The shoulder is an elegant and complex piece of body machinery.  Its design allows us to reach and use  our hands in many different postions.  However, while the shoulder joint has great range of motion, it is not very stable.  This makes the shoulder vulnerable to various problems if all of the parts are not working the way they should.

The shoulder is made up of three bones: the scapula, which is the shoulder blade, the humerus, which is the upper arm bone, and the clavicle, or collarbone.  The rotator cuff is what connects the humerus to the scapula.  The rotator cuff is made up of the tendons of four muscles: the supraspinatus, infraspinatus, teres minor, and subscapularis.  Tendons are what attach muscles to bones, so when muscles pull on the tendons they move the bones. The rotator cuff is what rotates and raises the arm and is very important to a healthy functioning shoulder. However the rotator cuff is subject to alot of wear and tear as we use our arms and damaging a rotator cuff can be a very painful injury and creates a very weak shoulder.

Rotator cuff injury treatments range from a conservative regimen of rest, ice and therapy to pain medications and possible surgery, depending on the severity of the injury. In the case is extreme enough, a shoulder may have to be replaced. Simply resting the shoulder, undergoing physical therapies and applying ice packs, usually is all rotator cuff injuries need. If the pain is not alleviated, doctors may suggest a steroid injection into the joint, however these shots can weaken the tendon, so they should be only used in extreme situations and very limited.

Physical therapy consists of a series of exercises to give the shoulder its strength and flexibility back after a rotator cuff injury. Surgical options begin with bone spur removal. If bone growths are inflamming the rotator cuff, this procedure removes the bone and smooths the damaged area of the tendon, often using arthroscopy instead of open surgery

Another surgical option is tendon replacement or repair. Doctor can repair a torn rotator cuff tendon and reattach it to the bone of the upper arm provided the tendon damage is not too severe.  Surgeons sometimes use another tendon nearby to replace it, unless the rotator cuff injury, such as those connected with degenerative joint disease, is too damaged, then replacement of the shoulder may be necessary.

With chiropractic care, the doctor’s first goal will be to control the pain and inflammation. This can be achieved with treatments such as electrical muscle stimulation (PEMF), ultrasound, heat and ice. Hands on treatments (adjustments) and different types of excercises are used to improve the range of motion in the shoulder and the joints and muscles that are nearby. Gentle joint mobilization and adjustments are utilized to restore normal biomechanics to the shoulder joint.  This is where chiropractic has an advantage over other specialties.  It is important to manipulate and stretch capsular joint restrictions during the intial treatments. Additionally adjustments to the spine can help remove any joint fixations that could inhibit normal healing and proper motion of the shoulder.  Advanced muscle massage and release techniques can be used to help restore nomal length and elasticity to the muscles, ligaments and the tendons. This can also break down scar tissue, adhesions in and around the joint and associated soft tissue. Later, excersises can be used to improve the strength and control of the rotator cuff and shoulder blade muscles. Regular chiropractic care will help to retain the muscles to keep the ball of the humerus in the socket which will help your shoulder move smoothly during all of your activities.

Chiropractic treatments for six to eight weeks may be required, and most patients are able to get back to their activities with full arm use within this timeframe. Even if surgury wasn’t required, the chiropractor may lay out a program of rehabilitation excercises to help regain shoulder function and suggest tips and excercises for improving posture and shoulder alignment. It is very important to improve the strength and coordination in the rotator cuff and shoulder blade muscles.  The chiropractor may also evaluate workstations and the way the body is being used in activities to suggest changes to avoid further, and future, problems.