Diagnosis Explanation:

A shoulder strain occurs when the muscles or tendons around the shoulder joint are overstretched or torn, usually due to overuse, repetitive overhead motions, poor posture, or sudden lifting movements. It commonly affects the rotator cuff muscles and deltoid.

Symptoms:

• Pain and tenderness in the shoulder, especially with movement.
• Stiffness and weakness, making lifting difficult.
• Swelling or mild bruising in the affected area.
• Pain at night or after prolonged activity.

Specific Work Modifications:

• If your job requires standing or walking: Avoid carrying weight on the injured side and take breaks to rest the arm.
• If your job involves lifting: Avoid lifting, pushing, pulling, or repetitive overhead movements. Use both hands when possible.
• If your job is desk-based: Keep the shoulder supported, avoid leaning on the affected arm, and take posture breaks every 30 minutes.
• Avoid: Overhead reaching, repetitive shoulder use, and carrying heavy loads.

Specific Activity Modifications:

• If you play sports: Avoid throwing, swimming strokes, or overhead racket sports until fully healed.
• If you do weightlifting: Avoid bench presses, overhead presses, dips, and pull-ups; instead, focus on controlled, pain-free movements.
• If you do yoga or Pilates: Modify poses to avoid excessive shoulder stretching, deep rotation, or weight-bearing on the arms.
• Avoid: High-impact activities, repetitive overhead motions, and exercises that cause discomfort.

Recommended Supplements:

• Collagen Peptides – 10g daily for muscle and tendon repair.
• Vitamin C – 500mg daily to support collagen synthesis.
• Glucosamine & Chondroitin – 1500mg/1200mg daily for joint and tendon health.
• Omega-3 Fatty Acids – 1000mg daily to reduce inflammation.
• Turmeric (Curcumin) – 500-1000mg daily for natural pain relief.

Recommended Nutrition and Hydration:

• Increase Lean Protein (chicken, fish, tofu, eggs) to support muscle healing.
• Eat Anti-Inflammatory Foods (berries, leafy greens, turmeric, nuts) to reduce swelling.
• Consume Hydrating Foods (cucumber, watermelon, citrus) to maintain tendon flexibility.
• Limit Processed Foods & Sugars to prevent inflammation.
• Hydration: Drink 8-10 cups of water daily to support muscle function and recovery.

Home Exercise Prescription (Rehabilitation for Shoulder Strains)

Early Phase (0-2 Weeks, Reducing Pain & Protecting the Joint):

• RICE Protocol – Rest, Ice (15-20 min, 3x/day), Compression, Elevation.
• Pendulum Exercises – Lean forward, let the arm hang, gently swing in small circles, 10 reps, 2x/day.
• Scapular Squeezes – Pinch shoulder blades together, hold 5 seconds, repeat 10 reps, 2x/day.
• Isometric Shoulder Holds – Press palm against a wall without moving the shoulder, hold 5 seconds, repeat 10 reps, 2x/day.

Strengthening Phase (2-6 Weeks, Improving Stability & Mobility):

• Wall Walks (Forward and Lateral) – Use fingers to "walk" the arm up the wall, hold 5 seconds, repeat 10 reps, 2x/day.
• External Rotation with Resistance Band – Keep elbow at 90 degrees, rotate forearm outward, 10 reps, 2x/day.
• Internal Rotation with Resistance Band – Keep elbow at 90 degrees, rotate forearm inward, 10 reps, 2x/day.

Advanced Phase (6+ Weeks, Preventing Recurrence & Maintaining Mobility):

• Lateral Arm Raises (Light Resistance) – Raise arms to shoulder height, 10 reps, 2x/day.
• Scapular Stability Exercises (Resistance Band Rows) – Pull resistance band toward chest, 10 reps, 2x/day.
• Modified Push-Ups (Wall or Knees) – Maintain control, 10 reps, 2x/day.

Helpful Books:

1. The Shoulder Pain Solution: Simple Exercises to Prevent and Recover from Injury – John M. Kirsch, MD.
2. Overcoming Shoulder Pain: A Guide to Rehabilitation and Recovery – Peter T. J. Barrett.

Contact the Key West orthopedic clinic or reach out to Dr. Jason Pirozzolo.