Shoulder Pain in San Antonio, TX

Understanding Shoulder Pain: Clinical Analysis

Common Shoulder Conditions Treated at Pyramid Physical Therapy

Dr. Mendez’s extensive orthopedic training enables precise diagnosis and treatment of complex shoulder conditions:

1. Rotator Cuff Injuries

• Clinical Definition: Tears or inflammation in the four muscles stabilizing the shoulder joint
• Symptoms: Deep shoulder ache, weakness with overhead activities, night pain
• Treatment Approach: Progressive strengthening protocol, manual therapy, movement re-education

2. Shoulder Impingement Syndrome

• Clinical Definition: Compression of rotator cuff tendons beneath the acromion during arm elevation
• Symptoms: Sharp pain with overhead reaching, weakness, catching sensation
• Treatment Approach: Joint mobilization, scapular stabilization, postural correction

3. Frozen Shoulder (Adhesive Capsulitis)

• Clinical Definition: Progressive stiffening of the shoulder capsule causing severe mobility loss
• Symptoms: Gradual onset of stiffness, severe pain, inability to reach behind back
• Treatment Approach: Gentle capsular mobilization, controlled stretching, pain management

4. Shoulder Bursitis

• Clinical Definition: Inflammation of fluid-filled sacs reducing friction between shoulder structures
• Symptoms: Localized tenderness, pain with pressure, swelling
• Treatment Approach: Anti-inflammatory techniques, activity modification, biomechanical correction

5. Labral Tears

• Clinical Definition: Damage to the cartilage rim stabilizing the shoulder joint
• Symptoms: Deep shoulder pain, clicking/popping, instability with overhead activities
• Treatment Approach: Stability training, controlled loading, functional rehabilitation

The Shoulder Joint Complex: Clinical Perspective

The shoulder is the most mobile joint in the human body, which inherently makes it unstable. Successful treatment requires understanding the intricate relationship between three articulations:

• Glenohumeral Joint: The ball-and-socket joint providing primary shoulder movement
• Acromioclavicular Joint: Connecting the collarbone to the shoulder blade
• Scapulothoracic Junction: The shoulder blade’s movement on the chest wall

Orthopedic specialists assess how dysfunction in one area affects the entire kinetic chain, ensuring comprehensive treatment rather than isolated joint therapy.

Evidence-Based Shoulder Treatment Protocols

Initial Orthopedic Evaluation (75-90 minutes):

Phase 1: Clinical History & Symptom Analysis

• Detailed injury mechanism and symptom progression
• Activity limitations and functional goals assessment
• Previous treatment history and imaging review
• Occupational and recreational demands evaluation

Phase 2: Physical Examination

• Range of Motion Testing: Active and passive mobility in all planes
• Orthopedic Special Tests: Hawkins-Kennedy, Neer’s, Drop Arm, O’Brien’s test
• Strength Assessment: Manual muscle testing of rotator cuff and scapular muscles
• Postural Analysis: Evaluation of forward head posture and rounded shoulders
• Scapular Kinematics: Assessment of shoulder blade movement patterns

Phase 3: Movement Analysis

• Functional movement screening
• Overhead activity simulation
• Kinetic chain assessment from cervical spine to thoracic spine

Frequently Asked Questions About Shoulder Pain

When should I seek immediate evaluation for shoulder pain?

Seek prompt evaluation if you experience sudden onset of severe pain following trauma, visible deformity, complete inability to move the arm, numbness or tingling down the arm, or signs of infection such as fever and redness. These may indicate fractures, dislocations, or serious soft tissue injuries requiring immediate intervention.

How long does shoulder pain recovery typically take?

Recovery timelines vary significantly based on the specific diagnosis and individual factors. Minor rotator cuff strains may resolve in 2-4 weeks, while frozen shoulder can take 12-18 months. Treatment focuses on accelerating healing through targeted interventions while preventing compensation patterns that can prolong recovery.

Can shoulder pain cause neck pain and headaches?

Yes, shoulder and neck pain are often interconnected. The shoulder and neck share muscle groups and nerve pathways. Shoulder dysfunction often leads to compensatory neck muscle tension, resulting in cervical pain and tension headaches. Comprehensive treatment addresses both regions simultaneously for optimal outcomes.

What’s the difference between a rotator cuff strain and tear?

A strain involves overstretching of muscle fibers with microscopic damage, while a tear involves actual disruption of tendon fibers. Strains typically respond well to conservative treatment within 4-6 weeks. Tears may require longer rehabilitation, and full-thickness tears might need surgical consultation. Orthopedic specialists can accurately differentiate through specific clinical tests.

Is surgery always necessary for shoulder problems?

Most shoulder conditions respond well to conservative treatment when properly diagnosed and managed. Conditions like impingement syndrome, minor rotator cuff tears, and frozen shoulder often resolve completely with targeted physical therapy. Pyramid Physical Therapy works closely with orthopedic surgeons when surgical intervention is truly necessary.

About Dr. Cynthia Mendez, PT, DPT, OCS

Educational Background:

• Bachelor of Science in Kinesiology – University of Texas at Austin (Health Promotion & Fitness emphasis)
• Master’s in Physical Therapy – UT Health Science Center San Antonio (2006)
• Doctor of Physical Therapy (DPT) – UT Health Science Center San Antonio (2015)
• Board Certification in Orthopedic Physical Therapy (OCS) – 2011
• Certified Pilates Instructor – Body Arts and Science International (2008)

Professional Experience:

• 18+ years of clinical practice in San Antonio
• Owner & Clinical Director – Pyramid Physical Therapy & Pilates (2021-present)
• Former Clinical Director – Pyramid Plaza Physical Therapy (2008-2021)
• CEO & Founder – Non-profit organization (5 years leadership experience)

Take Action Against Shoulder Pain Today

Don’t let shoulder pain limit your daily activities, work performance, or sleep quality any longer. Dr. Cynthia Mendez’s board-certified expertise and proven treatment protocols have helped thousands of San Antonio residents return to pain-free, active lifestyles.

Schedule Your Comprehensive Shoulder Evaluation!

Pyramid Physical Therapy & Pilates
Board-Certified Orthopedic Specialist

Dr. Cynthia Mendez, PT, DPT, OCS
Owner & Clinical Director
Board-Certified Orthopedic Clinical Specialist

Shoulder Pain Relief • Sports Injuries • Post-Surgical Rehabilitation • Pilates Therapy

Individual results may vary. This information is for educational purposes and does not replace professional medical evaluation. Please schedule a consultation with Dr. Mendez for personalized assessment and treatment recommendations.