Your shoulder is a large, complex ball-and-socket joint that connects your humerus (upper arm) to your shoulder blade.
The shoulder has a wide range of motion because your humerus sits fairly loosely in the joint, but that can make it more vulnerable to injury.
Tears of the rotator cuff (a collection of muscles and tendons that support your shoulder) are common, and may happen from a sudden injury or as a result of consistent overuse.
What happens then? Well, begin by considering these five things...
1. A Rotator Cuff tear is not necessarily the cause of your shoulder pain
‘All cats have 4 legs. My dog has 4 legs. Therefore, my dog is a cat.' This obviously ridiculous conclusion was reached because of a false premise. Unfortunately, that happens in healthcare too.
‘My shoulder hurts. My scan shows a rotator cuff tear. Therefore the tear is causing the pain.’
That seems logical. But the evidence says that this is not always the case.
Rotator cuff tears are the most common shoulder disorders we see in our practice. They’re very common in the population, affecting 22% of people and increasing with age.
Interestingly though, most of these people don’t know they’ve got a tear. Asymptomatic tears are twice as common as symptomatic ones. It’s easily possible, then, to have a rotator cuff tear with no shoulder pain or other symptoms at all. In fact, it’s the most likely situation.
So, what else could be causing your shoulder pain? There are many possibilities including a pinched nerve, arthritis, swollen bursa or an overuse injury.
2. Rotator cuff tear surgery may not be any better than conservative treatment
If you’ve been diagnosed with a rotator cuff tear, you may have been told to do two things:
- Restrict your activities
- Book in for surgery as that’s the only option for properly fixing your shoulder.
The evidence can suggest otherwise, though. A systematic review and meta-analysis of 57 randomised controlled trials concluded that most patients demonstrated a consistent pattern of improvement over 12 months, whether they were treated with surgery or with conservative care.
The take-home message? You could be in for a slow recovery from a rotator cuff tear. It may not fully recover even with surgery, but with or without surgery, it will most likely improve. And that rate of improvement can be just as good with conservative treatment. So, it's important to consider the potential risks and costs of surgery against the potential benefits of non-invasive treatment.
3. Cold laser can be a good alternative to corticosteroid
Shoulder tendinopathy is caused by damage or irritation to the tendons in your shoulder. It’s often caused by repeated microtrauma, for example when you lift your arm. Inflamed, swollen tendons can be painful and may lead to a loss of strength or motion.
Cold laser therapy (or low-level laser therapy) uses a low-intensity laser to stimulate healing while using low levels of light that are not enough to heat your body’s tissues. It’s been shown to help reduce inflammation in the tendons, muscles and bursa of the shoulder.
Low-level laser therapy has similar success levels to a corticosteroid injection in patients with shoulder impingement. That’s worth knowing because repeated steroid injections may cause complications.
4. Consider treatment that addresses the whole spine and posture
So far, we’ve recommended that you don’t assume the cause of your shoulder pain and that you don’t assume that surgery is the best way to fix it. We’ve highlighted evidence saying that conservative treatment can deliver equal outcomes to surgery and that laser therapy is a good alternate to injections.
Let’s now think about the bigger picture. Ideally, you would have a treatment approach that addresses your whole spine and posture.
Restricted spinal movement can play a role in shoulder problems. A restricted range of movement in your mid back can limit your ability to move your arms to the side or lift them above your head. Poor posture can further contribute to shoulder problems.
Chiropractic adjustments have been shown to help shoulder problems. Thoracic manual therapy can speed up your recovery and reduce your pain, both immediately and for the next year.
5. Consider a technique that reprograms muscle patterns
Inflamed or damaged shoulder muscles struggle to communicate with your spine and brain.
Spinal adjustments can help improve this communication, using a technique called Trigenics® Functional Muscle Neurology, which aims to reprogram your muscle patterns. This is a low-force multimodal manual procedure where your chiropractor uses resisted exercises movements, muscle nerve sensor stimulation, and focused diaphragmatic breathing exercises. This maps out your muscles, noting differences in strength and length.
If we identify dysfunctional patterns, we then focus on particular muscles using direct muscle manipulation, stretching techniques or neurological repatterning to relax overactive muscles.
How can Windsor Chiropractic help you?
At Windsor Chiropractic, we take a holistic approach to how the body works and responds to any weakness. We know that your body can compensate around specific joints, and that’s why we don’t solely focus on your shoulder but on its supporting structures too. We aim to improve the function of the entire spine and pelvis so that your shoulder has the best chance of healing.
Our approach is to improve overall spine and pelvic alignment with chiropractic care, mobilisation and a number of other techniques to help improve your ability to move and exercise.
Your treatment plan may include:
- Manipulation (chiropractic adjustments) to balance the spine and pelvis
- Mobilisation to help reduce pain and improve function.
- Cold laser treatment to reduce pain and inflammation, and promote tissue repair.
Chiropractic may also improve the effects of exercise.
To give you the best chance of regaining function, it’s important that you do your exercises in the correct order, mastering the basics before progressing to something harder. We can help with a suitable program. We’d love to help you regain confidence in moving and feel more positive about your future.
For more information or to book an appointment with Dr Alan, please call our team on 07-3357 3366 or book online anytime
DISCLAIMER: All content is created and published online for informational purposes only. It is not intended to be a substitute for professional medical advice and should not be relied on as health or personal advice. Always seek the guidance of your doctor or other qualified health professional with any questions you may have regarding your health or a medical condition.