Managing Rotator Cuff Tears with Chiropractic
What you need to know
FAQ about the Rotator Cuff
How Chiropractic Can Help
01
What tests do Chiropractors do for Rotator Cuff Syndrome
Supraspinatus
Jobes Test
Drop Arm Test
Infraspinatus
Strength testing
External rotatoion lag sign
Teres Minor
Strength testing
Hornblowers sign
Subscapularis
IR lag sign
Passive ER ROM
Lift off test
Belly press
03
How effective is Chiropractic Care for Rotator Cuff
Patients who start with Chiropractic , improvement occurs between 6 to 12 weeks
Patients with tears but have no symptoms, Chiropractic is an appropriate choice - Emphasis on addressing core and scapular muscle strengthening
Often Chiropractors will offer the following
Rehab for inhibited muscles
Shockwave Therapy
Scapular and spinal Adjustments
Cupping and Dry Needling
02
Other conditions that might co exist with rotator cuff tears are :
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SLAP or other labral tears
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Subacromial impingement from bursitis, os acromiale, bone spurs
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Acromioclavicular osteoarthritis
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Biceps tendinitis
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Calcific tendinitis
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Cervical radiculopathy
04
What Scans Do I Need?
Xray- To see if the humerus has moved superior , and to see if there are any spurs at the acromium
Ultrasound - Usually less expensive and great for evaluating the rotator cuff
MRI - The Best option to determine tear size, location, muscle atrophy and chronic changes in the tendon
What is the Rotator Cuff
What you need to know
The shoulder joint classifies as a ball and socket joint; however, the joint sacrifices stability for mobility. The glenoid is a shallow rim, and one description is as looking like a golf ball on a tee or a basketball on a dinner plate The rotator cuff consists of four muscles originating on the scapula and inserting on the superior humeral head to improve stability The muscles are Subscapularis - the internal rotator Supraspinatus- abductor for the 1st 30 degrees Infraspinatus - external rotator Teres Minor - external rotator And all 4 act as stabilisers of the shoulder joint
What Causes Rotator Cuff Problems
How does rotator cuff damage occur? Most common reasons are increase in age Smocking Family history Poor posture (tears were present in 2 in 3 patients with kyphotic lordotic postures , over half had flat backs and sway postures. Do you have ideal posture, good news, only 2.9% of patients with tears had ideal alignment Overhead sports - overhead work conditions Other conditions that might co exist with rotator cuff tears are : SLAP or other labral tears Subacromial impingement from bursitis, os acromiale, bone spurs Acromioclavicular osteoarthritis Biceps tendinitis Calcific tendinitis Cervical radiculopathy Causes of Rotator Cuff Syndrome : Rounded tenocytes (apoptosis) Extracellular matrix disorganization and myxoid degeneration Vascular changes (focal hypervascularity; focal hypovascular regions as well) Reduced total cellularity Calcified depositions Collagen fiber thinning Degenerative acromion
What are the signs and symptoms of Rotator Cuff Problems
How does rotator cuff damage occur? Most common reasons are increase in age Smocking Family history Poor posture (tears were present in 2 in 3 patients with kyphotic lordotic postures , over half had flat backs and sway postures. Do you have ideal posture, good news, only 2.9% of patients with tears had ideal alignment Overhead sports - overhead work conditions What are the signs and symptoms Pain from a traumatic event Can be pain that gradually gets worse Sports that have overhead activities like baseball where a pitcher for example starts throwing more sidearm instead of overhead motion is a sign the rotator cuff may be damaged Pain lifting or carrying objects Pain radiating to the deltoid muscle Pain when lying on side of tear when sleeping
Surgery Vs Chiropractic Care
Surgery Vs Chiropractic Care- Which one should you choose? Patients under 40 with complete tear with symptoms- surgery then rehabilitation Surgical treatment tends to be most effective in patients that have failed or reported persistent or worsening symptoms despite at least 4 to 6 months of exhaustive nonoperative treatment modalities nitially, patients are instructed to avoid heavy lifting and exercises to facilitate soft tissue healing. Cryotherapy devices are often applied for the first 10 to 14 days postoperatively. Physical therapy is often started postoperatively once the sling is discontinued. Following surgery patients are kept in a sling for 1 to 2 weeks with early passive ROM rehabilitation parameters. Full active ROM should be achieved by 3 to 6 weeks maximum. If applicable, return to sport-specific skills at 6 to 8 weeks as tolerated. Patients who start with Chiropractic , improvement occurs between 6 to 12 weeks Patients with tears but have no symptoms, Chiropractic is an appropriate choice - Emphasis on addressing core and scapular muscle strengthening
