Physical Therapy and Prevention for Shoulder Injuries

Geoff Kandes demonstrates physical therapy for shoulder issues. "Once a physician and physical therapist evaluate a patient, they can determine the right course of action," he says.
Throughout our lifetimes, our bodies serve  us well, carrying out work-related jobs requiring  strength and balance, performing daily tasks, and  allowing us to enjoy sports as well as an endless  variety of activities.

With time, our muscles age, losing mass, a  result of the decreasing number and size of muscle  fibers. And although this is a part of the aging  process, research shows that muscles can continue  to get stronger. Learning how to optimally use  muscles can slow the aging process, help maintain  strength, and increase flexibility, thereby  decreasing potential injuries.

In particular, our shoulders carry a heavy load of responsibility  for all the work they do, and with age, some of the ligaments,  tendons and structures surrounding the shoulder can begin to  deteriorate and fray, preventing optimal function. Although this can  happen through traumatic injury, more often, normal wear and tear  progresses over time.

“The rotator cuff is just as susceptible to the aging process as  every other part of the body,” says Geoff Kandes, PT, DPT,  Supervisor, Physical Therapy, Eisenhower Desert Orthopedic Center.  “The joints wear down, the tendons weaken, and the rotator cuff  muscles do not work as well.”

Symptoms of rotator cuff injuries – non traumatic

According to Kandes, people may first notice shoulder problems at  night, especially if they’re lying on the shoulder that is bothering  them. They may also notice pain while reaching behind their back or  reaching into the back seat of a car.

“The pain often starts small, with the individual feeling it  intermittently, and then the symptoms start to progress,” explains  Kandes.

“Typically, I tell people that if they experience anything  traumatic like a fall or any sudden pain that is continually  increasing, they should see a physician.

“For milder and non-traumatic shoulder pain, I’d recommend  using a cold pack as a first line of defense,” continues Kandes. “It  not only helps to reduce the pain but also inflammation. It’s best to  use a cold pack for 15 to 20 minutes with at least one layer of towel  between the skin and the cold pack. If the shoulder improves,  inflammation due to activity may have been contributing to the  symptoms.”

For aches and pains that aren’t helped with conservative  measures like cold packs and over-the-counter anti-inflammatory medicine, Kandes recommends seeing a physician and getting a  referral to begin working with a physical therapist.

“Once a physician and physical therapist evaluate a patient, they  can determine the right course of action, using stretching and  strengthening exercises to help reduce the symptoms,” says Kandes.


Just as important as seeing a physical therapist when there is a  problem, it is equally as important to learn how to use proper body  mechanics when exercising, especially in the gym, to prevent injury.  Physical therapists can teach patients how to use their bodies in  safer ways, specific to their needs.

“If an exercise becomes painful to do, don’t push through it,” says  Kandes. “Get help in figuring out what specific exercises would be  best for you.”

Paige Larson, Clinical Director, Physical Therapy, Eisenhower Desert Orthopedic Center, discusses physical therapy for orthopedic  conditions on an episode of Eisenhower’s Living Well podcast. Visit  To learn more about Eisenhower Desert Orthopedic Center’s physical therapy department, call 760.773.4545, or visit and click on Physical Therapy.

Tips for proper movement  

Always test the load you’re going to lift.  If possible, divide it into smaller, lighter loads.  

When carrying something, use two hands  and keep the item close to your body. don’t  hold anything heavy away from your body.  

Avoid lifting anything overhead if possible.  Try to keep the item at shoulder level. If need  be, use a sturdy ladder or step stool to put  something away, rather than to lift it overhead.  

Be aware of your posture, especially when  using a computer. Take breaks often, moving  and stretching.