Rotator Cuff Injury
Rotator cuff injuries mean different things to different people. And that’s not surprising given that a rotator cuff injury can be more than one thing – it can be a strain of one of the rotator cuff muscles, a tendinopathy (old term: tendinitis) or a rotator cuff tear. For this post, we will focus on the rotator cuff strain/tendinopathy type of injury and leave tears to be discussed in a future post.
The rotator cuff itself is a group of four muscles which originate on the shoulder blade and wrap around the head of the shoulder. These muscles may be referred to as the SITS muscles which stands for Supraspinatus, Infraspinatus, Teres minor, Subscapularis.
Each muscle in the rotator cuff group has the potential to become injured with some injuries more common than others. For instance, when you are juggling chainsaws*, you could strain the supraspinatus muscle over time just from the repetitive process of regular practice. If juggling the chainsaws from behind your back, however, it may be the subscapularis muscle which becomes torn because of the different angle of the stresses placed on the rotator cuff. Or it may be something as simple as falling down onto your outstretched arm as you try to roll away from the wrath of descending chainsaws during a practice session gone wrong. Whatever the cause, we can all agree that chainsaw juggling can be hazardous to your rotator cuff.
Pain is often felt on or around the tip of the shoulder and often towards the front or side. You may notice pain or weakness with lifting the arm or with overhead activities. There may also be some referral of pain into the arm or forearm.
There are many orthopaedic tests that can be used to determine shoulder injuries; however newer research is showing that there is no gold standard test. To diagnose a rotator cuff strain/tendinopathy, we look at the combination of symptoms, range of motion, orthopaedic tests and possible imaging (x-ray) if necessary. Chiropractors can order an x-ray directly if need be without having to refer you back to your doctor. This may be considered if you have had a fall or if we would like to rule out other conditions. An x-ray can show if there’s been displacement of the humerus (shoulder bone) and this may indicate if there has been a complete tear of one of the tendons. Alternatively, diagnostic ultrasound can also be used.
For a rotator cuff strain/tendinopathy, treatment can include a variety of approaches:
In clinic treatment:
- Active release therapy or muscle release therapy
- Adjustments of related spine joints
- TENS for initial pain relief and to decrease muscle spasm
- Microcurrent therapy to promote healing
- (click here for a description of the above chiropractic treatments)
At home therapy:
- Ice or heat as advised
- Pendulum exercise (gentle arm swinging) to encourage motion and prevent frozen shoulder
- Range of motion exercises
- Strengthening exercises of weak shoulder musculature
For more information on shoulder pain and how we can help feel free to give one of our Guelph Chiropractors a call or send us an email.
*There may be other mechanisms of rotator cuff injury besides chainsaw juggling. It could be juggling bowling balls, anvils, or frozen sword fish to name a few.