Shoulder Injuries and How to Rehabilitate Them

Many rotator cuff and general shoulder injuries can be treated with chiropractic and massage therapy, as an alternative to medications and surgery.

Types of Shoulder Injuries

The shoulder is made up of muscles, tendons, and joints. The bones of this body part include the clavicle, scapula, and humerus. The tissues that help keep the arm centered in the shoulder are referred to as the rotator cuff. Shoulder pain can have many causes, and it can be temporary or chronic. The general categories of shoulder pain are instability, arthritis, fracture, or inflammation of the tendon (i.e., tendinitis, bursitis). Rarely, nerve problems, infection, and tumors are involved. Bursitis refers to when the fluid-filled sacs of the joints (bursae), which cushion between the bones and soft tissues, are inflamed. Typically, this is due to excessive shoulder use. In tendinitis, the tendon is overused and worn down. This can happen from an acute injury, such as overhead activities, ball throwing, or other sports. Tendinitis may also be chronic, with repetitive stress or degenerative diseases (i.e., arthritis) as thecauses. Sometimes, tendons can get torn, due to age, overuse, injury, or degeneration. Rotator cuff injuries are a common type of tendon tear. Impingement refers to when the shoulder blade puts pressure on soft tissues “when the arm is lifted away from the body”. This can rub on the bursa and rotator cuff tendons, leading to a future tear. Some people may experience the arm bone being “forced out of the shoulder socket” from overuse or an injury; this is shoulder instability. The dislocation can be partial or complete, leading the shoulder to repeat this type of injury in the future, and potential arthritis. Osteoarthritis is the “wear and tear” type of arthritis. Because of the pain, sometimes patients will choose to avoid moving the shoulder, but this could lead to tightness and stiffness and a restricted range of motion. Fractures are breaks in the bone, and they can cause shoulder pain as well.¹

Exercises and Stretches

There are many exercises and stretches that can be done to strengthen a healthy shoulder. There are also activities that can assist with rehabilitation of a problem of this body part. First, patients should practice PRICE: protection (i.e., a sling), rest, ice, compression, and elevation. When it is time to rehabilitate the area, it is important to consider both flexibility and strength. Flexibility concerns range-of-motion (ROM), dynamic stretching, and static stretching. Strengthening involves exercises, dumbbells, and tubing. Some of the stretches and exercises are done lying down, while others are done while standing or sitting. Some involve using just the patient’s body weight, while others utilize various exercise equipment, such as weights, balls, tables, towels, sticks, or bands.²

Chiropractic and Massage Care

Chiropractors are trained in musculoskeletal therapy and rehabilitation. First, they will see what the cause of the shoulder pain is. The patient may have shoulder pain from bursitis, tendonitis, arthritis, or a tear, as mentioned before. They may also have frozen shoulder, biceps tendon rupture, calcific tendonitis, a labral tear or Superior Labrum Anterior and Posterior (SLAP) lesion, or some other instability, dislocation, or separation. Once the cause is known, the chiropractor can prescribe exercises and stretches, and they can perform gentle adjustments and techniques to realign the vertebrae in the neck. The goals are to relieve stiffness and pain and improve mobility. Additional therapy may involve heat, ice, traction, or even massage. Many chiropractors employ massage therapists.³