21/04/2025
Yesterday, I saw a man for a shoulder evaluation. He said the pain had been going on for more than six months. When I asked him to lift his arm forward and to the side, he could only go up to shoulder level. He said it felt stuck.
He denied any injury or trauma. His X-ray was clear.
But during passive range of motion, I was able to move his shoulder all the way. Painful, yes β but the joint moved. Flexion, abduction, external rotation, and lowering the arm from overhead all brought discomfort. Still, the joint moved.
Then I asked him to try lifting his arm again. This time, he did it better. Higher than before.
That moment stuck with me. Many people avoid pain, and that makes sense. Pain is there to protect; it's a signal. But when we stop moving because of pain, that can lead to more problems. Joints can stiffen. Muscles weaken. Fear builds. Confidence fades.
His case likely points to a rotator cuff issue. But more than the diagnosis, it reminded me that pain isnβt always the problem. Sometimes, itβs the bodyβs response to pain β and the habits built around it.
This idea might seem like common sense to us as PTs. But honestly, it still surprises me when I see how powerful the fear of pain can be. It reminds me that we need to do a better job of helping our patients understand the benefits of movement β and how healing often begins with simply trying again.
As physical therapists, we donβt just treat pain. We help people trust their movement again. We guide them back to confidence in their own bodies. We help them get unstuckβnot just in their joints, but in their thinking, their fears, and the way they see whatβs still possible.
Sometimes, they just need a little help to realize:
βMaybe I can still do this.β