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FRISCO, TX – As many as 7.5 million people each year in the U.S. visit a physician complaining of shoulder pain, says the American Academy of Orthopedic Surgeons, with more than half of them dealing with rotator cuff issues alone.

While a belief prevails that surgical options are best for most rotator cuff tears, Frisco-based physical therapist Chris Bell, PT, points out that physical therapy can be the best choice for non-traumatic rotator cuff injuries, especially in the case of athletes who want to return back to peak competitive performance.

“Dedicated players or swimmers can repeat overhead motions tens of thousands of times over the course of their competitive careers,” he said. “Combined with velocity, this puts a lot of stress on the shoulder muscles and tendons.”

Bell’s contention is research-based. A 2014 study published in Bone & Joint Journal, for instance, showed that for non-traumatic rotator cuff tears, physical therapy can produce results equal to those produced following surgery. It concluded that “conservative treatment (i.e., physical therapy) should be considered as the primary treatment for this (rotator cuff) condition.”

“Studies show that only 5 to 15 percent of baseball players make it back to a high level of performance after rotator cuff surgery,” Bell said. “Those are not great odds for someone with aspirations.”

The rotator cuff is comprised of four muscles that wrap around the top of the humerus bone, keeping it tucked into the shoulder joint. Over time, repetitive motions can cause tiny tears, shredding parts of the muscle to look like frayed rope. Symptoms of deterioration and injury can be lost strength, instability in the shoulder joint, or even tingling in the hand.

“[Shoulders] are designed for functional mobility,” Bell said. “But, unlike the knee that has ligaments to support it, shoulders have to depend fully on muscles and tendons for their strength and stability.”

Such qualities make the shoulder particular susceptible to the long-term effects of bad posture, which over time can increase the chances of injury. When addressing shoulder injuries, Bell and other physical therapists often take a three-pronged approach.

First, he recommends letting the muscle and/or tendon heal itself through several weeks of limited movements and anti-inflammatory medication. Once some strength and stability have been restored, Bell introduces a balance of stretching and resistance training to gradually rebuild the muscle or tendon.

Finally, Bell breaks down the sport-specific motions and designs therapies that address specific muscles, with a focus on what the athlete wants to restore (i.e., acceleration, range of motion, technique).

For an athlete, Bell says, one of the greatest promoters of shoulder strength and stability is rest.

“In Texas, baseball athletes can play 365 days a year, but they shouldn’t,” he said. “They should take a few months off and focus on exercises like strength training, yoga and Pilates. These are a holistic approaches to strengthening muscles that, in turn, support the spine and joints.”

As a way of working the shoulder muscles, as well as testing the tightness and flexibility in your shoulder, Bell recommends trying an exercise he calls “the snow angel.” Here’s how it works:

Stand against the wall with your head and shoulder blades flat against the wall. Spread your arms out with elbows straight, and lay your arms against the wall. Have your palms faced forward, and raise your arms out to your side to up over your head. Try to keep your arms in contact with the wall through the entire motion. Once at the top, slowly lower them back to your sides. Repeat several times.

While it’s normal if your arms move slightly away from the wall at the top of your motion, if you need to pull your arms away at other times, you probably have a range of motion restriction that could lead to shoulder problems.


Vista Rehab Partners is an independent, therapist-owned network of 19 outpatient orthopedic physical therapy clinics located in the North Texas Area. We provide personalized physical therapy, sports rehabilitation, and injury prevention services to patients through a hands-on approach is designed to return you to your full potential, as soon and as safely as possible.

CONTACT: Megan McNeal
Sports Medicine Outreach Coordinator, Vista Rehab Partners
214-402-4165 (Cell),

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