Dr. Howard Liss treats disorders that cause pain and disability by providing consultative services and soft tissue and joint injections when needed. When medically appropriate, he makes specific referrals for diagnostic testing (lab work, imaging, electrodiagnosis), physical and occupational therapy, interventional procedures (epidurals and facet joint injections), and surgery.
As the most mobile joint in the body, the shoulder has a particularly small joint zone. Simply put, this means that the shoulder joint is unstable. It relies heavily on surrounding muscles for controlled movement and stabilization. With this in mind, it’s easy to understand that most cases of shoulder pain are due to weak muscles and lack of coordination. Considering these factors, the shoulder is at risk for injury, and most fall into these categories: rotator cuff injuries, shoulder dislocation, frozen shoulder, shoulder fractures and shoulder arthritis.
With connections to multiple muscle groups, tendons, ligaments and structures, shoulder pain and injuries are related to numerous other types of pain and conditions:
- AC (acromioclavicular) joint injury
- Bicep tendonitis
- Broken shoulder (humerus bone fracture)
- DOMS (delayed onset muscle soreness)
- Muscle strain
- Neck and arm pain
- Nerve impingement
- Overuse, repetitive strain injury
- Pinched nerve
- Rheumatoid arthritis
- Rotator cuff tear, calcific tendonitis
- Swimmer’s shoulder
- Thoracic outlet syndrome
Treatment and Rehabilitation for Shoulder Injuries
While the majority of shoulder injuries occur due to muscle weakness and lack of control, these disorders are easily treated with selective exercises and rehabilitation to rebuild and retrain muscles and surrounding structures. Yet, with a long list of related conditions and an equal number of risks to the shoulder, effective treatment and rehabilitation is best determined through a multidisciplinary approach.
With a unique, whole person perspective, physiatrists combine expertise from multiple fields. Often consulting a team of medical professionals such as physical and occupational therapists, clinicians and interventionists, physiatrists advise early treatment to relieve pain and inflammation. Rest, ice therapy, pain relievers, anti-inflammatory medication, ultrasound, electrical stimulation, acupuncture or gentle massage may accomplish this. Based on the patient’s response to early pain management techniques, important diagnostic information is relayed back to the physiatrist, which provides a framework for continued treatment.
It’s likely that concentrated rehabilitation for shoulder injuries will include some form of shoulder stabilization. More specifically, scapular exercises and an awareness of posture become important. Trapezius muscles play a vital role in the stabilization of the scapula, and with better shoulder mechanics, pain is relieved and further injury may be prevented. Other selective exercises may include rhythm movements and rotator cuff exercises. Physiatrists understand that the order in which therapy is introduced makes a difference in both the safety and effectiveness of treatment. For instance, in order for a patient to engage in rotator cuff conditioning, it is important that the timing and coordination of the scapular movements (in relation to the shoulder) are first corrected.
At the Howard Liss, M.D. Rehabilitation Institute in Tenafly, patients can rely on Dr. Liss to put together the right treatment, therapy and rehabilitation plan to ensure the most optimal outcome. Dr. Liss works closely with other specialists required to rehabilitate patients suffering from chronic pain or serious injuries, and Dr. Liss will refer patients as needed to ensure appropriate treatment. With extensive education and exposure to a variety of conditions that affect the cervical and lumbar spine, bones, nerves, joints, ligaments, tendons, muscles, brain, and spinal cord, Dr. Liss is uniquely positioned to help patients manage their pain and maximize their functioning.
If you are experiencing shoulder pain or injury, contact the Howard Liss, M.D. Rehabilitation Institute in Tenafly today.