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Healing Chronic Shoulder Pain

As we get older, years and decades of mechanical stress may lead to deterioration of joints, ligaments, and tendons. This degenerative process, commonly known as arthritis, primarily affects weight-bearing joints such as the hips and knees and those found in the lumbar spine. The shoulder, too, is especially prone to undergo arthritic changes owing to its extreme mobility. The extensive range of motion at the shoulder is built-in to the design of this structure, but the tradeoff is instability. The design of the shoulder sacrifices stability for mobility.
Degenerative disorders of the shoulder typically involve the rotator cuff. This broad, flat structure is composed of the muscle-tendon units of the four rotator cuff muscles: the supraspinatus, infraspinatus, subscapularis, and teres minor. The thick covering of the rotator cuff surrounds the head of the arm bone and supports and strengthens the shoulder joint. But owing to the shoulder's inherent instability contrasted with its great mobility, the soft tissues of the rotator cuff undergo repetitive stress and strain. Ultimately, degenerative changes may occur, leading to the two prominent symptoms of pain and restricted range of motion.
An entire orthopedic sub-specialty focuses on treatment of chronic shoulder pain and includes long-term use of anti-inflammatory medication, corticosteroid injections when medications do not provide sufficient relief, and eventually surgery to repair tears in the various rotator cuff tendons. "Revision" surgery is commonly performed when the benefits of prior surgery are exhausted.1
The good news is that in many cases, a more optimal approach is available, one that utilizes the body's own natural recuperative powers. For many people, chronic shoulder pain can be reduced and chronic loss of mobility can be improved by engaging in specific activities and performing specific rehabilitative exercises. The goals of rehabilitation are to increase shoulder range of motion and build up shoulder strength. As these goals are accomplished, the likely result is reduction of intensity and frequency of occurrence of shoulder pain.
Engaging in an overall strength training program is an important general approach to managing chronic shoulder pain.2,3 Strength training should be done progressively, starting with light weights and building up over time. Exercises specific to the shoulder include seated dumbbell or barbell presses, dumbbell or cable lateral raises, seated bent-over rows, and internal and external rotation exercises done with very light dumbbells on a flat bench. If one has experienced an acute shoulder injury, early rehabilitation should precede rehabilitative strength training. Early rehabilitation includes pendulum exercises and finger-walking up a wall in both forward-facing and side positions.
Your chiropractor is experienced in injury rehabilitation and will be able to help you design an effective flexibility and strengthening program for improved shoulder function.
1Keener JD: Revision rotator cuff repair. Clin Sports Med 31(4):713-725, 2012
2Lewis JS: A specific exercise program for patients with subacromial impingement syndrome can improve function and reduce the need for surgery. J Physiother 58(2):127, 2012
3Andersen LL, et al: Effectiveness of small daily amounts of progressive resistance training for frequent neck/shoulder pain: randomised controlled trial. Pain 152(2):440-446, 2011

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  • "Dr. Clark and the staff here are amazing. They are super friendly and thorough. I would highly recommend this practice!"
    Bobby H.
  • "I absolutely love going here. I've been referred by many that have had life changing experiences because of Dr. Porter . He is amazing at what he does & it shows. He knows what he is doing. I have already felt such a difference in my health. I have more energy and less digestive issues and it's only been a couple of months. Everyone is so nice and especially Dr. Porter. He really shows care & concern. He takes his time and doesn't rush you. You won't regret going here 😊 Also his wife is so sweet and has a great sense of humor ."
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  • "I found my way to Porter-Clark by accident. I drove a friend to her appointment and as I waited in the waiting room I began to notice the efficiency of the staff , process and patient flow. I’m a healthcare consultant that assists organizations with operational efficiency and I was amazed at how efficient they actually were. We call it continuous flow and using the pull system. This means no waiting, bottlenecks or backups within the office process. Many organizations pay to achieve this kind of workflow. The best part of the visit is the friendliness of staff and the expertise of the docs. Hands down, the heat, massage and the skill of the message therapists for 10 minutes in the beginning of the visit is heavenly and worth the trip!! Many offices talk about putting patients first, but at Porter-Clark, they demonstrate it in everything they do. Great job!"
    Rita D.
  • "Excellent patient care and results from this clinic, which uses a holistic approach that combines chiropractic, massage, and clinical nutrition. Highly recommended!"
    Rachel M.
  • "I am new to your clinic and getting great results with the Nutritional Response Testing. Thank you so very much. I highly recommend the services of PCCC in Flat Rock."
    Emily S.
  • "I love it here! Everyone is extremely polite and helpful. I see Doctor Porter II and he’s been a lifesaver. He’s made room for me on his schedule multiple times when I’ve been randomly hit with a chronic migraine. He genuinely takes his time and cares about his patients. I’m really thankful for the friends that recommended me to this place and I highly recommend everyone else comes here as well."
    Alexandria V.
  • "I have been a patient of Dr. Porter for more than 20 years. He has helped me maintain a strong immune system and to live without pain. I trust him more than any medical doctor or specialist with my health and well-being."
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  • "Dr. Cara and the staff at Porter & Clark Chiropractic are wonderful! The adjustments, heat and massage have healed my aches and pains (slight and severe) over the last several years. I would highly recommend Dr. Cara to anyone needing Chiropractic care."
    Chris T.
  • "The staff, they make this place amazing. If you need an adjustment or a massage check everyone out. The staff are helpful in finding you the type of therapist you need for your massage, and each doctor is pretty amazing, in their quality of care and concern for you as a client while you are on their tables."
    Adam I-L
  • "Been coming here for 11 years now... I feel immediate relaxation after adjustments and 9 out of 10 times my back pain has subsided. Some days I'm so bad I call to make an appointment and they get me in the office same day!! I can't say enough about Dr. Porter and the staff in general."
    Brandon L.
  • "I love this place! Dr. Clark has taken care of my chronic pain for years! No other treatments have been nearly as effective. A bonus is that the staff is always so friendly and helpful!!"
    Mary B.
  • "Dr. Porter has been treating me with an ongoing problem for years. I starting going to him after I could not get relief from my family physician. Through his treatments and a vitamin regimen, I don't need pain meds & feel so much better."
    Review from healthgrades.com
  • "The doctors and all the staff are excellent!"
    Tanya W.
  • "I am no longer in pain under Dr. Cara Phillips' care! Staff is always very friendly and greet you when you walk in. My first appointment they took xrays and did an evaluation. I now go to be adjusted monthly. They also offer heat therapy and a massage before being adjusted."
    Maggie J.
  • "With his gift for healing, and his expertise with NRT (Nutritional Response Testing), Dr. Porter has saved my life! I am off prescription medications and no longer suffer from chronic lower GI pain and problems."
    Charles K.
  • "Dr. Michael Porter II has taken care of me since I was in an auto accident last year, and monthly visits keep me out of pain. The office is a welcoming place, and patient care is clearly their priority. Highly recommended."
    Adam W.
  • "Dr. Clark has the best practice on the planet. Great individual time and attention. Chiropractors and massage therapists truly concerned about your health. Pleasant office atmosphere."
    Debbie A.

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