Dear Colin: My shoulder has been hurting for four months after playing ball with my kids. It’s now hurting with most daily activities, especially those requiring my arms overhead. My primary doctor’s advice: Take pain medication, and avoid anything that hurts. MRI and X-rays showed no problems (which shocked my doctor). I feel weaker and stiffer every day, as I’m now really favoring my other arm. Are there exercises I can do that may help? — John N.

There are many different causes for shoulder pain, from a torn ligament to inflammation of a rotator cuff tendon. The shoulder joint offers the most range of motion, so muscular control is key if you want to minimize damage of surrounding structures due to joint “sloppiness.” If you don’t perform any specific strengthening exercises, your injury risk skyrockets because weak muscles can’t stabilize your upper arm bone against your shoulder blade, allowing excessive motion between the two and encroaching on sensitive structures.

There are definitely physical therapy exercises that help promote stability, but first get an exam from an orthopedist specializing in the shoulder. John Austin, a Hillsboro-based orthopedist, says, “A medical diagnosis from a specialist is often necessary to rule out more serious problems related to the shoulder and to ensure appropriate treatment, even when imaging studies are normal.”

Photo Credit: SUBMITTED PHOTO - Proper technique important -- A volunteer demonstrates the starting position in the wall press exercise.Following your orthopedist exam is a physical therapist exam so you can begin an exercise program tailored to your situation and needs. Your primary doctor’s advice doesn’t address the cause of your problem, so you’re going to have to be more proactive if you’re going to resolve your issue within a reasonable time.

“Almost all chronic shoulder problems, even those that may eventually require surgery, will benefit from a tailored exercise program in order to address the specific cause of the problem so that normal shoulder function can be restored,” Austin said.

The wall press is an excellent exercise for three main reasons: you can tell if you’re doing it correctly, it safely trains the rotator cuff and upper back muscles (crucial for shoulder stability), and it requires zero equipment.

Begin by leaning back against a wall with your feet in front of you, belly drawn in and spine neutral. Put your arms in the starting position, but don’t move your spine and/or pelvis off the wall. Slide your arms up the wall, keeping your elbows and wrists flush against the wall.

This exercise is harder for folks with slouched posture because of chest/shoulder tightness, so it may be initially impossible to simultaneously touch the wrists and elbows to the wall without arching. In that case, simply get them as close as you can to the wall during each repetition and over time, you’ll get closer.

Expect physical therapy to be primarily exercise-based to address the cause of your pain as opposed to providing additional passive treatments (massage, ultrasound) that only temporarily relieve symptoms. Yes, it may take time for the exercises to reduce symptoms, but once reduced they’ll stay reduced as long as you continue to exercise. Isn’t that the whole point?

Colin Hoobler is a certified physical therapist and writes a regular column

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