Franklin Chiropractor | Shoulder Impingement’s
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. Your Home ExercisesPatients often ask “What caused my problem and how do I keep it from returning?” Sometimes the origin of a condition may be easily identified as an accident or injury. More often, the exact cause is more difficult to pinpoint because the problem was generated by a series of seemingly harmless events and circumstances (i.e. your posture, increased activity, mild repetitive strains, etc). Most conditions are started by a “recipe” of irritants rather than any single “ingredient”. Muscle, bone, joint and nerve problems begin when life’s physical demands exceed your bodies tolerance for those challenges. So the answer to the second half of the “…and how do I keep it from returning” question is answered by increasing your flexibility and strength, so you can increas e your “threshold” for future injury. When your injury threshold is greater than life’s demands-you win and stay healthy! Phase I1.YTWL Scapular Depression -Stand with your straight arms raised above your head in a “Y” position. Squeeze your shoulder blades together and downward throughout the following sequence of movements. Lower your straightened arms to shoulder level, into a “T” position. Next bend your elbows so that your fingers are pointing straight up while slightly lowering your elbows to make a “W”. Finally, while keeping your elbows bent 90 degrees, lower your arms to your sides so that your elbows are touching your ribs to form an “L” on each side and squeeze. Hold each position for 1-2 seconds and repeat 3 sets of 10 repetitions, twice per day or as directed. 2.Corner Pectoral Stretch -Begin standing, facing a corner with your palms on the walls above head level. Step toward the corner and “lean in” to stretch your chest muscles. Against the resistance of the wall, attempt to push your hands into the wall and toward each other for 7 seconds. Relax and “lean in” to increase the stretch. Lock into this new position and repeat 3 contract/ relax cycles, twice per day or as directed.
3.Glenohumeral Internal Rotation -Begin sitting or standing with good posture. Place the affected arm behind your back and reach towards your opposite hip. Using the unaffected arm, gently pull the wrist of your affected arm further toward your opposite hip. A stretch should be felt in the affected shoulder. Pull gently to the point of tightness ten times. Each pull should be slow and stopped if you feel a sharp pain. This stretch should be performed for ten repetitions, once per hour or as directed. 4.Codman Pendulum – Lean over a table using the uninvolved arm for support as shown. If directed, you may hold a light weight in your hand to increase traction. Allow the involved arm to hang freely. Use your torso to swing your involved arm in a clock-wise circle for 50 repetitions. Repeat in a counter-clockwise circle for 50 repetitions. Perform 50 repetitions in each direction twice per day or as directed. 1.Low Row – Attach the center of an elastic exercise band to a doorknob or other sturdy object in front of you. Grasp one end of the band in each hand and with straight arms at your side, stretch the band backwards. Keep your palms facing backward and arms pointed straight down throughout the exercise. Return to neutral and repeat 3 sets of 10 repetitions daily, or as directed. 2.Brugger with Band -Begin sitting or standing with an elastic exercise band wrapped and secured around your palms. Begin with your arms at your side, elbows bent, forearm’s pointing forward. Move your hands apart from each other to maximally stretch the band while simultaneously rotating your palms out, straightening your arms, and pinching your shoulder blades together as your hands move behind your hips. Return to the start position and repeat 3 sets of 10 repetitions daily, or as directed