Many people with shoulder problems suffer needlessly by delaying treatment. They ignore early symptoms such as pain in the front or back of the shoulder, difficulty reaching into a back pocket, aching at night or a sharp twinge when raising the arm. Integrative Manual Therapy addresses these issues.

The shoulder is a complex joint used all day long. It is often injured or overused. By the time an individual feels pain or experiences loss of function, the problem has progressed.

Shoulder conditions can be caused by irritations such as:

Tendonitis – inflammation of the tendon.

Bursitis – inflammation of the “bursa,” a fluid-filled sack protecting the joint.

Arthritis – inflammation of the joint itself.

Joint compression

Bone Bruises – tiny cracks or bone spurs.

People need full range of motion to paint a ceiling, play tennis or lift overhead. Attempting activities involving a lot of shoulder movement without proper range of motion can lead to inflammation of the rotator cuff, the main muscle of the shoulder. There can be a buildup of bone spurs or bony tissue in the tendon, ligaments or muscles.

Impingement, “pinching or putting pressure on,” develops when chronic or long-term inflammation persists. This causes the tendon and other tissues to thicken, narrowing the space beneath the shoulder. The more inflamed the tissue becomes, the narrower the space. More pinching occurs causing significant pain, especially when reaching across the body. Left untreated, an impingement can progress to a “frozen shoulder.”

Chronic wear and tear or an injury can lead to a breakdown of the tissue. A rotator cuff tear occurs when the tendons separate from the bone. In Integrative Manual Therapy, this is a “disruption of membrane” (DOM) and is addressed with a technique that helps increase range of motion, improve stability and decrease pain. The treatment of shoulder pain depends on the cause of the problem. For this reason it is important to seek medical advice before treatment.

The first thing an IMT practitioner does after reviewing the physician’s referral is a special evaluation. An IMT practitioner’s skill and training enables him to identify what is needed to get the patient back to normal in terms of motion and function. During the evaluation, all directions of motion are measured and the muscles are tested individually and as a whole. The therapist asks questions about pain and function, and observes the patient’s posture and movement.

Pain is addressed using hands-on techniques to relax muscles, increase circulation, decrease swelling and inflammation, and restore proper movement.

Combined with precise joint mobilizations, one will likely regain mobility quickly. Then, depending on the problem, the patient will learn specific exercises designed to re-educate, rebuild and improve the stability of his shoulder.


Qigong, Chinese energy classes. Try a no-impact qigong class. Your first class, a $30 value, is free! Classes are held at Y.P.T.  Call for more info.


Sheila Yonemoto, P.T., has been a physical therapist for over 30 years, specializing in Integrative Manual Therapy utilizing a holistic approach. She can be reached at Yonemoto Physical Therapy, 55 S. Raymond Ave., Suite 100, Alhambra, CA  91801. Call (626) 576-0591 for a free consultation and free insurance evaluation, or visit www.yonemoto.com for more information.

Leave a comment

Your email address will not be published. Required fields are marked *