Shoulder range of motion

Shoulder Instability

Our shoulder is a ball and socket joint, the equivalent of a golf ball sitting on a tee.  Thus, the reason we are able to move our shoulder in multiple directions, or at least we should be able to (with control of movement).  

Having full shoulder range of motion is ideal, having too much motion can lead to instability.  Instability occurs when the structures around the shoulder joint do not work to maintain the ball in the socket (subluxation or dislocation).  This can happen from trauma, wear and tear on the joint or genetics. When a person experiences instability in the shoulder joint, pain and fear of movement is often associated with it.

Instability of the shoulder can be in one direction: Anterior instability (subluxation or dislocation to the front of the joint)/ Posterior Instability (subluxation or dislocation to the back of the joint) or Multidirectional Instability (subluxation or dislocation of the front and back of the joint).

Once a subluxation or dislocation occurs, the ligaments around the glenohumeral joint can become over-stretched or torn, leading to an increased prevalence of recurrence.  So, how can we overcome an injury of instability? STABILIZE! Working with a physical therapist to learn specific exercises to strengthen the glenohumeral joint, will help the shoulder to return to normal function.  

The scapula and shoulder should work together to raise the arm overhead.  This is important for the shoulder to mechanically work the right way. When raising your arm up, ⅓ of the movement occurs at the scapula and ⅔’s of the movement occurs at the glenohumeral joint. The timing and coordination of these two structures moving are critical for stabilizing the shoulder in overhead movements. 


If you are experiencing symptoms of shoulder instability or have dislocated your shoulder in the past, the Dr. Amanda DeRosa can help you and show you specific strengthening exercises to stabilize your shoulder!  Call today, 619-693-8047.

Scar Tissue Post Mastectomy

Mastectomy surgery is a common approach for the treatment of breast cancer. As with any surgery, scar tissue develops as part of the normal healing process. However, with the development of scar tissue, decreased range of motion and pain are often an un-welcomed side effect. Scar tissue can become hyper-sensitive, especially at the drain site after a mastectomy and reconstruction. Maturation of scar tissue typically happens about 3 weeks post-surgery, so early scar tissue intervention will help improve the quality of the scar and decrease pain. So, how can scar tissue be managed?

There are ways to manage the scar tissue and improve function, minimizing and often eliminating pain. Astym (Augmented Soft Tissue Mobilization) is a soft tissue treatment used by certified clinicians. Instruments designed specifically for certain body parts are used to help regenerate tissues and break up adhesions from scar tissue.


Astym can be safely used as early as 3 weeks after surgery, as long as there are no signs of infection, the scar is completely closed and the doctor approves early intervention. The ideal treatment would be 2 days/week, with two days in between sessions, for 2-3 weeks. Treatments will vary case-by case.

Patients who are also receiving radiation will benefit from Astym. Often times after a mastectomy, shoulder range of motion may be limited from scar tissue being produced. Typically for radiation treatment to the breast, the patient needs to have a minimal of 90 degrees of shoulder abduction (raising arm to side). If scarring is preventing the shoulder from abducting, the Astym will help reduce the fibrotic tissue and improve shoulder range of motion in a shorter time, allowing for earlier radiation treatment.

If you are going through breast cancer treatments, know that you can regain function and minimize pain and scarring. At On Point Physical Therapy, physical therapist, Dr. Amanda DeRosa is certified in Astym. This specialized treatment, along with proper stretching can get you back to moving and being pain-free.

To set up your FREE 20 minute consult or to start your treatment plan, call 619-693-8047.