Shoulder have you out of the Game this summer??

Healing Chronic Shoulder Pain

Chiropractic Care and Rehabilitation of Chronic Pain

Chronic injuries require specific rehabilitation and a long-term approach. Patience is required and it is important to recall that the problem has developed over the course of years and will not be fixed in a matter of weeks or months. Progress should be obtained in the short-term, but such situations usually require consistent, ongoing attention to achieve a long-term solution. Performing the appropriate rehabilitative activities is critically important and chiropractic care can be of great assistance in getting the most out of your exercise program. Regular chiropractic care improves the mobility of your spinal column and removes nerve interference which may cause tight, inflamed muscles. The result is a body that is optimized for good health and full function. By enabling maximum spinal mobility and maximum function of your nerve system, regular chiropractic care helps maximize your body's ability to recover from chronic injury.

As we get older, years and decades of mechanical stress may lead to deterioration of joints, ligaments, and tendons. This degenerative process, commonly known as arthritis, primarily affects weight-bearing joints such as the hips and knees and those found in the lumbar spine. The shoulder, too, is especially prone to undergo arthritic changes owing to its extreme mobility. The extensive range of motion at the shoulder is built-in to the design of this structure, but the tradeoff is instability. The design of the shoulder sacrifices stability for mobility.

Degenerative disorders of the shoulder typically involve the rotator cuff. This broad, flat structure is composed of the muscle-tendon units of the four rotator cuff muscles: the supraspinatus, infraspinatus, subscapularis, and teres minor. The thick covering of the rotator cuff surrounds the head of the arm bone and supports and strengthens the shoulder joint. But owing to the shoulder's inherent instability contrasted with its great mobility, the soft tissues of the rotator cuff undergo repetitive stress and strain. Ultimately, degenerative changes may occur, leading to the two prominent symptoms of pain and restricted range of motion.

An entire orthopedic sub-specialty focuses on treatment of chronic shoulder pain and includes long-term use of anti-inflammatory medication, corticosteroid injections when medications do not provide sufficient relief, and eventually surgery to repair tears in the various rotator cuff tendons. "Revision" surgery is commonly performed when the benefits of prior surgery are exhausted.¹

The good news is that in many cases, a more optimal approach is available, one that utilizes the body's own natural recuperative powers. For many people, chronic shoulder pain can be reduced and chronic loss of mobility can be improved by engaging in specific activities and performing specific rehabilitative exercises. The goals of rehabilitation are to increase shoulder range of motion and build up shoulder strength. As these goals are accomplished, the likely result is reduction of intensity and frequency of occurrence of shoulder pain.

Engaging in an overall strength training program is an important general approach to managing chronic shoulder pain.^2,3 Strength training should be done progressively, starting with light weights and building up over time. Exercises specific to the shoulder include seated dumbbell or barbell presses, dumbbell or cable lateral raises, seated bent-over rows, and internal and external rotation exercises done with very light dumbbells on a flat bench. If one has experienced an acute shoulder injury, early rehabilitation should precede rehabilitative strength training. Early rehabilitation includes pendulum exercises and finger-walking up a wall in both forward-facing and side positions.

Your chiropractor is experienced in injury rehabilitation and will be able to help you design an effective flexibility and strengthening program for improved shoulder function.

¹Keener JD: Revision rotator cuff repair. Clin Sports Med 31(4):713-725, 2012

²Lewis JS: A specific exercise program for patients with subacromial impingement syndrome can improve function and reduce the need for surgery. J Physiother 58(2):127, 2012

³Andersen LL, et al: Effectiveness of small daily amounts of progressive resistance training for frequent neck/shoulder pain: randomised controlled trial. Pain 152(2):440-446, 2011

Mind and Body Connection.

What's on and in your mind can and will effect your health. A quick look in a few medical dictionaries confirm this.

psy·cho·so·mat·ic (s k -s -m t k) adj. 1. Of or relating to a disorder having physical symptoms but originating from mental or emotional causes. 2. Relating to or concerned with the influence of the mind on the body, and the body on the mind, especially with respect to disease: psychosomatic medicine.

psy cho·so·mat i·cal·ly adv.

The American Heritage® Dictionary of the English Language, Fourth Edition copyright ©2000 by Houghton Mifflin Company. Updated in 2009. Published by Houghton Mifflin Company. All rights reserved.

psychosomatic [ˌsaɪkəʊsəˈmætɪk] adj (Psychology) (Medicine / Pathology) of or relating to disorders, such as stomach ulcers, thought to be caused or aggravated by psychological factors such as stress

Collins English Dictionary – Complete and Unabridged © HarperCollins Publishers 1991, 1994, 1998, 2000, 2003

This is also common in sayings in our society. "They seem to have the whole weight of the world in their shoulders." "My boss is a pain in my neck." These are just a few.

It is common for me to see patients with real physical symptoms that may be traced back to emotional stress.

So what can be done? Take time to de-stress. Maybe just some quite time, a walk, exercise, reading a book, prayer, meditation, vacation, ... in some cases professional help with a physiologiest, or a pastor.

Point is you must learn to take care of you Mind, and it will help take care of your Body!

Dr. Parrish Skrien.

Check your Spine

Remember to Schedule Your Spinal Screening

Chiropractic Care and Long-Term Health

Regular, vigorous physical exercise, a healthful diet, and sufficient rest are not the only components of a comprehensive program of health and well-being. Regular chiropractic care is an additional key factor. Each of these lifestyle choices contributes to the benefits derived from the others. In the case of regular chiropractic care, maintaining a healthy spine and nerve system helps support all the other things you're doing. A healthy spine helps keep your muscles and joints limber so you can get the most out of your exercise. By identifying and correcting nerve interference, regular chiropractic care helps your digestive system to efficiently utilize the good food you're consuming. By reducing neck and back aches and pains, regular chiropractic care helps you achieve a more restful, reinvigorating sleep. Overall, regular chiropractic care helps your body be more at ease and helps you enjoy increased health.

Most of us have undergone some type of screening exam in the last several years. Depending on your age, personal history, and family history, you may have needed to go for a periodic mammography, colonoscopy, or cardiac stress test. If everything was fine, you have probably been instructed to follow-up next year, in three years, or in five years or more. As treatment is usually more effective and easier to accomplish in the early stages of illness, screening procedures are an important component of a public health and health care policy. Most people are generally aware of the usefulness of periodic screening exams for chronic diseases such as cancer and cardiovascular disease. Spinal screening, performed by your chiropractor, is an additional important service to assist you in maintaining your long-term health and well-being.^1,2

Your spinal column is designed for two primary purposes: to provide for an extensive range of motion in three directions (forward and backward, side-to-side, and rotation) and to house and protect the spinal cord. Both of these functions are critical to ensuring ongoing health and wellness. A chiropractic spinal screening exam analyzes your spine to identify localized regions of limited mobility and to detect the presence of nerve interference.

First, if your spine is not freely movable, you will likely begin to experience neck, mid back, or low back pain. People often wonder why they have such pains. A person will typically say, "I didn't do anything, really. I was driving and just looked around to make sure I could change lanes safely. Now I can't move my neck." Another person might say, "All I did was bend over to pick up the mail. My back really hurts." The problem causing their pain wasn't the simple twisting or bending motion. The problem was an underlying one - a lack of full mobility in the affected region of the spine.³

Next, your spinal cord is a direct extension of your brain. Your spinal cord connects your brain with the rest of your body through numerous pairs of spinal nerves. These spinal nerves branch out and create a complex communication network, sending signals from your brain to your body and from your body back to your brain. A mechanical problem in the spinal column can cause irritation to local spinal muscles, ligaments, and joints, which in turn can irritate spinal nerves and cause nerve interference. Nerve interference can cause disturbances in your body's neural network, delaying nerve signals or causing information to be transmitted incorrectly or at the wrong time. Over time, symptoms develop in the affected region or regions as cells, tissues, and organs no longer do their job effectively. Eventually, symptoms may develop into full-blown chronic diseases.

Often, mechanical problems in the spine are not immediately obvious. The effects of nerve interference and back pain on a person's health take time to develop. As with other chronic health issues, prevention is the best strategy. A spinal screening performed by your local chiropractor is the best way of detecting underlying problems. Chiropractic care then corrects nerve interference, helping your body perform effectively and helping you to enjoy long-lasting health and well-being.

¹Goertz CM, et al: Adding chiropractic manipulative therapy to standard medical care for patients with acute low back pain: the results of a pragmatic randomized comparative effectiveness study. Spine (Phila Pa 1976) 2012 Oct 10 [Epub ahead of print]

²Morningstar MW: Outcomes for adult scoliosis patients receiving chiropractic rehabilitation: a 24-month retrospective analysis. J Chiropr Med 10(3):179-184, 2011

³Bishop PB, et al: The Chiropractic Hospital-based Interventions Research Outcomes (CHIRO) study: a randomized controlled trial on the effectiveness of clinical practice guidelines in the medical and chiropractic management of patients with acute mechanical low back pain. Spine J 10(12):1055-1064, 2010