Irvine Spine and Sport
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Rotator Cuff Injuries

Don’t let anyone tell you that you need to do certain exercises or take particular drugs for the rest of your life.

Finding a cure means eliminating the source of the problem .

The “rotator cuff” muscles are the most commonly injured muscles of the shoulder.

The rotator cuff (four muscles in total) is also the primary support structure for the shoulder. Therefore, even minor dysfunction associated with these muscles can create significant pain and disability including shoulder pain, arm weakness, and decreased athletic performance. When a rotator cuff injury becomes severe enough to irritate the many nerves that pass through the shoulder joint it is called a Rotator Cuff Impingement. The symptoms associated with an impingement are often more severe and can include numbness, tingling and sharp, shooting pain into the arm or hand.

A Rotator Cuff problem can be caused by many everyday activities. These activities include traumatic events (e.g. fall on an outstretched arm, “yanking” of the arm), repetitive motions (e.g. throwing a ball, weightlifting, swimming) and chronic, improper postures (e.g. operating a computer, driving).

Treatment for Rotator Cuff Injuries

Proper function of the shoulder requires a delicate balance between mobility and stability. Healthy joint mechanics are critical to allowing mobility and the proper combination of muscle flexibility and strength provide the necessary stability.

One of the most important and most commonly injured rotator cuff muscles is called the subscapularis (meaning “under the shoulder blade”). It is often missed by doctors because of its “hidden” position underneath the shoulder blade. When the subscapularis works properly it creates a large space between the arm bone (humerus) and the shoulder socket (glenoid fossa). If this muscle becomes overly tight or “gummed up” with scar tissue the shoulder mechanics become disrupted leading to nerve irritation. Extended periods of nerve irritation can lead to significant nerve damage and chronic pain. Although this muscle can be weak in many cases, strengthening exercises (such as seen with physical therapy) rarely produce a cure. Addressing the cause of the weakness (scar tissue) is the only way to eliminate rotator cuff dysfunction, joint pain and related nerve irritation.

Therefore, treatment for a Rotator Cuff injury requires a combined approach that addresses both the joint mechanics AND the muscles that support joint function. Joint mechanics are best corrected with corrective chiropractic adjustments. Active Release muscle therapy is effective at restoring both strength and flexibility to damaged muscles.

Dr. Ken Erickson can identify the proper areas involved and provide the necessary treatment based on your specific needs.

“Chiropractic adjustment” describes hundreds of ways of using carefully directed and controlled pressure to restore joints to normal motion and position. It also alleviates strain on surrounding muscles that are overworked in their efforts to compensate for joint dysfunction.

Active Release is a patented, state-of-the-art soft tissue (muscles, ligaments, fascia and nerves) treatment system that was designed specifically to restore balance to dysfunctional muscles. The Active Release doctor uses precisely applied tension in combination with specific patient movements. Patients often notice improvement in their levels of pain, flexibility and strength within seconds following the treatment.

Contact Dr. Ken Erickson at (949) 857-1888 to arrange for a free consultation on the phone or in person.

Is Surgery Effective at Treating a Rotator Cuff Impingement?

Surgical procedures have been developed over the years to reduce the pressure on the nerves passing through the shoulder by permanently “shaving” bone away from the underside of the collarbone (clavicle). Unfortunately, these procedures are rarely successful over the long term and almost never address the cause of the nerve irritation. Common sense would tell us that it is unlikely that the nerve tunnel would simply “shrink” without warning. Therefore, increasing the size of the tunnel will only provide temporary benefit especially if an underlying mechanical problem remains untreated. Also, post-surgical scar tissue may even negatively impact shoulder function contributing to increased pressure on the nerves.

Is Physical Therapy Effective at Treating a Rotator Cuff Impingement?

The Physical Therapy approach to rotator cuff problems generally involves strengthening exercises, hot and cold packs and ultrasound. Hot and cold packs offer temporary relief, but can easily be performed at home more conveniently and less expensively. Ultrasound is effective at providing drug-free inflammation reduction, but offers little curative, long-term value. Strengthening exercises are also helpful at providing improved stability to the supportive muscles of the shoulder. However, one must ask, “What is causing the weakness?” In most cases the weakness is the result of a trauma to the muscle or the accumulation of injury over an extended period of time (often months to years). The body repairs this damage by infusing scar tissue into the muscles, tendons and ligaments. This scar tissue prevents muscle from fully lengthening (making it tight) and interferes with its ability to shorten (making it appear weak). The ability of the muscle fibers to contract strongly has not changed. What has changed is the resistance (caused by the scar tissue) that the muscle fibers must now overcome in order to shorten. Imagine a tug-of-war team standing on firm grass competing against an evenly matched “scar tissue” team that is standing waist deep in quicksand. Wouldn’t the quicksand hamper that team’s ability to win despite the equivalent strength of the two teams? Making the muscle stronger will help, but only temporarily and only for as long as you continue to do the exercises.
Don’t let anyone tell you that you need to do certain exercises or take particular drugs for the rest of your life. Finding a cure means eliminating the source of the problem