Tulane Institute of Sports Medicine I. Inflammation and Repair . Pain may contribute to the pain-spasm cycle, further decreasing motion and increasing pain. Swelling may cause increases in pain secondary to pressure on pain fiber nerve endings, and may also cause reflex-inhibition of muscles crossing the shoulder joint. Chronic inflammation prolongs this phase and prevents proper alignment of collagen. Appropriate stress must be applied to healing tissues to facilitate proper alignment of the collagen fibers.
Prolonged immobilization leads to abnormal scarring and weakens connective tissue.
Early and controlled motion is vital to provide normal healing. Joint motion is necessary for articular cartilage nutrition via synovial fluid movement, and muscle action is necessary to maintain proper fluid balances. Common mechanisms of shoulder injury Determining the initial mechanism of injury is vital in planning the rehabilitation. Patients must be ready to return to similar activities which may have caused the injury. Mechanisms may be traumatic or atraumatic.