Shoulder & Rotator Cuff Pain | North Vancouver

No. Chronic rotator cuff issues respond to loaded rehab, sometimes better than acute ones, because there's less guarding. Shockwave therapy is often the unlock for tendons that have stayed irritated for 6 or more months and haven't responded to exercise alone. We build the loading program around kettlebell carries, landmine presses, and banded external rotation rather than basic theraband work.

Most rotator cuff problems don't. A small, atraumatic partial tear often does well with loaded rehab and never needs a surgeon, while a traumatic full-thickness tear from a fall or a heavy lift is a different conversation where the timeline to surgical opinion matters more. We'll be honest if we think a surgical consult is warranted, and we work with the Lions Gate orthopaedic team when it is.

Yes. Most partial tears respond to a loading-first approach and never need surgery. Full-thickness tears, especially traumatic ones in active patients under 60, more often warrant earlier surgical opinion to avoid retraction. Massive or chronic full-thickness tears in older, lower-demand patients can still do well conservatively. We map your specific case to the right pathway.

Usually within the first 1 to 2 weeks, following your surgeon's sling and range-of-motion protocol. We stage post-op rotator cuff repair rehab through passive range of motion, then active-assisted, then loaded work, coordinated with your surgeon's protocol rather than a generic timeline. Bring the post-op instructions to your first session so we can match the plan to what your surgeon specified.

For acute pain and post-op swelling, often yes, since laser therapy targets the inflammatory phase directly. For chronic tendinopathy that hasn't responded to exercise alone, shockwave therapy is usually the better choice. We sort out which category your shoulder falls into during the first session, then recommend the option that fits your specific tendon and timeline.

No. Frozen shoulder behaves nothing like a torn tendon and responds badly to aggressive stretching, while a rotator cuff problem is tendinopathy, a partial tear, or a full tear. Sorting out which one you actually have is the point of the first session, since frozen shoulder is a longer arc, often several months, where pain typically eases well before mobility fully returns.

Treatment for a rotator cuff problem combines manual therapy to restore glenohumeral and scapular movement with loaded rehab, kettlebell carries, landmine presses, and banded external rotation rather than just theraband work. We add IMS dry needling for stubborn supraspinatus and upper trap tension, shockwave for chronic tendinopathies that haven't responded to exercise alone, and sleeping position or desk-setup coaching so you stop irritating it at night.