Rotator Cuff Strain-- What can your Chiropractor do?
What is it?
The shoulder is a ball-and-socket joint that has great mobility however, has poor structural stability. The rotator cuff is composed of 4 muscles: supraspinatus, infraspinatus, teres minor, and subscapularis. The primary function of the rotator cuff is to stabilize the shoulder whereas the larger muscles move the shoulder. The rotator cuff muscles compress the humeral head into the shoulder joint.
Rotator cuff injuries are the most common problems affecting the shoulder. Injuries range from a mild strain of a piece of the tendon to complete rupture of all the tendon. Strains of the rotator cuff can happen abruptly from trauma like falling, pushing, pulling, throwing, or lifting. Other factors that could contribute to rotator cuff pathology include repetitive injury and age-related erosion in the joint.
Some predisposing factors include obesity, hypercholesterolemia, genetics, diabetes, or a history of corticosteroid injections. Impingement and hypovascularity (having a large number of blood vessels) may produce recurring damage and impair the cuff’s ability to recover.
Repetitive overhead activity predisposes you to a rotator cuff type injury. Jobs such as carpentry, painting, cleaning windows, and washing cars can also cause rotator cuff issues.
Those with scapular dyskinesis (an issue with the movement of the shoulder blade) or upper cross syndrome are highly susceptible to rotator cuff damage.
Patients usually feel “snapping” or “tearing” accompanied by severe pain and weakness, mostly when abducting (movement of shoulder away from the body) the shoulder. Patients often report gradual onset of pain and weakness within the shoulder followed by crepitus (popping, grinding, or crunching when moving the joint). Pain is most commonly localized to the anterolateral (front of body and away from the midline of body) aspect of the shoulder but can radiate down the arm.
Symptoms traditionally are provoked by overhead activity and may progress to the point of not being able to raise their arm over their head.
Pain arises at night, especially when lying on the affected shoulder. This causes patients to report troubles with sleeping. The shoulder will demonstrate a lack in range of motion with passive (someone helping you with the movement) internal rotation and active elevation and abduction.
If patients are over the age of 60, have supraspinatus weakness (abduction weakness), and weakness in resisted external rotation are positive signs for rotator cuff pathology.
Mechanical defects can start to occur, especially with overhand athletes, which cau