Rotator Cuff Syndrome Sioux City
Rotator cuff syndrome is also known as supraspinatus tendinitis. There are four main muscles of the rotator cuff that form the joint capsule. The supraspinatus muscle lies on top; it runs from the top of the scapula and inserts on the top of the humerus. The muscle travels underneath the scapula as it attaches to the humerus. This attachment site is the most common point of pain on the top and side of the shoulder.
When the shoulder muscles become overworked, they start to tighten up, especially the deltoid muscle. Deltoid muscle spasms cause the humerus to become elevated towards the head. The slight change in position increases the likelihood of the supraspinatus tendon rubbing against the scapula. Raising the arms above the head and reaching forward increases this “pinching” effect, which is why it hurts with these motions. People tend to describe a sharp stabbing pain when reaching up into a cabinet. Severe injuries can cause pain to radiate down the arm toward the elbow.
Supraspinatus tendinosis, or rotator cuff syndrome, is a very common shoulder injury that we treat in the office. The first goal of treatment is to decrease pain and inflammation. The second goal is to decrease muscle spasms and dysfunction of all the muscles that control shoulder movements. A contributing factor to rotator cuff syndrome is a slouching-head and shoulder-forward posture. This position increases the likelihood of “rubbing” and developing supraspinatus tendinitis.
If the scapula cannot stabilize itself, then the humerus excessively shifts with movement, which increases the likelihood of developing shoulder tendinitis. The third phase of treatment focuses on correcting this weakness by establishing proper muscle mechanics in the neck, upper back, scapula, and arm muscles. Exercises begin as basic range-of-motion, flexibility, and strengthening exercises. With improvement, the exercises shift to shoulder stabilization, which is teaching the shoulder muscles how to work with proper muscle patterns.
An example of this would be performing push-ups on an exercise ball. Push-ups on the ground are difficult because of the strength required. Performing push-ups on an exercise ball is significantly harder. It requires multiple muscles to work together to maintain balance of the torso and shoulders. People are often amazed by how much harder this is than normal push-ups on the ground and often perform only a few repetitions before stopping.
Performing push-ups on the ball very quickly overworks and fatigues the shoulder stabilizers.Therapeutic exercises that focus on the stabilizers’ strength and endurance result in long-term recovery and reduce the risk of reaggravation. There are a variety of stabilization exercises that involve exercise balls, BOSU, rubber bands, and vibration platforms.
Massage therapy is incorporated into treatments to address muscle spasms, tenderness, and trigger points of the chest, neck, back, and shoulder muscles. People are often surprised by how many trigger points they have in the muscles along the scapular border. These trigger points disrupt normal muscle control and scapula movements, which produces extra strain on the supraspinatus, infraspinatus, teres, and subscapularis muscles. Proper scapula motion is very important to shoulder recovery and decreasing future injuries. Many people develop chronic bicep tendinitis or rotator cuff injuries because all of the muscle mechanics were not properly addressed in therapy
The Graston Technique accelerates healing and is utilized to decrease scar tissue, muscle spasms, and adhesions of the rotator cuff and supporting shoulder muscles. It is an excellent tool for addressing tendinitis, as it helps increase blood flow and tissue repair at the tendon insertion. The Graston Technique is especially important for people with chronic shoulder injuries who have developed scar tissue.
Cold laser therapy further speeds recovery by increasing blood flow to the injured shoulder, decreasing scar tissue formation, and speeding repair.
There are more goals in supraspinatus tendinosis treatment than just getting rid of the pain. Rotator cuff syndrome can be properly treated in the office by combining multiple therapies and activities to re-establish proper mechanics of the shoulder. Failing to establish muscle patterns and mechanics increases the likelihood of future rotator cuff tendinitis injuries and pain. It is worth putting the extra effort into your therapy in order to prevent your shoulder pain from returning.