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shoulder pain

Rotator Cuff Rehabilitation

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In the opinion of this Courtenay chiropractor, problems with internal rotation of the shoulder are often a major component of the rotator cuff issues seen in my office.

In office, I will employ soft tissue therapy, chiropractic adjustments and taping to help restore proper function to the rotator cuff and surrounding structures. I also believe it is important to arm the patient with exercises to do at home. One of the most important stretches out there is the Sleeper Stretch.

A great explanation of the sleeper stretch can be found here, with pictures to clarify.

If you have pain putting on your coat, or unhooking a bra, then you may have problems with internal rotation and impingement in the back of your shoulder. See a professional for a correct diagnosis, and ask them about the Sleeper stretch. It can be used to help alleviate the problem, and as a precaution to prevent it from returning.

Dr. Debbie Wright is a practicing Courtenay Chiropractor.

Rotator Cuff Rehab Exercises

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Rotator Cuff Pain
Rotator Cuff Pain

It’s just as important to strengthen and rehabilitate the rotator cuff as it is to heal it in the first place. Treatment is needed to restore proper function, decrease inflammation and generally heal the shoulder joint. After this, it is crucial to ensure that the muscles that make up the rotator cuff are strengthened and stabilized so the same problem doesn’t happen again.

I prefer a two-part shoulder rehab program – early and late.

Early rehabilitation when the shoulder is not quite 100% is aimed at restoring proper functioning of the shoulder blade and shoulder joints (scapulo-humeral joint). This involves gently activating  the muscles around the shoulder blade, which include the rotator cuff muscles. Two examples of such exercises (which are listed in this research paper) are:

1.    Inferior Glide – Sit beside a flat surface (such as a table) that is slightly lower than your shoulder.  Raise your shoulder to 90 degrees and place your arm flat on the surface. Press down through your fist like you are attempting to return your arm to your side. At the same time, draw your shoulder blade down your back and hold for 5 seconds.

2.    Low Row – With your arm at your side, place your hand (palm facing you) on the front edge of a table or counter.  Extend your trunk and push your hand into the edge of the table like you are pulling your shoulder back. At the same time, squeeze your shoulder blades backwards and down your back and hold for 5 seconds.

Late shoulder rehabilitation involves more active movements of the rotator cuff including internal rotation, external rotation and abduction. I’ve included a copy of the handout I use below.

The main thing to remember about rotator cuff rehab is to make sure all movements are done in a pain-free zone. Any pain or pinching indicates impingement or irritation a structure and will further aggravate the condition. And finally, make sure you consult a health care provider in order to get a proper diagnosis for your shoulder, and get the right exercises to help your specific condition.

Rotator Cuff Exercises
Rotator Cuff Exercises
Rotator Cuff Exercises
Rotator Cuff Exercises

Dr. Debbie Wright is a practicing Comox Valley Chiropractor.

Laser Therapy for Rotator Cuff Injuries

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Low intensity laser therapy is a great option for treating rotator cuff problems. The laser therapy system used by your Comox Valley Chiropractor is especially suited to treat the entire joint and provide quick relief. For a quick explanation of rotator cuff impingement and how laser therapy can help, watch the following video.

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Dr. Debbie Wright is a practicing Comox Valley Chiropractor.

Chronic Shoulder Pain? Probably Rotator Cuff Tendonitis…

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One of the most common things that this Comox Valley Chiropractor sees in my practice is rotator cuff tendonitis. I’ll treat at least 2-3 per day, sometimes as a primary complaint but usually as an add-on to other complaints. Most often, the problem with be chronic and will have been around for many months. Most people believe that since the pain is not too bad, it will go away on its own. Sadly, it often doesn’t, but progressively gets worse as time goes on.

The rotator cuff of your shoulder is a group of small muscles which help to co-ordinate the movement of your arm bone in your shoulder socket. When they aren’t functioning properly, the head of the arm bone doesn’t rotate smoothly in the socket and you will get clicking, clunking and pinching of the tendon of one of the muscles. This will result in pain with certain arm movements such as lifting it up to the side, putting on your coat or opening the door. Often it will be accompanied by night pain, resulting from sleeping on the sore side.

Rotator cuff problems are fairly straightforward to diagnose with a proper orthopedic examination. Once diagnosed, the goal of therapy should be to restore proper functioning of the rotator cuff and the shoulder joint. In our Comox Valley Chiropractic office, this entails active release therapy for the muscles, joint mobilization and manipulation, kinesiotaping and many home stretching and strengthening exercises. Once the shoulder has regained a full and painless range of motion, it is imperative that the muscles are strengthened in order to prevent the problem from coming back.

Another option which works well, especially for chronic and stubborn cases, is low intensity laser therapy. Although current research has variable results, I have had great success with laser therapy in my practice. Once specific case involved complete resolution of left-sided shoulder pain in two treatments, and no further recurrence in the last 6 months. What makes this case more remarkable is that the patient had previously had rotator cuff surgery on the other shoulder, and was slated to follow the same course for the left side.

The most important thing to remember about rotator cuff problems is that the sooner they are diagnosed and treated, the faster they get better. Leaving a rotator cuff for too long can make recovery a longer process, and can increase your chances of developing frozen shoulder syndrome which has a recovery time measured in years. If you have any questions about rotator cuff pain, feel free to contact your Comox Valley Chiropractor.