Franklin Chiropractor | Shoulder Impingement

Shoulder Impingement The “Rotator Cuff” describes a group of four muscles that hold your shoulder in its socket while your larger muscles move your arm. Your rotator cuff tendon lives in an area of your shoulder called the “subacromial space”. Sometimes this space can become crowded by: abnormally shaped bones, arthritis, spurs or even lazy muscles that fail to keep the bones separated properly. This overcrowding may create a painful pinching of the rotator cuff tendon and or bursa when you raise your arm. This condition is called “Shoulder Anterior Impingement Syndrome”, or simply “Impingement”. Long-standing impingement leads to rotator cuff tears in much the same way that a rope is damaged by repeatedly being struck by a dull stone. Impingement is the most common shoulder disorder and accounts for about half of all shoulder complaints seen by physicians. Those who perform repetitive overhead activity are at greater risk for impingement. This includes athletes who participate in: swimming, baseball, volleyball, weightlifting and tennis as well as jobs like: carpenters, electricians, painters and wall paper hangers. Impingement often starts after a period of overuse. Initially, your symptoms may be limited to a sharp pain during overhead activity or while reaching behind the back to fasten a bra or close a zipper. As your condition progresses, you may develop a constant ache that is present even at rest. Nighttime pain is common, often disrupting sleep. Impingement is a disorder that, if left untreated, will progress through 3 stages and eventually lead to rotator cuff tearing and surgery. Your successful treatment will focus on restoring your range of motion while avoiding aggravating movements i.e. reaching overhead and behind your back. If you work out at the gym, you should especially avoid overhead presses, lateral raises and push-ups. Avoid sleeping on the “bad” shoulder, especially if this causes pain. You may benefit from sleeping on your “good” side and placing a pillow between your side and “bad” arm. Therapy modalities like ultrasound, and ice may be used initially to relieve your pain. NSAIDS like ibuprofen are often helpful. Your Franklin chiropractor will use some specialized soft tissue manipulation and stretching to help loosen tight muscles and tendons. Specific strengthening exercises will be prescribed to help restore normal and pain- free function of your shoulder. Our Treatment Here is a brief description of the treatments the Franklin chiropractor may use to help manage your problem. Joint Manipulation-Your Franklin chiropractor has found joints in your body that are not moving freely. This can cause tightness and discomfort and can accelerate unwanted degeneration i.e. arthritis. Your Franklin chiropractor will apply a gentle force with their hands,
or with hand held instruments, in order to restore motion to any “restricted” joints. Sometimes a specialized table will be used to assist with these safe and effective “adjustments”. Joint manipulation improves flexibility, relieves pain and helps maintain healthy joints. Therapy Modalities-The Franklin chiropractor may apply electrotherapy modalities that produce light electrical pulses transmitted through electrodes placed over your specific sites of concern. These comfortable modalities work to decrease your pain, limit inflammation and ease muscle spasm. Hot or cold packs are often used in conjunction, to enhance the effect of these modalities. Another available option is therapeutic ultrasound. Ultrasound pushes sound vibrations into tissues. When these vibrations reach your deep tissues, heat develops and unwanted waste products are dispersed. Myofascial Release -Overworked muscles often become tight and develop knots or“trigger points”. Chronic tightness produces inflammation and swelling that ultimately leads to the formation of “adhesions” between tissues. Your Franklin chiropractor will apply pressure with their hands, or with specialized tools, in order to release muscle tightness and soft-tissue adhesions. This will help to improve your circulation, relieve pain and restore flexibility. Therapeutic Exercise -Muscle tightness or weakness causes discomfort and alters normal joint function, leading to additional problems. Your chiropractor will target tight or weak muscles with specific therapeutic stretching and strengthening to help increase tissue flexibility, build strength, and ease pain. Healthy, strong, and flexible muscles may help prevent re-injury. Some Things That You Can Do To Help Yourself Sleep Posture – Your mattress and the position you sleep in may affect your condition. Choose a mattress that provides medium or firm support, such as a traditional coil spring or adjustable airbed. Avoid waterbeds, thick pillow tops and soft, sagging mattresses.Always sleep on your back with a pillow either underneath your knees or on your side with a pillow between your knees. Avoid sleeping on your stomach. Keep your neck and back covered while sleeping to avoid drafts that could cause potential muscle spasms.Home Ice -Application of ice will help reduce inflammation by constricting swollen blood vessels. Ice may also help reduce muscle spasm and numb irritated nerves. Apply for 10-15 minutes. Break for 30 minutes. Reapply. (Alternatives to the ice pack include Ziploc bags filled with ice, or a bag of frozen vegetables.) Repeat several times a day as needed. Place a thin towel between your skin and the ice pack for comfort and safety. Use ice-massage for smaller areas. Begin by freezing a small paper cup of water. When frozen, tear off the bottom inch of the cup to expose the ice. Massage the indicated area for 5-10 minutes in a slow figure-eight pattern. Do not hold the ice in one position. Sports Cream -Sports creams come in a variety of styles that produce either a sensation of heat or cold. These creams do not speed healing, but may provide temporary relief. Their effect is to pleasantly irritate the skin by stimulating the highly sensitive surface nerves, so that your brain can temporarily “forget” about your underlying deeper pain. Sports creams have no known side-effects when applied in small amounts but do not apply
more than a 2-3 of times per day unless otherwise directed. Sleep Habits -Researchers recommend sleeping for 7-9 hours per night. Even small deficits can pose problems like decreased athleticism, diminished brain function, increased inflammation and a greater likelihood to get sick- sleeping only 6 hours per night makes you four times more likely to catch a cold when compared to sleeping 7 or more hours. Follow these additional tips for better sleep: Limit screen time before retiring- the blue light emitted from computer monitors, phones and TV’s can limit melatonin production and adversely affect sleep. Try reading from a book or magazine instead. Ideally, eat your last meal 3-4 hours before bedtime and especially limit heavy, spicy or high-fat foods. Ration how much you drink before bedtime to minimize bathroom breaks. Particularly limit caffeine in the afternoon and evening- caffeine has a half-life of 6-9 hours and can keep you awake long after the last sip. Stick to a sleep schedule, trying to retire and arise at the same time each day, including weekends. Sleep on a comfortable mattress and pillow. Choose 100% cotton sleep clothes and sheets over synthetic materials (i.e. polyester). Some research has suggested that your “deep” REM sleep improves when your mattress is oriented so that your body is aligned North and South as opposed to East and West. Most people sleep best in a cool room; ideally between 60-67 degrees F.