Repetitive stress and injuries can affect the rotator cuff in the shoulder. This can lead to severe pain and long-term range-of-motion problems. Before considering surgery, a patient may choose to explore the option of chiropractic care for this problem. The muscles and tendons that stabilize the shoulder are the rotator cuff. If the tendons tear, it will cause the patient to have pain and restriction in their arm movements. Typically, rotator cuffs are injured through repetitive motions—most likely “overhead motions or forceful pulling motions”. The types of athletes commonly affected are baseball or softball pitchers, quarterbacks in football, weight lifters, cheerleaders, shot put throwers, swimmers, kayakers, martial artists, tennis players, and bowlers. Those in the field of music could also be affected (i.e., conductors, drummers).1 Even sedentary computer work can cause problems due to keeping the arm in the same position. Household chores, such as carpentry or painting, where the arm is kept over the head, might also lead to rotator cuff tears. Finally, poor posture and aging tendons can lead to rotator cuff tendinitis. The amount of rehabilitation necessary depends on whether or not the patient has tendinitis, partial tears, or complete tears.2
Doctors may recommend ibuprofen, naproxen, or steroid injections to ease the pain and swelling.3 Conservative treatments for rotator cuff injuries are similar to those used in other types of strains: RICE. The acronym RICE stands for Rest, Icing, Compression, and Elevation. RICE aims to reduce swelling and inflammation and to limit additional injury. Doctors may even recommend various exercises to strengthen and rehabilitate the shoulder. The patient’s sleeping positions will also need to be adjusted to compensate for healing the injury. There could, however, be bone injuries underlying the rotator cuff strain. Some patients remain in a state of pain despite pursuing conservative care. Doctors might then recommend surgery, especially if the rotator cuff is completely torn. Surgery will then reattach the bone and tendon.4 Arthroscopic surgery can be used to “remove inflamed tissue and part of the bone”.5
Chiropractic Approach for Rotator Cuff Injuries
Chiropractors will tend towards treatments that help patients with mobility and stability. There can be scar tissue from the injury, leading to further irritation of the nerves and continued joint pain. Chiropractic adjustments can assist with the “joint mechanics”, and some chiropractors may employ “Active Release muscle therapy” to restore flexibility and strength. The latter refers to a doctor using “precisely applied tension in combination with specific patient movements”. Surgery might increase scar tissue, and it rarely addresses the cause of the nerve irritation. The physical therapy approach of hot and cold packs (which can be done at home) and ultrasound may offer little long-term results.6 Typical chiropractic treatments involve spinal manipulation, massage, traction, stretching, and strengthening exercises.7 Chiropractic aims to resolve the underlying problems so that patients do not have to take medications, have surgeries, or perform certain exercises for the rest of their lives.
In addition to treatment from a chiropractor, patients might also choose to look to a massage therapist for an extra, complementary treatment option. Massage treats impingement as one cause of injury in the rotator cuff. Massage reduces inflammation, scar tissue buildup, and pain. Effleurage, friction, static pressure, and stretching are all massage strokes used in treatment. Massage might also help the patient recover from muscle strains and tendinitis that cause rotator cuff injury.8 Deep tissue massage is helpful when the cause of the injury to the rotator cuff is a soft tissue injury. Deep tissue massage provides stimulation to the local area and encourages the body’s production of anti-stress hormones to decrease pain and discomfort. Superficial massage is what increases blood flow and prevents the formation of scar tissue. This type of massage also promotes healing and reestablishes normal functioning of the rotator cuff. Superficial massage, which might also be done in addition to ice therapy, is a great way of restoring joint functionality. Friction massage uses slowly increasing intensity, at a bearable level, to really reach and stretch the pained region. Strokes are slow and long, with pressure only increasing to a point that the patient can handle and no further. This particular treatment only lasts less than 10 minutes, and it may be performed up to three times a day. The patient may also perform massage on themselves at home, in between visits to the professional. Patients can lie on their back and, using a small tennis ball, apply pressure to a specific point to massage the affected area and relieve shoulder pain. Lateral and forward stretching along with the back massage is done to improve blood circulation. Coconut oil and aroma therapy oils might also facilitate relief and flexibility in the joint. Essential oils have a calming affect on many patients that help them to relax, even when they did not know that they were so tense in the first place. Massage therapists use the same oils when treating their patients, so it is fine to use these oils at home.9