Why Chiropractic Care & PEMF Therapy Are A Great Choice For A Rotator Cuff Injury
“Why is it so difficult to raise my arm?” “What did I do to cause pain in my shoulder if I didn’t fall?” “Did playing too much baseball yesterday cause my shoulder to hurt?” “How am I going to fix this sharp pain in the front of my shoulder?”
At one point or another every person is going to ask themselves these types of questions when they encounter some type of pain in their shoulder. The pain could be located on the back, side as well as the front and it can vary in intensity. Popping or clicking can occur as an early warning sign.
Stabbing, sharp or deep burning are all sensations they let you know there is a serious problem on your hands but even dull nagging type pain if left untreated can become an even bigger problem down the road. The best thing to do is to catch it early and get it treated. You may notice limited range of motion without pain, because you aren't doing any of the movements that would typically cause pain. The statistics for rotator cuff injuries suggests this is a very common condition for patients dealing with shoulder pain.
What Is The Rotator Cuff?
A rotator cuff is a group of tendons (muscle to bone) that connect to the upper arm to help to stabilize the joint. There are four muscles that make up the entire rotator cuff: the infraspinatus, the supraspinatus, the teres minor and the subscapularis. They originate from the shoulder blade which is another important structure when it comes to arm movement. All or some of the rotator cuff muscles are always being used when the arm is moving. They allow the arm to be secure when making a wide variety of motions because the shoulder is a free moving joint like the hip.
The supraspinatus is the most commonly injured of the four muscles and it allows the arm to abduct (raise to the side) to the height of the shoulder. The infraspinatus and teres minor allow the arm to externally rotate or turn outwards. These two muscles become weakened over time when the bigger muscles such as the pectoral (chest) and front of the shoulder (deltoid) become too tight over time. The rolling of the shoulders going forward to hunched type posture are both warning signs of eventual rotator cuff injury if they are not corrected. The last muscle is the subscapularis that allows the arm to move inward toward the body or internally rotate. It is the least commonly injured and is usually related to age degeneration.
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What Causes Rotator Cuff Injury?
The rotator cuff can be torn in many different ways but the two most common types of injuries are trauma and overuse. Trauma occurs from a direct blow to the shoulder such as falling on an outstretched arm, onto the shoulder itself or even in a motor vehicle accident. Overuse type injuries happen with repetitive movements in sports or occupations such as painting and window washing. But even working at a computer for over 8 hours a day can eventually cause a rotator cuff injury.
If you think about it the shoulder is usually placed in a position with the arm extended out for a long period of time where it barely moves. This will cause muscle imbalances more and more while the rotator cuff muscles are being pulled. The fibers of the muscles can only withstand so much pulling or strain before they finally decide to give way. An important thing is to note the warning signs before you have a bigger problem on your hands.
What Are The Symptoms Of A Rotator Cuff Injury?
- Popping and clicking in the shoulder
- Pain or difficulty when trying to lift the arm
- Weakness in the shoulder and unable to lift objects
- Discomfort or or shoulder pain in certain positions
- Not being able to raise the arm to shoulder level
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What Are The Types Of Rotator Cuff Injuries?
The three levels of a rotator cuff tear are types 1, 2 and 3. Type 1 is when one of the muscles is slightly torn which means that only some of the fibers are affected. These typically respond well to conservative care (in 2-3 months) such as chiropractic and physical therapy exercises. Type 2 is when the rotator muscle is partially torn. These can heal with conservative therapy but take much longer (between 4-6 months) and in the event that they do not then surgery is warranted. Type 3 rotator injuries is when the muscle is completely torn and surgical intervention is the only option.
How Does A Rotator Cuff Injury Get Diagnosed?
A complete and thorough orthopedic examination will help determine if a rotator cuff is damaged. Checking the range of motion of the shoulder will help to determine which of the muscles is being compromised the most since some of the muscles make similar movements.
It is important to also check the cervical and thoracic spine for any restrictions that will limit the motion of the shoulder blade or the neck. An x-ray or radiograph will only be necessary if there was direct trauma to the shoulder joint in the patient’s history or if the person is elderly and has arthritis. Any arthritis in the shoulder can cause extensive damage to the tendons and leads to worse tears over time.
The best diagnostic test to determine the severity of a rotator cuff tear is a MRI. These can be very expensive and are usually only necessary when arm and shoulder pain is too severe to manage, the shoulder feels unstable or when conservative treatment does not work.
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How Do You Treat A Rotator Cuff Injury?
Spinal Adjustments
Upon initial injury it is always best to use ice on the affected area to help with any swelling or inflammation. Once the affected area is determined by the chiropractor then proper adjustments to the cervical and thoracic spine will be helpful in allowing the shoulder blade to move freely which is where the rotator cuff muscles originate.
Shoulder Adjustments
An adjustment to the arm bone (humerus) itself will also be performed if needed when it is out of position so that the rotator cuff muscles can heal in the optimal position. Once the arm and spine are adjusted it is best to tape the area to allow for better stabilization and to help prevent further injury while the muscles are healing. Muscle stimulation and ice are applied to the affected areas following the adjustment to help with pain and swelling.
PEMF Therapy
PEMF (pulsed electromagnetic field) therapy will also aid in recovery to allow for the cells within the tissues that are affected to be raised to a higher energy level. This will allow the body to self heal and recover much faster. This type of therapy would need to be done on a consistent basis to obtain maximum therapeutic results.
Home Exercises
At-home exercises will be offered as well to assure that the rotator cuff muscles not only get stronger but the shoulder joint itself becomes more mobile. It is important to progress with the exercises over time to not only help the shoulder become stronger but to help make it even better than it was before the injury occurred.