Combined Therapy Specialties for All Shoulder Complaints

Recurrance of shoulder problems often exceeds 50%. Call Combined Therapy Specialties for services that can enhance long-term results.

Lack of bony stability and superlative capacity for motion make the shoulder one of the body’s most vulnerable regions for pain, injury, and dysfunction.  In fact, the AAFP ranks shoulder dysfunction as the second most common orthopedic complaint brought to family practitioners (behind knee pain).  Since the shoulder’s design lacks bony stability, good shoulder function relies on the integrity of muscles and ligaments more than most joints.  Because of the universal muscular involvement, the combined OT, PT, and massage therapy services of Combined Therapy Specialties can serve as a valuable part of your team for most shoulder complaints.         

The majority of shoulder problems seen in general practice result from cumulative microtrauma, disuse, overuse, and/or incomplete recovery from an earlier injury.1  While corticosteroid injections have been shown to produce more rapid pain relief than physical therapy for some common categories of shoulder complaints, the probability of recurrence becomes an additional consideration.   Indeed, conservatively treated shoulder problems have recurrence rates measured at 52% in a synovial group2, 73% in a shoulder girdle group2, and 90% in athletes performing overhead motions.3  While reduction of pain and inflammation is a primary goal of treatment, one could reason that taking measures to address the causal factors and reduce recurrence would be a reasonable approach.  With one simple referral to Combined Therapy Specialties, you can make available to your patients a host of services for the shoulder while still maintaining oversight of the treatment plan.

Combined Therapy Approach: Assessment and treatment for shoulder complaints at CTS can include :

  • Complete orthopedic testing including neck, spine, and elbow to identify all involved structures
  • Mobilization: passive joint, soft tissue, grades I – V, transverse friction massage
  • Targeted Stretching & Strengthening
  • Customized Home Exercise Plans
  • E-Stim, Ultrasound, Laser & Thermal modalities
  • Posture Analysis / Correction (especially rounded shoulders and forward head posture)

Occupational Therapy Treatment & Assessment:  With combined OT and PT expertise, you will find CTS particularly qualified at identifying and addressing extrinsic factors affecting the shoulder :

  • Workplace Ergonomics
  • Sports Technique Consultation
  • Sports Equipment Consultation
    Sleeping Posture
  • Protective Equipment
  • Adaptive Equipment – especially where full recovery is unlikely as in some arthritis cases
  • Adaptive ADL Techniques
  • Good to Know About Shoulder Therapy :
  • Manual therapy combined with exercise & stretching is proven more effective than exercise & stretching alone.1
  • Therapist supervised exercise has been shown to be just as effective as subacromial decompression surgery plus rehab for stage II primary impingement.1
  • In cases of calcific tendonitis, ultrasound therapy actually stimulates resorption of calcium deposits.4


  1. Bang MD, Deyle GD. Comparison of supervised exercise with and without physical therapy for patients with shoulder impingement syncrome. Journal of Orthopaedic & Sports Physical Therapy. March 2000; 30 (3): 35-39.
  2. Winters JC, et al. Treatment of shoulder complaints in general practice: long-term results of a randomized, single blind study comparing physiotherapy, manipulation, and corticosteroid injection. BMJ May 22, 1999;318:1395-6.
  3. Woodward TW, Best TM. The Painful Shoulder: Part II. Acute and Chronic Disorders. Am Fam Phys, June 1, 2000; 61 (11): 3291-3302.
  4. Ebenbichler GR, et al. Ultrasound therapy for calcific tendinitis of the shoulder. N Engl J Med, May 20, 1999; 340: 1533-8.
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