if you suspect a Frozen Shoulder, don’t delay! Call our office TODAY to see how our techniques can benefit you.


Call now…

(718) 839-6933

Shoulder Bursitis:

As discussed in the shoulder anatomy page above, the shoulder joint is encapsulated by a mesh of fibrous bands called ligaments. When this capsule thickens, it can significantly restrict shoulder movement in all directions, and is thus termed “Frozen Shoulder”. Frozen shoulder is also associated with progressive, often times severe pain.

Frozen shoulder may come on insidiously - meaning we are not really sure why - or it may follow traumatic injury, or can even be associated with underlying systemic conditions such as diabetes.

The cause and the nature of the frozen shoulder of course dictates the appropriate course of physical therapy or medical treatment.

Since the ligaments have a very poor blood supply, healing times are prolonged and will definitely require an appropriate course of conservative physical therapy.

Deferring therapy or medical consult for even a couple of days may severely lengthen recovery times if at all.

We are specifically trained to diagnose and treat all types of shoulder injuries, but don’t guess if this condition will get better on its own – because it probably won’t!

We have been helping patients just like you recover from serious shoulder injuries, without surgery for more than 14 years.

If you are experiencing symptoms associated with a shoulder injuries, or if you suspect Shoulder Bursitis, don’t delay! Call our office TODAY to see how our techniques can benefit you.


Call now…

(718) 839-6933

Shoulder Tendonitis:

As I mentioned in the anatomy discussion above, the shoulder is surrounded by the Rotator Cuff, which is made up of four muscles that together are responsible for rotating your shoulder in all directions. These muscles are all anchored to the bone by a fibrous band called a tendon.

When one or more of these tendons becomes irritated it will become swollen and painful, and is termed “Shoulder Tendonitis”.

Shoulder tendons pass through many tight spaces, cross bones and high friction areas, are pulled in many difficult directions throughout your daily activities. Overuse, disuse, trauma, poor posture, shoulder impingement and weakness are all common causes of shoulder tendonitis.

The cause and the nature of the shoulder tendonitis of course dictates the appropriate course of therapy or medical treatment.

The good news is that since muscles and tendons have a very good blood supply, they often heal quickly with the appropriate course of conservative therapy.

The bad news is that if shoulder tendonitis is left untreated, scar tissue can develop which can lead to other more serious conditions (such as frozen shoulder), and can make reversal more difficult.

Often times, shoulder tendonitis associated with partial or complete tears, which may not respond to conservative therapy.

Since symptoms shoulder tendonitis can present like more serious conditions such as partial shoulder muscle or shoulder tendon tears, arthritis, etc, it is important to get evaluated by a trained clinician ASAP. We are specifically trained to diagnose and treat all types of shoulder injuries, but don’t guess if this condition will get better on its own – because it probably won’t!

We have been helping patients just like you recover from serious shoulder injuries, without surgery for more than 14 years.

If you are experiencing symptoms associated with a shoulder injuries, or if you suspect a rotator cuff injury, call our office today to see how our techniques can benefit you.


Call now…

(718) 839-6933

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