Repairing an Injured Rotator Cuff
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| Regular Chiropractic Care and Injury Rehabilitation |
Recovery from injury can’t be rushed, but the rehabilitation
process can be impeded or facilitated. In other words, sufficient time
is required to allow for healing of damaged structures. Re-injury is
possible if you attempt to return to full activity before healing is
complete. In contrast, use of tested rehabilitative protocols help you
prepare properly for return to full activity and may even help you to
come back stronger.
Regular chiropractic care is an important component of injury
rehabilitation. By helping ensure that your spinal column is well
aligned, regular chiropractic care facilitates optimal functioning of
all of your body’s systems. Mechanical loads are balanced so your spine,
hips, legs, and arms work effectively, aiding in the recovery process.
Spinal nerve irritation is reduced and removed, helping your internal
organ systems do their job properly. As a result, oxygen and nutrition
are delivered where they’re needed most. Regular chiropractic care
supports your rehabilitation program and the healing process, helping
you get back as quickly as possible to doing the things you want to do. |
As we get older, rotator cuff injuries become more common,
a result of the natural aging process. A similar mechanism operates in
the discs separating the vertebras in your lower back. These
cartilaginous structures lose water over time, becoming less flexible
and more brittle as the decades roll by. In the case of the shoulder,
the rotator cuff tendon is pulleyed to and fro as the arm swings forward
and back and up and down. As the years pass, this constant motion may
cause fraying in the rotator cuff tendon and inflammation in the muscles
that comprise the rotator cuff. Eventually, partial or full thickness
tears may develop in one or more of these musculotendinous units,
causing pain and some loss of function. Importantly, conservative care
may be all that’s needed to reduce pain and restore needed motion.
The shoulder joint is beautifully designed and a marvel of
engineering. Its construction makes possible a full 360-degree arc of
motion in both the sagittal and frontal planes. In other words, you can
swing your arm in a complete circle from front-to-back and
to-the-side-and-up-and-around. In the third, horizontal, plane, 180
degrees of motion is available. The overall combination of movements in
three-dimensional space makes the shoulder joint the most freely movable
joint in your body. However, as with all freedoms we enjoy in this
life, there is a price. The shoulder joint’s great mobility is countered
by its very limited stability.
The shoulder’s lack of stability needn’t concern us in our
average day-to-day tasks. Protection to the joint is built-in by way of
the rotator cuff muscles, which form a strong hood that envelops the
intersection of the arm bone and shoulder blade. Falling on an
outstretched arm may result in a dislocated shoulder, so we need to have
some care in this regard.
If you’re a young athlete and have suffered a rotator cuff tear, surgery may be an appropriate option.1
But for the vast majority of people, especially for those over age 40,
most rotator cuff injuries are chronic rather than acute and can be
treated with rest and rehabilitative exercise. Again, if you’re a
60-year-old skier who has torn his or her rotator cuff in a downhill
accident, surgery could be indicated. For the rest of us, rehabilitative
exercise is the key.2,3
Four or five primary strength training exercises are
involved in shoulder or rotator cuff rehabilitation. The three basic
shoulder exercises are (1) seated overhead press, which trains all the
shoulder girdle muscles simultaneously; (2) standing side [lateral]
raise; and (3) seated or standing bent-over raise. The lateral raise
specifically trains the middle deltoid muscle and the bent-over raise
specifically trains the posterior deltoid muscle. Specific rotator cuff
strength training exercises include internal rotation and external
rotation on a flat bench using very light dumbbells. More painful
injuries with greater loss of mobility may require (1) Codman pendulum
exercises and (2) finger-walking (up a wall) to the front and to the
side.
The goals of rotator cuff rehabilitation, as for any
mechanical injury, include decreased inflammation, decreased pain,
return to more full active range of motion, return to more full muscular
strength, and restoration of function.
1 Plate JF, et al: Rotator cuff injuries in professional and recreational athletes. J Surg Orthop Adv 22(2):134-142, 2013
2 Escalmilla RF, et al: Optimal management of shoulder impingement syndrome. Open Access J Sports Med 5:13-24, 2014
3 McMahon PJ, et al: What Is the Prevalence of
Senior-athlete Rotator Cuff Injuries and Are They Associated With Pain
and Dysfunction? Clin Orthop Relat Res 2014 Mar 12. [Epub ahead of print]
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