Neck Shoulder & Back Pain Cervicalgia. Cervicogenic Headaches. Symptoms of Cervical Disc Injuries. Call 024 7622 2002. Reg’d with BUPA. AXA PPP. HSA. AVIVA. CIGNA. Simplyhealth. Standard life. Pru health. Mercia health.Medicash Medisure. All health insurance accepted. 

Neck and shoulder pain, including back pain, are very common medical conditions, and ones seen many times by Chiropractors and Physiotherapists. Neck pain can be caused by many different disorders and diseases which affect the tissues in the neck, such as degenerative disc disease, neck strain, “whiplash”(WAD), herniated disc, or pinched or trapped nerve/nerves. Neck pain is also referred to as cervical pain.  

Symptoms

Neck pain is associated with a dull ache or aching around the afflicted area and will become worse with neck movement.  Other symptoms associated with neck pain include numbness, tingling, tenderness, sharp and shooting pains, headaches, difficulty swallowing, pulsations, dizziness or light headedness. It is also possible for the neck glands to swell.

Treatments for Neck Shoulder and Back Pain

Neck pain treatment options include rest, ice applications, physical therapy chiropractic manipulation, local injections of cortisone or anaesthetics, muscle relaxants, analgesics and surgical procedures. Cold/Low Level Laser Therapy is also a possible form of treatment.

Neck, shoulder and back pain are usually common after injuries to the neck Shoulder or back. The pain may come on gradually or it may be acute and come on suddenly. Bad posture is a common cause in the onset of this pain but it is not the only cause. Chiropractors and Physiotherapists understand the various causes of neck shoulder and back pain and can offer advice.

Cervicalgia

The neck muscles are constantly placed under tension, although this tension helps to keep the head in position i.e. upright. However, the muscles in the neck are more prone to becoming stiff and painful as a result of this tension and can be a result of violent movement or sudden impact (sometimes known as “whiplash” (WAD).
Cervicalgia is a localised pain that does not radiate through into other areas of the neck. Symptoms include:

• sharp pain in the neck
• neck ache
• pain resulting from head movement
• pain radiating to the shoulders, arms and fingers

 

Pain also may radiate pain into other areas; this is usually caused by a trapped nerve or nerves. Nerves can become compressed by tight muscles, disc damage or the formation of bony deposits. Radiating pain in the neck which affects the shoulders and arms may also affect the fingers.

Neck dysfunction can result in dizziness, nausea or headaches but it can be successfully treated by Cold Laser Therapy, one of the treatments offered by Central Chiropractic and Physiotherapy Clinic.

Cervical Disc Injuries

Most cervical disc injuries are caused by hyperextension, which results in compression of the neck area. 

Symptoms of Cervical Disc Injuries

The pain, loss of sensation or tingling/pins and needles to the arms and weakness are the main symptoms and signs of cervical disc injury. The pain is most noticeable symptom and it is usually the only one. Cervical disc injury can complicated by compression of either a cervical nerve root or by a compression of the spinal cord, but this reported injury is very infrequent.  When compression of the nervous tissue occurs, patients may report different sensations other than pain. Weakness to the legs/leg this is called spinal cord compression. If the arms/arm are affected this is called nerve root compression

Pain can be felt in the neck shoulder or arm. 

Pain is always in the area of the neck and upper back and between the shoulder blades. This is due to inflammation of the disc and the cervical vertebra joints. Sever inflammation can flare up after a minor added injury or for other unknown reasons. Neck shoulder and back pain are due to the disc bulges that herniate and stretch the posterior longitudinal ligament.  

Rarely, the pain will be felt down the arm.  This pain can be lightning, caused or aggravated by movements of the neck, or can be dull and persistent. Pre-existing neck pain is also present in many individuals. After the arm pain starts, some people report feeling less pain in their neck. When arm pain is present, it is usually because of a combination of disc herniation and bony spurs compressing a nerve root. A free disc fragment can also intrude on a cervical root and cause quite a bit of pain in shoulder or down the arm.

 Sensory symptoms other then pain.

When pain is felt in only one arm, it is usually due to compression of a cervical root and felt in the territory of the cervical root. The C4 root mainly supplies the shoulder with nerves, while the C5 root supplies primarily the arm. The C6 root supplies nerves to the radial side of the forearm, the C7 root addresses the arm and forearm, and the C8 and the T1 root handle mostly the hand. Broadly speaking, two types of sensory symptoms are felt: loss of sensation and new sensations. A loss of sensation is simply numbness. New sensations include tingling (pins and needles), heat, or cold sensations.

If the spinal cord is compressed, most patients will report losing sensation in their hand and in the lower part of their body.

Sometimes patients have difficulty feeling the floor when they walk and cannot feel that their bladder is full, this is an emergency and patients should be brought to the hospital right away.

Motor symptoms and signs.

Weakness of one arm (the other one being normal) only signals a compression of a nerve root. A compression of C4 results in a weak shoulder; C5 indicates a weak bicep muscle; C6 represents a weak wrist, thumb, and index finger; C7 is a weak triceps, extension of the fingers, and pectoralis muscles; C8 designates weak flexion of the fingers; and T1 corresponds to a weak hand.

When to seek emergency  treatment.

If the spinal cord is compressed, patients report having difficulty walking and weak legs and hands these can be the only symptoms and should be treated as an emergency.

Although neck pain can be caused by injury, such as ‘whiplash’ injuries, it is often caused by the cumulative effect of improper sitting posture, reading in bed, poor work habits, stomach sleeping, lack of proper exercise and other lifestyle-related factors. All of these factors cause misalignments in the spine and eventually pain. In fact, the most important factor producing neck pain appears to be spinal misalignments. Even for people who complain that “stress” is causing their pain, the great majority of those have significant spinal misalignments that are contributing to their condition.

Uncorrected chronic spinal misalignments can eventually cause neck shoulder and back pain. As a spinal misalignment worsens, pressure can be put on delicate nerves, sending the surrounding neck muscles go into painful and movement-limiting spasm, headache, even numbness, tingling or weakness in the arms or hands

Cervicogenic headaches  

Cervicogenic headaches are defined as headaches originating from the neck. The location is typically at the back of the head, sides and top of the head as well as around the forehead and eyes affecting one or more of the above regions at once. These headaches can be located on one or both sides of the head. Cervicogenic headaches are usually associated with dysfunction of the upper neck which can present itself as neck pain or local tenderness, reduced neck range of motion and exacerbation of the headaches by neck movement. The past history of neck trauma is typical for this type of headaches.

The cervicogenic headaches are caused by irritation of nerve endings of injured joints, ligaments, muscles and discs of the neck. The nerve endings in the injured areas send pain signals up the upper nerves of the neck to the brain causing “cross wiring” with the fibres of the trigeminal nerve (one of the nerves in the head) which is responsible for perception of the head pain thus causing the headaches.

Neck pain as well as “whiplash” injuries (WAD) and both conditions can result in headaches and all three are commonly treated by Chiropractors and Physiotherapists
the treatment is focused on the small joints in the back of the neck called facet joints that are responsible for neck pain. When these joints dysfunction but injury to the muscles he nerve fibres that innervate / act as sensors for these facet joints also serve to act as sensors to parts of the head. With facet joints dysfunction these sensors become active, the brain cannot clearly differentiate between the facet joints and the mapping of the head and create the sensation of pain in a broader area- Headache.

Whiplash Associated Disorder (WAD) commonly known as “whiplash” (WAD).

Form the Journal of Orthopaedic Medicine 1999;   21 (1):   22–25 university Department of Orthopaedic Surgery. Bristol. UK

Conclusion: ”Whiplash” (WAD) and neck injuries are common. Chiropractic is the only proven effective treatment in chronic cases. Our study enables patients to be classified at initial assessment in order to target those patients who will benefit from such treatment.

Khan S, Cook J, Gargan M, Bannister G 

Objective:   To determine which patients with chronic “whiplash”(WAD) will benefit from chiropractic treatment.

Design:   Retrospective review by structured telephone interviews of 93 consecutive patients seen in chiropractic clinic.

Setting:   Independent chiropractic clinic in a large city.

Subjects:   93 patients, 68 female.

Main outcome measure:   Gargan and Bannister grading pre and post treatment.

Results:   Three groups of patients were recognised. Group 1 consisted of patients with isolated neck pain associated with a restricted range of neck movement. Group 2 consisted of patients with neurological symptoms or signs associated with a restricted range of movement. Group 3 comprised patients who described severe neck pain but all of whom had a full range of neck movement. Patients in this group often described an unusual group of symptoms, with a bizarre, non-dermatomal pain distribution. There was a significant difference in outcome between the three groups (p<0.001) with only groups 1 and 2 improving following chiropractic manipulation.

Conclusion:   “Whiplash”(WAD) and neck injuries are common. Chiropractic is the only proven effective treatment in chronic cases. Our study enables patients to be classified at initial assessment in order to target those patients who will benefit from such treatment.

Neck Anatomy

The head  weight of 12 lbs  not only does the neck fully support all that weight, it enables the  head to turn or move up or down No other part of the spine has the ability to move so much: in forward motion, and in backward motion, this also includes the  side-to-side motion, and from  shoulder to shoulder. 

The neck is called the cervical spine, and it begins at the base of your skull. It contains 7 small bones (vertebrae), which doctors label C1 to C7 (the ‘C’ means cervical). The numbers 1 to 7 indicate the level of the vertebrae. C1 is nearest to the skull, while C7 is nearest to the chest.

In between each vertebra are tough fibrous shock-absorbing discs called the intervertebral discs? Each disc is made up of a gel-like outer band (annulus fibrosus) and a gel-like inner substance (nucleus pulposus).

Besides the bones and the discs, the neck consists of joints, muscles, and ligaments these stabilize and give the neck its full range of movement.

The neck is the upper part of the spinal cord, and consists of nerve roots, and an elaborate system of arteries and veins. The nerves in the neck help the brain communicate with the shoulders, arms, and chest. The arteries and veins circulate blood to both the brain and the heart.

For Further in depth information on Neck Shoulder Pain including Back Pain or Headaches, please go to top left corner listed under “Pain” or “Conditions “and for Cold/Low Level Laser Therapy, please go to top left corner under “Treatments”

The collarbone

The collarbone is a part of the shoulder. Its function is to connect the arm to the body. The collarbone sits directly above several important nerves and blood vessels. These vital soft tissues are rarely injured when the collarbone breaks. The collarbone is a long bone, and most breaks occur in the middle of the bone. 

Cause. 

A broken collarbone, or the medical term a fractured clavicle is a common injury. Many babies are born with a broken collarbone this is due to child birth, also to people in contacted sports such as rugby or just  general accidents where a fall results in a  severe blow or  a heavy fall to the shoulder .    

The collarbone doesn’t   harden until a person is about 21 years old; a child’s collarbone can easily be broken from a direct blow or fall.  

Symptoms include. 

A hump or “bump” over the fracture area  

Shoulder hanging down and forward   

Unable to lift the arm due to the pain  

A grinding sensation attempting to raise the arm 

  Diagnosis.

There is always an obvious deformity, or “bump,” around the fractured area. A small amount of pressure over the fracture area will bring about pain. Also, a grinding feeling can be felt when the patient attempts to raise the arm. Its rare for a fragment of bone to break through the skin, An X-ray is often done to pinpoint the location and severity of the break.  Then an assessment should be carried out by a medical trained practitioner. 

Nonsurgical Treatment .

Most broken collarbones heal well without surgery.

A simple arm sling will be used to immobilize the arm. A child may have to wear the sling for 4 to 6 weeks; an adult may have to wear it for 4 to 8 weeks. Depending on the location of the break

Medications, such as aspirin or ibuprofen, will help reduce pain. But for a speedy recovery and pain relief, view our cold/ Low Level laser therapy section this is under inflammatory conditions on the home page.

Cold/Low Level Laser Therapy (LLLT)

Cold/Low Level  Laser Therapy (LLLT) has a 5 star rating for soft tissue injuries,conditions and inflammation. Cold/ Low Level Laser Therapy is a handheld, non-invasive, light-emitting medical device which is used over different areas of the body. It provides an unmatched advantage in the treatment of conditions such as;

Collar Bone Fracture,and Fractures

Athletic and sports Injuries, Soft tissue injuries including Sprains and Strains, Tendonitis and Haematomas

Lower leg (calf pain) inflammation, Shin splints, Hamstring, Achilles tendonitis, Bursitis, conditions and disorders

Ankle sprains, injury, and fractures, inflammation conditions and disorders

Heel and foot injury, pain, Bursitis, Achilles Tendonitis, Plantar fasciitis, conditions and disorders

Knee pain, injuries, tears, ligament, Tendon injury, ruptures, Runners Knee, inflammation, Bursitis, conditions and disorders

Shoulder injury, pain, Shoulder tears, fractures inflammation, Tenosynovitis ,Tendonitis, Bursitis, conditions such as frozen shoulder, and disorders

Neck injury, Neck Pain, Neck sprain, Whiplash injury.

Back Injury,   Lower back pain, Sciatica, slipped discs, prolapsed disc, herniated / bulging discs, Trapped nerves and inflammation.

Elbow, Wrist and Hand injury, Tendonitis, inflammation, fractures, conditions and disorders, such as Tennis Elbow,(Golfers Elbow) Carpal Tunnel Syndrome,

Hip injury and pain, Sacroiliac Joint inflammation, groin and thigh strain (pull), sports hernia, Hip Bursitis/Tendonitis, Trochanteric Bursitis, conditions and disorders

Muscle sprain and spasms, Cramps, Joint Pain and stiff Joints.

Pain Relief, including Arthritic pain relief.

Wound Management including Skin Ulcers, Pressure Sores and Burns, Skin infections

Chronic pain such as Trigeminal Neuralgia and Chronic Neck and Back pain.

Safety

Cold/Low level laser therapy(LLLT) is not harmful. Lasers used for tissue stimulation have insufficient strength to damage cells. 30 years of clinical studies and clinical use have shown no adverse effects whatsoever.

The Advantages of Low Intensity Laser Therapy

• Non-invasive
• Non-toxic
• Easily applied
• Highly effective
• Cure rate > 95%
• No known negative side effects

Mechanism of Action

Therapeutic lasers work by supplying energy to the body in the form of photons of light. The tissues and cells then absorb this energy, where it is used to accelerate the normal rate of tissue healing.

Therapeutic Benefits of Laser Therapy:

• Anti-inflammatory Action: Laser light reduces swelling, leading to decreased pain, less stiffness, and a faster return to normal joint and muscle function.
• Rapid Cell Growth: Laser light accelerates cellular reproduction and growth.
• Faster Wound Healing: Laser light stimulates fibroblast development and accelerates collagen synthesis in damaged tissue.
• Reduced Fibrous Tissue Formation: Laser light reduces formation of scar tissue, leading to more complete healing, with less chance of weakness and re-injury later.
• Increased Vascular Activity: Laser light increases blood flow to the injured area.
• Stimulated Nerve Function: Laser light speeds nerve cell processes which may decrease pain and numbness associated with nerve-related conditions.

Frequency of Treatments

While some patients get immediate results, others require 6-12 treatments before seeing a lasting effect. Less severe or acute injuries will require fewer treatments than chronic or severe conditions.

Cold/Low Level Laser Therapy (LLLT) Applications, Case Studies and Low Level Laser Research with some  Worldwide Clinical Studies are presented below:

Musculoskeletal pain syndromes, both chronic and acute.Cold/Low level laser therapy (LLLT)has been shown to be effective in a variety of musculoskeletal conditions and associated pain presentations.In Rheumatoid Arthritis, LLLT can benefit not only the pain of acute small joint inflammation but also the chronic pain.In a review article on rheumatology (3), some 18 papers were considered. All studies involved double-blind trials with LLLT in chronic rheumatoid, and reported significant improvement in pain (80% success rate in relieving pain). Upon comparing LLLT to a similar rate of pain attenuation using anti-inflammatory drugs (NSAIDs), the LLLT was free of any side-effects while 20% of patients treated with NSAIDs suffered unacceptable side-effects of medication . In another study of 170 patients with rheumatoid arthritis using LLLT (4), pain attenuation of up to 90% was noted.Trellis et al (6) used LLLT for osteoarthritis of the knee in 40 patients. He reported a significant reduction of 82% of the patients with improved joint mobility. Among 36 randomized patients, with pain caused by cervical osteoarthritis, those who received Infra-Red and Low Level Laser treatment improved 75% compared with the group receiving mock treatment (31%) . Similarly, a study of 60 patients with Cervical Osteoarthritis, Low Pulsed Laser was successful in relieving pain and in improving function.
The results of a study show that cervical myofascial pain is significantly improved at 3-month with Diode laser . A similar successful LLLT treatment has been described for whiplash injuries.In a randomized study with 30 patients with supraspinatus or bicipital tendonitis, the results demonstrated the effectiveness of laser therapy in tendonitis of the shoulder . Another study with a patient population (n = 324), with either medial epicondylitis (Golfer’s elbow; n = 50) or lateral epicondylitis (Tennis elbow; n = 274), and randomly allocated, provides further evidence of the efficacy of LLLT in the management of lateral and medial epicondylitis .

Treatment with low-level laser therapy (LLLT) was shown effective in treating Carpal Tunnel Syndrome pain. Another study, significant decreases in McGill Pain Questionnaire scores, median nerve sensory latency, and Phalen and Tinel signs were observed after treatment series with Low Level Laser Therapy. Patients could perform their previous work  .

In acute trauma there is a soft tissue injury comprising swelling, haematoma, pain and reduced mobility. Sporting injuries and domestic accidents usually involve damage to muscles, joint ligaments and tenclass. In the absence of bone fracture or other injury demanding priority treatment, LLLT should be instituted at the earliest opportunity. Kumar reported a comparative study in 50 patients with inversion injuries of the ankle. He found that compared to conventional physiotherapy, the LLLT treated patients showed a more rapid resolution of symptoms and an earlier return to full weight-bearing .

Fibromyaliga (FM) is characterized by widespread pain in the body, associated with particular tender points. It is often accompanied by disturbed sleep patterns, fatigue, headaches, irritable bowel and bladder syndrome, morning stiffness, anxiety and depression. FM can cause a high level of functional disability and have a significantly negative effect on quality of life. One study suggests that “Laser Therapy is effective on pain, muscle spasm, morning stiffness, fatigue, depression and total tender point number in Fibromyalgia”.

A randomized controlled study with 63 with non-radiating low back pain showed that LLLT significantly improved pain and function.

In summary, the bulk of published work to date supports the use of LLLT for treatment of a variety of musculoskeletal conditions and associated pain. Moreover, the LLLT proved to be not only more effective than conventional methods, but more economical as well. The added advantage of absence of side effects, non-invasive nature of therapy and the ease of application, ensures good patient acceptance of the treatment modality.

Low Intensity Laser Therapy(LILT) for Head, Neck and Facial Pain.

Prof P.F. Bradley

The clinical application of low incident power density laser radiation for the treatment of acute and chronic pain is now a well established procedure. This paper reviews the currently available English speaking literature and summarises a selection of serious scientific papers which report a beneficial effect following the treatment of a wide variety of acute and chronic syndromes whose main presenting symptom is pain.

Head and Neck Clinical Applications of LILT

LILT is proving useful in a wide variety of painful conditions in the Head and Neck but the following are particular applications:

  1. TM Joint Pain Dysfunction

  2. Post Herpetic Neuralgia

  3. Trigeminal Neuralgia

  4. Painful Ulcerative Conditions

  5. Pain of Advanced Oro Facial Cancer

 The above information has been suppled by Quantum Healing Lasers .Com

  The Ability of Low Level Laser Therapy (LLLT) to Mitigate Fibromyalgic Pain.

  The CFIDS Chronicle Physicians’ Forum Fall 1993

  Douglas Ashendorf, MD, FAAPMR Newark, New Jersey

Physiotherapist Shows Lasers Relieve Pain.

A physiotherapist at Royal Brisbane Hospital (Australia) recently received a PhD from the University of Queensland for demonstrating that laser treatment prompts the release of endorphins into the bloodstream. Endorphins are a type of natural morphine that dulls pain. Physiotherapist Liisa Laakso studied the effects of lasers on 56 people who suffered myofascial pain syndrome, a chronic hypersensitivity often secondary to a person’s primary painful affliction, such as arthritis. Previous experiments linking endorphin release and lasers have only been done on rats.

In the study, Laakso applied different doses and wavelengths of a laser diode to “trigger points” on the body and took blood samples measuring endorphin levels in these subjects and a control group. The control group reported some pain relief – most likely a placebo effect – but endorphins were present. Those patients that underwent laser treatment reported pain reduction of up to 78%, and endorphins were present in their blood.

THERMOGRAPHIC STUDY OF LOW LEVEL LASER      THERAPY FOR ACUTE-PHASE INJURY.

 Yoshimi Asagai, M.D.1, Atsuhiro Imakiire, M.D.2, Toshio Ohshiro, M.D.3,  1. Shinano Handicapped Children`s Hospital Shimosuwa, Nagano, Japan    2. Department of Orthopaedic Surgery, Tokyo Medical University Shinjuku, Tokyo, Japan     3. Japan Medical Laser Laboratory, Shinanomachi, Tokyo, Japan. 

Acute-phase injury is generally treated by localized cooling of the region, and rarely by theactive use of low level laser therapy (LLLT) in Japan. Thermographic studies of acutephase injury revealed that circulatory disturbances at the site of trauma occurred due to swelling and edema on the day following the injury, and that skin temperature was high at the site of the trauma and low at the periphery. Following LLLT, circulatory disturbances rapidly improved, while temperature in the high temperature zone around the site of trauma fell by 3 degrees on the average, but at the periphery the low temperature rose by 3 degrees on the average to nearly normal skin temperature. Clinically, swelling and edema improved. LLLT was also useful in treating necrosis of the skin in the wound area and in accelerating healing of surgical wounds of paralytic feet, which are prone to delayed, wound healing and also wounds due to spoke injury. LLLT is useful in treating swelling and edema in acutephase injury and in accelerating healing of surgical wounds. 

For in depth information on shoulder injuries and treatment please go to top left corner under“Conditions”  “Pain” and “Treatments” for Cold Low Level Laser therapy for in depth information.

The collarbone

The collarbone is a part of the shoulder. Its function is to connect the arm to the body. The collarbone sits directly above several important nerves and blood vessels. These vital soft tissues are rarely injured when the collarbone breaks. The collarbone is a long bone, and most breaks occur in the middle of the bone. 

Cause. 

A broken collarbone, or the medical term a fractured clavicle is a common injury. Many babies are born with a broken collarbone this is due to child birth, also to people in contacted sports such as rugby or just  general accidents where a fall results in a  severe blow or  a heavy fall to the shoulder .    

The collarbone doesn’t   harden until a person is about 21 years old; a child’s collarbone can easily be broken from a direct blow or fall.  

Symptoms include. 

A hump or “bump” over the fracture area  

Shoulder hanging down and forward   

Unable to lift the arm due to the pain  

A grinding sensation attempting to raise the arm 

Diagnosis.

There is always an obvious deformity, or “bump,” around the fractured area. A small amount of pressure over the fracture area will bring about pain. Also, a grinding feeling can be felt when the patient attempts to raise the arm. Its rare for a fragment of bone to break through the skin, An X-ray is often done to pinpoint the location and severity of the break.  Then an assessment should be carried out by a medical trained practitioner. 

Nonsurgical Treatment .

Most broken collarbones heal well without surgery.

A simple arm sling will be used to immobilize the arm. A child may have to wear the sling for 4 to 6 weeks; an adult may have to wear it for 4 to 8 weeks. Depending on the location of the break

Medications, such as aspirin or ibuprofen, will help reduce pain. But for a speedy recovery and pain relief, view our cold/ Low Level laser therapy section this is under inflammatory conditions on the home page.

Cold/Low Level Laser Therapy (LLLT)

Cold/Low Level  Laser Therapy (LLLT) has a 5 star rating for soft tissue injuries,conditions and inflammation.  Low Level Laser Therapy is a handheld, non-invasive, light-emitting medical device which is used over different areas of the body. It provides an unmatched advantage in the treatment of conditions such as;

Collar bone fracture and fractures

Athletic and sports Injuries, Soft tissue injuries including Sprains and Strains, Tendonitis and Haematomas

Lower leg (calf pain) inflammation, Shin splints, Hamstring, Achilles tendonitis, Bursitis, conditions and disorders

Ankle sprains, injury, and fractures, inflammation conditions and disorders

Heel and foot injury, pain, Bursitis, Achilles Tendonitis, Plantar fasciitis, conditions and disorders

Knee pain, injuries, tears, ligament, Tendon injury, ruptures, Runners Knee, inflammation, Bursitis, conditions and disorders

Shoulder injury, pain, Shoulder tears, fractures inflammation, Tenosynovitis ,Tendonitis, Bursitis, conditions such as frozen shoulder,conditions and disorders

Neck injury, Neck Pain, Neck sprain, Whiplash injury.

Back Injury,   Lower back pain, Sciatica, slipped discs, prolapsed disc, herniated / bulging discs, Trapped nerves and inflammation.

Elbow, Wrist and Hand injury, Tendonitis, inflammation, fractures, conditions and disorders, such as Tennis Elbow,(Golfers Elbow) Carpal Tunnel Syndrome,

Hip injury and pain, Sacroiliac Joint inflammation, groin and thigh strain (pull), sports hernia, Hip Bursitis/Tendonitis, Trochanteric Bursitis, conditions and disorders

Muscle sprain and spasms, Cramps, Joint Pain and stiff Joints.

Pain Relief, including Arthritic pain relief.

Wound Management including Skin Ulcers, Pressure Sores and Burns, Skin infections

Chronic pain such as Trigeminal Neuralgia and Chronic Neck and Back pain.

Safety

Low level laser therapy(LLLT) is not harmful. Lasers used for tissue stimulation have insufficient strength to damage cells. 30 years of clinical studies and clinical use have shown no adverse effects whatsoever.

The Advantages of Low Intensity Laser Therapy

• Non-invasive
• Non-toxic
• Easily applied
• Highly effective
• Cure rate > 95%
• No known negative side effects

Mechanism of Action

Therapeutic lasers work by supplying energy to the body in the form of photons of light. The tissues and cells then absorb this energy, where it is used to accelerate the normal rate of tissue healing.

Therapeutic Benefits of Laser Therapy:

• Anti-inflammatory Action: Laser light reduces swelling, leading to decreased pain, less stiffness, and a faster return to normal joint and muscle function.
• Rapid Cell Growth: Laser light accelerates cellular reproduction and growth.
• Faster Wound Healing: Laser light stimulates fibroblast development and accelerates collagen synthesis in damaged tissue.
• Reduced Fibrous Tissue Formation: Laser light reduces formation of scar tissue, leading to more complete healing, with less chance of weakness and re-injury later.
• Increased Vascular Activity: Laser light increases blood flow to the injured area.
• Stimulated Nerve Function: Laser light speeds nerve cell processes which may decrease pain and numbness associated with nerve-related conditions.

Frequency of Treatments

While some patients get immediate results, others require 6-12 treatments before seeing a lasting effect. Less severe or acute injuries will require fewer treatments than chronic or severe conditions.

Cold/Low Level Laser Therapy (LLLT) Applications, Case Studies and Low Level Laser Research with some Worldwide Clinical Studies are presented below:

Musculoskeletal pain syndromes, both chronic and acute.Cold/Low level laser therapy (LLLT)has been shown to be effective in a variety of musculoskeletal conditions and associated pain presentations.In Rheumatoid Arthritis, LLLT can benefit not only the pain of acute small joint inflammation but also the chronic pain.In a review article on rheumatology (3), some 18 papers were considered. All studies involved double-blind trials with LLLT in chronic rheumatoid, and reported significant improvement in pain (80% success rate in relieving pain). Upon comparing LLLT to a similar rate of pain attenuation using anti-inflammatory drugs (NSAIDs), the LLLT was free of any side-effects while 20% of patients treated with NSAIDs suffered unacceptable side-effects of medication . In another study of 170 patients with rheumatoid arthritis using LLLT (4), pain attenuation of up to 90% was noted.Trellis et al (6) used LLLT for osteoarthritis of the knee in 40 patients. He reported a significant reduction of 82% of the patients with improved joint mobility. Among 36 randomized patients, with pain caused by cervical osteoarthritis, those who received Infra-Red and Low Level Laser treatment improved 75% compared with the group receiving mock treatment (31%) . Similarly, a study of 60 patients with Cervical Osteoarthritis, Low Pulsed Laser was successful in relieving pain and in improving function.
The results of a study show that cervical myofascial pain is significantly improved at 3-month with Diode laser . A similar successful LLLT treatment has been described for whiplash injuries.In a randomized study with 30 patients with supraspinatus or bicipital tendonitis, the results demonstrated the effectiveness of laser therapy in tendonitis of the shoulder . Another study with a patient population (n = 324), with either medial epicondylitis (Golfer’s elbow; n = 50) or lateral epicondylitis (Tennis elbow; n = 274), and randomly allocated, provides further evidence of the efficacy of LLLT in the management of lateral and medial epicondylitis .

Treatment with low-level laser therapy (LLLT) was shown effective in treating Carpal Tunnel Syndrome pain. Another study, significant decreases in McGill Pain Questionnaire scores, median nerve sensory latency, and Phalen and Tinel signs were observed after treatment series with Low Level Laser Therapy. Patients could perform their previous work  .

In acute trauma there is a soft tissue injury comprising swelling, haematoma, pain and reduced mobility. Sporting injuries and domestic accidents usually involve damage to muscles, joint ligaments and tenclass. In the absence of bone fracture or other injury demanding priority treatment, LLLT should be instituted at the earliest opportunity. Kumar reported a comparative study in 50 patients with inversion injuries of the ankle. He found that compared to conventional physiotherapy, the LLLT treated patients showed a more rapid resolution of symptoms and an earlier return to full weight-bearing .

Fibromyaliga (FM) is characterized by widespread pain in the body, associated with particular tender points. It is often accompanied by disturbed sleep patterns, fatigue, headaches, irritable bowel and bladder syndrome, morning stiffness, anxiety and depression. FM can cause a high level of functional disability and have a significantly negative effect on quality of life. One study suggests that “Laser Therapy is effective on pain, muscle spasm, morning stiffness, fatigue, depression and total tender point number in Fibromyalgia”.

A randomized controlled study with 63 with non-radiating low back pain showed that LLLT significantly improved pain and function.

In summary, the bulk of published work to date supports the use of LLLT for treatment of a variety of musculoskeletal conditions and associated pain. Moreover, the LLLT proved to be not only more effective than conventional methods, but more economical as well. The added advantage of absence of side effects, non-invasive nature of therapy and the ease of application, ensures good patient acceptance of the treatment modality.

Low Intensity Laser Therapy(LILT) for Head, Neck and Facial Pain.

Prof P.F. Bradley

The clinical application of low incident power density laser radiation for the treatment of acute and chronic pain is now a well established procedure. This paper reviews the currently available English speaking literature and summarises a selection of serious scientific papers which report a beneficial effect following the treatment of a wide variety of acute and chronic syndromes whose main presenting symptom is pain.

Head and Neck Clinical Applications of LILT

LILT is proving useful in a wide variety of painful conditions in the Head and Neck but the following are particular applications:

  1. TM Joint Pain Dysfunction

  2. Post Herpetic Neuralgia

  3. Trigeminal Neuralgia

  4. Painful Ulcerative Conditions

  5. Pain of Advanced Oro Facial Cancer

 The above information has been suppled by Quantum Healing Lasers .Com

  The Ability of Low Level Laser Therapy (LLLT) to Mitigate Fibromyalgic Pain.

  The CFIDS Chronicle Physicians’ Forum Fall 1993

  Douglas Ashendorf, MD, FAAPMR Newark, New Jersey

Physiotherapist Shows Lasers Relieve Pain.

A physiotherapist at Royal Brisbane Hospital (Australia) recently received a PhD from the University of Queensland for demonstrating that laser treatment prompts the release of endorphins into the bloodstream. Endorphins are a type of natural morphine that dulls pain. Physiotherapist Liisa Laakso studied the effects of lasers on 56 people who suffered myofascial pain syndrome, a chronic hypersensitivity often secondary to a person’s primary painful affliction, such as arthritis. Previous experiments linking endorphin release and lasers have only been done on rats.

In the study, Laakso applied different doses and wavelengths of a laser diode to “trigger points” on the body and took blood samples measuring endorphin levels in these subjects and a control group. The control group reported some pain relief – most likely a placebo effect – but endorphins were present. Those patients that underwent laser treatment reported pain reduction of up to 78%, and endorphins were present in their blood.

THERMOGRAPHIC STUDY OF LOW LEVEL LASER      THERAPY FOR ACUTE-PHASE INJURY.

 Yoshimi Asagai, M.D.1, Atsuhiro Imakiire, M.D.2, Toshio Ohshiro, M.D.3,  1. Shinano Handicapped Children`s Hospital Shimosuwa, Nagano, Japan    2. Department of Orthopaedic Surgery, Tokyo Medical University Shinjuku, Tokyo, Japan     3. Japan Medical Laser Laboratory, Shinanomachi, Tokyo, Japan. 

Acute-phase injury is generally treated by localized cooling of the region, and rarely by theactive use of low level laser therapy (LLLT) in Japan. Thermographic studies of acutephase injury revealed that circulatory disturbances at the site of trauma occurred due to swelling and edema on the day following the injury, and that skin temperature was high at the site of the trauma and low at the periphery. Following LLLT, circulatory disturbances rapidly improved, while temperature in the high temperature zone around the site of trauma fell by 3 degrees on the average, but at the periphery the low temperature rose by 3 degrees on the average to nearly normal skin temperature. Clinically, swelling and edema improved. LLLT was also useful in treating necrosis of the skin in the wound area and in accelerating healing of surgical wounds of paralytic feet, which are prone to delayed, wound healing and also wounds due to spoke injury. LLLT is useful in treating swelling and edema in acutephase injury and in accelerating healing of surgical wounds. 

For in depth information on shoulder injuries and treatment please go to top left corner under ”Conditions”  “Pain” and “Treatments” for Cold Low Level Laser therapy for in depth information.

Specific Shoulder Injury, conditions and disorders list include;  Shoulder Function,Shoulder Problems,Shoulder Dislocation,Shoulder Instability,Frozen Shoulder,Tendonitis,Tennis Elbow (Gofers Elbow),Rotator Cuff Tendonitis, Bursitis,Rotator Cuff Tear,Shoulder Joint Tear (Glenoid Labrum Tear),Labral Tears,Biceps Tendon Tear,Acromioclavicular Joint Injury, ”Burners” and “Stingers,Tendonitis,Tennis Elbow (Gofers Elbow),DeQuervain’s Tenosynovitis.Triceps,Trigger finger,Collarbone,Scapula Fracture.

Call 02476 222002.Registered with BUPA. AXA  PPP. HSA. AVIVA. Simplyhealth. Standard Life. Mercia health. BHSF. Pru health .Cigna Police health care scheme Medicare  Medisure. Medicash and all other healthcare insurers .

Cold/low level  laser Therapy/ Treatment this therapy has a five star rating in the acceleration and the healing process and pain relief, reducing convalescing periods

Shoulder

In human anatomy, the shoulder joint comprises the part of the body where the humerus attaches to the scapula. It is made up of three bones: the clavicle (collarbone), the scapula (shoulder blade), and the humerus (upper arm bone) as well as associated muscles, ligaments and tendons. The articulations between the bones of the shoulder make up the shoulder joints

There are two kinds of cartilage in the joint. The first type is the white cartilage on the ends of the bones (called articular cartilage) which allows the bones to glide and move on each other. When this type of cartilage starts to wear out (a process called arthritis), the joint becomes painful and stiff. The labrum is a second kind of cartilage in the shoulder which is distinctly different from the articular cartilage. This cartilage is more fibrous or rigid than the cartilage on the ends of the ball and socket.  The shoulder must be flexible for the wide range of motion required in the arms and hands and also strong enough to allow for actions such as lifting, pushing and pulling. The compromise between these two functions results in a large number of shoulder problems not faced by other joints such as the hip.

 How Common Are Shoulder Problems?

Throughout the UK people seek medical care each year for shoulder pain, sprain, strain, dislocation, or other associated conditions and disorders. Shoulder problems are ones of the most common, seen by Chiropractors, Physiotherapists and Doctors who treat disorders of the bones, muscles, and related structures.

What Are the Structures of the Shoulder and How Does the Shoulder Function?

The shoulder joint is composed of three bones: the clavicle (collarbone), the scapula (shoulder blade), and the humerus (upper arm bone) (see diagram). Two joints facilitate shoulder movement. The acromioclavicular (AC) joint is located between the acromion (part of the scapula that forms the highest point of the shoulder) and the clavicle. The glenohumeral joint, commonly called the shoulder joint, is a ball-and-socket type joint that helps move the shoulder forward and backward and allows the arm to rotate in a circular fashion or hinge out and up away from the body. (The ball is the top, rounded portion of the upper arm bone or humerus; the socket,” or glenoid, is a dish-shaped part of the outer edge of the scapula into which the ball fits.) The capsule is a soft tissue envelope that encircles the glenohumeral joint. It is lined by a thin, smooth synovial membrane.

The bones of the shoulder are held in place by muscles, tendons, and ligaments. Tendons are tough cords of tissue that attach the shoulder muscles to bone and assist the muscles in moving the shoulder. Ligaments attach shoulder bones to each other providing stability. For example, the front of the joint capsule is anchored by three glenohumeral ligaments.

The rotator cuff is a structure composed of tendons that, with associated muscles, holds the ball at the top of the humerus in the glenoid socket and provides mobility and strength to the shoulder joint. Two fluid sac-like structures called bursae permit smooth gliding between bone, muscle, and tendon. They cushion and protect the rotator cuff from the bony arch of the acromion.

What Are the Origins and Causes of Shoulder Problems?

The shoulder is the most movable joint in the body. However, it is an unstable joint because of the range of motion allowed. It is easily subject to injury because the ball of the upper arm is larger than the shoulder socket that holds it. To remain stable, the shoulder must be anchored by its muscles, tendons, and ligaments. Some shoulder problems arise from the disruption of these soft tissues as a result of injury or from overuse or under use of the shoulder. Other problems arise from a degenerative process in which tissues break down and no longer function well.

Shoulder pain may be localized or may be referred to areas around the shoulder or down the arm. Disease within the body (such as gallbladder, liver, or heart disease, or disease of the neck) also may generate pain that travels along nerves to the shoulder.

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Rotator Cuff Tendonitis or Bursitis Therapy and Treatment

The tendons of the Rotator Cuff rotate the upper shoulder bone (humerus) and help raise the arm by pulling the Humeral head down as the Deltoid muscle pulls the arm up. These tendons may be irritated by pressure from the Acromion process of the Scapula (the upper part of the shoulder blade) and the Coraco-Acromial Ligament. This irritation of the tendons or the lubricating Bursa (connective tissue sack) is referred to as “Tendonitis” or “Bursitis”. This is known collectively as the “Impingement syndrome.

The symptoms of Impingement syndrome present not only as pain on movement, but also as constant pain. This can be accompanied by snapping or cracking sensations on movement. Symptoms may start after an injury which may result in a weakening of the shoulder muscles caused by the pain from the injury.

A clinical diagnosis of Impingement Syndrome is made by physical examination, and X-rays. Sometimes an MRI. scan is necessary to exclude rotator cuff tears.

Cold laser Therapy has a five star rating in the healing process and pain relief, reducing convalescing periods

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Tendonitis

Tendon problems what are they?

Two main problems associated with tendons include Tendonitis and Tenosynovitis. Tendonitis is an inflammation of the tendons-the tough cords of tissue that connect muscles to bones. This inflammation can affect any tendon, but is most commonly seen in the wrist and fingers. As the tendons become irritated, pain and swelling will occur.

Tenosynovitis is the inflammation of the lining of the tendon sheaths which enclose the tendons. Sometimes both the sheath and the tendon may become inflamed. The cause of Tenosynovitis is usually strain, excessive use, or injury. Tendonitis may also be related to diseases such as Rheumatoid Arthritis or Diabetis can be implicated in this condition.

Common tendon disorders include:

Lateral Epicondylitis. (Known as Tennis Elbow)
This condition is characterised by pain in the back of the elbow and forearm, and along the thumb side of the forearm when the arm is alongside the body when the thumb is turned out. The cause of pain is the damage to the tendons that bend the wrist backwards away from the palm (wrist extensors).

Medical Epicondylitis. (Known as Golfer’s Elbow).
This is a condition characterised by pain from the elbow to the wrist on the palm side of the forearm the pain is caused by damage to the tendons that bend the wrist toward the palm (wrist flexors).

DeQuervain’s Tenosynovitis.
This is far the most common type of Tenosynovitis disorder, this is when the sheath of the tendons of the thumb become swollen.

Trigger Finger.
A Tenosynovitis condition in which the tendon sheath of one of the finger flexors becomes inflamed and thickens, preventing the smooth extension or flexion of the finger. The finger may lock or suddenly hence the name “Trigger Finger”.

What are the Symptoms of Tendonitis?

The most common symptoms of Tendonitis are:

• Pain in the tendon with movement
• Fluid accumulation, swelling and inflammation
• There may be grating sensation in absence of swelling

Diagnosis of Tendonitis

Tendonitis is usually diagnosed after careful medical history and physical examination. The diagnosis is established after  tests have been completed to rule out other conditions or diseases. Joint aspirations may help to rule out gout or an infection, while X-rays may help to rule out arthritis.

Treatment for Tendonitis:

• Modification of your activity
• Splinting or immobilization
• Steroid injections
• Anti-inflammatory medications
• Surgery

Cold laser Therapy: – Tendonitis,Cold Laser therapy has  five star rating in the acceleration of the healing process and pain relief,thus reducing convalescing periods

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Shoulder Joint Tear (Glenoid Labrum Tear) injury Treatment. 

Three bones make up the shoulder joint, the shoulder blade (scapula), the collarbone (clavicle), and the upper arm bone (humerus). The head of the upper arm bone (humeral head) rests in a socket in the shoulder blade called the glenoid. The upper arm bone called the head is larger than the socket; a soft fibrous rim of tissue rim called the labrum surrounds the socket to help stabilize the joint. This rim deepens the socket, so that the head of the upper arm bone fits better. They also serve as an attachment site for several ligaments. Injuries to the tissue rim surrounding the shoulder socket can occur from acute trauma or repetitive shoulder motion.

Examples of traumatic injury include:

• Falling on an outstretched arm
• A blow to the shoulder
• A sudden jerk, as in trying to lift to heavy an object
• A violent overhead stretch or reach, as in when trying to stop a fall

Symptoms of a Shoulder Tear.

• Pain, in overhead activities
• Pulling locking, cracking or grinding
• Occasional pain with daily activities
• Perhaps a sense of instability in the shoulder
• Decreased range in movement
• Lack of strength

Cold laser Therapy: this therapy has a five star rating in the acceleration of the healing process and pain relief,thus reducing convalescing periods

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Labral Tears

Labral tears are injuries to the labrum surrounding the shoulder socket that can occur from acute trauma or repetitive shoulder motion. Examples of acute trauma include falling on an outstretched arm; a direct blow to the shoulder; a sudden violent pull, as when trying to lift a heavy object or a sudden overhead reach.

Tears can be located either above (superior) or below (inferior) the middle of the glenoid socket. A SLAP lesion (superior labrum, anterior [front] to posterior [back]) is a tear of the labrum above the middle of the socket that may also involve the biceps tendon. A tear of the labrum below the middle of the glenoid socket involving the inferior glenohumeral ligament is called a Bankart lesion. Tears of the labrum often occur with other shoulder injuries, such as a dislocated shoulder (full or partial dislocation).

The symptoms of a tear in the shoulder socket rim, which are similar to those of other shoulder injuries, include pain, usually with overhead activities; catching, locking, popping, or grinding; occasional night pain, or pain with daily activities; a sense of instability in the shoulder; decreased range of motion; or loss of strength.

Treatment

Anti-inflammatory medication and rest to relieve symptoms may be prescribed initially. Rehabilitation exercises to strengthen the rotator cuff muscles also may be recommended. If these conservative measures are insufficient, arthroscopic surgery may be prescribed.

During arthroscopic surgery, the doctor will examine the rim and the biceps tendon. If the injury is confined to the rim itself, without involving the tendon, the shoulder is still stable. The surgeon will remove the torn flap and correct any other associated problems. If the tear extends into the biceps tendon, or if the tendon is detached, the shoulder is unstable. The surgeon will need to repair and reattach the tendon using absorbable tacks, wires, or sutures.

Tears below the middle of the socket also are associated with shoulder instability. The surgeon will reattach the ligament and tighten the shoulder socket by folding over and “pleating” the tissues.

Rehabilitation

After surgery, a sling is used for three to four weeks. Your Chiropractor or Physiotherapist also will prescribe gentle, passive, and pain-free range-of-motion exercises. When the sling is removed, motion and flexibility exercises can be started. Athletes usually can begin doing sport-specific exercises six weeks after surgery, although it will be three to four months before the shoulder is fully healed.

Cold laser Therapy has a five star rating in the healing process and pain relief, thus reducing convalescing periods

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Biceps Tendon Tear at the Shoulder

The tendons attach muscle to bone. The biceps muscle in the upper arm divides into long head and a short heads near the shoulder both attach to the shoulder at different points. At the other end of the muscle the distal biceps tendon connects to the smaller bone in the lower arm called the radius. These connections help the muscle stabilize the shoulder and rotate the lower arm; it also controls the acceleration or deceleration of the arm during overhead motion.

The long head of the biceps tendon is vulnerable to injury because it travels through the shoulder joint to its point of attachment. The tears of the long head of biceps result in arm weakness; this could also affect arm further by being unable to turn the arm from palm down to palm up. Because the torn tendon can no longer keep the muscle taut, a bulge may also appear it eh upper arm. In case of the distal tendon tears the arm is unable to bed at the elbow.

Causes

Ruptures of the distal tendon near the elbow are not common. They usually occur when an unexpected or extreme force is applied to a bent arm.

The proximal biceps tendons ear the shoulder tear more readily. The tears can be partial or complete, more prevalent in people aged 35 or over and in people with previous shoulder injuries.

Symptoms

• Perhaps an audible snap.
• A bulge in the upper arm
• Bruising to the upper arm, down towards the elbow
• Sudden, sharp pain in the upper arm.
• Pain or tenderness at the shoulder

Diagnosis

A Chiropractor will examine the neck, shoulder and arm and ask you to bend the arm and tighten the biceps muscle. This is done to determine the extent of the injury.

Treatment

• Non-surgical treatment is usually all that is needed for tears in the proximal biceps tendon
• ice applications 20 minutes every hour keep down the swelling
• Anti-inflammatory medications, such as ibuprofen will reduce the pain
• Rest the muscle completely
• Flexibility and strengthening exercises will keep the shoulder mobile
• Surgical repair of a complete tendon tear
• Complete tears of the distal biceps tendon require surgery to reattach the tendon to the bone
• Partial tears of the distal biceps tendon may be treated either non- surgically or surgically
• Cold laser Therapy,Tendonitis, this therapy has a five star rating in the acceleration of the healing process, reducing convalescing periods

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 “Burners” and “Stingers”

“Burners” and “stingers” are injuries to the nerve supply of the upper limb, either at the neck or shoulder, most commonly caused by traction forces to the neck during contact or collision sports. A burning or “electric shock” sensation usually accompanies the injury followed  by immediate numbness or weakness. In most cases, the injuries are temporary and symptoms resolve quickly within seconds or minutes, although in 8 percent of cases, they can last hours, days, or even longer.

Treatment

Treatment begins by removing the athlete from the activity. Athletes are not allowed to return to sports activity until symptoms are completely gone. This can take a few minutes or several days. Athletes should never be allowed to return to sports if they have weakness or neck pain.

Although the injury gets better with time, the athlete may need to work with a Chiropractor or physiotherapist to regain strength and motion if the symptoms last for several days.

Prevention

To prevent most shoulder injuries, use correct sporting technique, along with a stretching and strengthening program that also includes the muscles of the neck.

Cold laser Therapy- this therapy has a five star rating in the acceleration of the healing process thus reducing convalescing periods.

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Triceps Anatomy

The Triceps Brachii consists of three heads: the lateral, medial, and long heads. Triceps joins the Humerus (shoulder bone) and the Scapula (shoulder blade) to the ulna which is the forearm bone. If you working out in gym you must assure you implement Triceps exercises that target all three of the Triceps heads, as this will fully develop the heads of triceps muscle.

In Training the triceps muscles, you must keep constant tension throughout triceps isolation movements over the full range of motion. It is also imperative to flex the entire triceps muscle by simply extending the arms fully to get the most muscle fibre recruitment.

Triceps Injuries Treatment

Cold laser Therapy, this therapy has a five star rating in the acceleration of the healing process, reducing convalescing periods.

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Shoulder Dislocation

Shoulder dislocations occur when the head of the humerus which is the upper arm bone, slips out of the shoulder socket of the scapula, which is called the glenoid. This can happen during severe wrench pulling the shoulder upward or outward, or from combined over-extension and external rotation of the humerus.

Glenohumeral dislocations are generally classified by the direction of dislocation of the humerus.

A dislocation can be full or partial:

• A partial dislocation which also known as subluxation, when the head of the humerus slips out of the socket momentarily and then snaps back into place (socket)
• A full dislocation, when the head of the humerus comes completely out of the socket

Shoulder dislocations are normally associated with fractures to different parts of the shoulder; there may be a fracture and dislocation at the same time. Nerves and blood vessels can sometimes be damaged with a severe shoulder dislocation.

Causes

• Falling on an outstretched arm
• A direct or powerful blow to the shoulder area.
• Repetitive sports or activities i.e. throwing or lifting
• Any kind of force applied to an outstretched arm

Symptoms

•   Swelling
•   Bruising
•   Pain, often severe
•   Shoulder contour appears abnormal
•   Bruising Instability and weakness in the shoulder area
•   Inability to move the shoulder
•   Bruising Instability and weakness in the shoulder area
•   Numbness and tingling around the shoulder or in the arm or fingers
•   Seek immediate medical attention

Cold laser Therapy, this therapy has a five star rating in the acceleration of the healing process,thus reducing convalescing periods

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Shoulder instability

Shoulder instability is a condition in which one of the bones in the shoulder joint moves partially or fully out of place. The head of the humerus, the upper arm bone, moves within the socket of the shoulder in more than one direction. Instability happens when the head of the humerus slips outside its normal position. The classification of this disorder is defined by the changes in degree of movement in the joint and by the change of direction in the movement of the joint.

Types of Shoulder Dislocation:

• Anterior
  when the humeral head moves forwards. This is a very common injury in young men. Men having great shoulder flexibility are more prone to this injury.
• Posterior
  when the humeral head moves backwards. This is due to severe muscle spasm during an electric shock or epileptic seizure.
• Multidirectional
  this occurs in people born with loose joints. Muscles contracting and relaxing may trigger a multidirectional instability episode. Also certain sports that require greater shoulder range of motion such as swimming may also lead to multidirectional instability.

Shoulder instability usually results from an old injury producing a dislocation that, even when healed, leads to stretching of the shoulder capsule and ligaments.  

 Diagnosis

 Symptoms of shoulder instability may include:

• Numb feeling down the arm
• Shoulder can slip out of place
• Pain in and around the shoulder area
• Shoulder or arm may feel weak
• Shoulder feels loose. (Slack)
• X-Ray may be needed

Treatment Options

• Cold laser Therapy, this therapy has a five star rating in the acceleration of the healing process,thus reducing convalescing periods
• Rest
• Ice will help control pain
• Nonsteroidal anti-inflammatory drugs These include: aspirin, ibuprofen (Motrin, Advil)

 Rehabilitation

Can last several months and may include: physical therapy to strengthen the muscles that control the shoulder joint.

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Collarbone fracture

The collarbone is a part of the shoulder. Its function is to connect the arm to the body. The collarbone sits directly above several important nerves and blood vessels. These vital soft tissues are rarely injured when the collarbone breaks. The collarbone is a long bone, and most breaks occur in the middle of the bone.

Causes 

A broken collarbone, or the medical term - fractured clavicle-  is a common injury. Many babies are born with a broken collarbone this is due to child birth trauma, it is also common in contacted sports such as rugby or just  as as result of general accidents where a fall results in a  severe blow or  a heavy fall to the shoulder .  

The collarbone doesn’t harden until a person is about 21 years old; a child’s collarbone can easily be broken from a direct blow or fall.

Symptoms include:

• A hump or “bump” over the fracture area
• Shoulder hanging down and forward
• Unable to lift the arm due to the pain
• A grinding sensation attempting to raise the arm

Diagnosis

There is always an obvious deformity, or “bump,” around the fractured area. A small amount of pressure over the fracture area will bring about pain. Also, a grinding feeling can be felt when the patient attempts to raise the arm. It’s rare for a fragment of bone to break through the skin, An X-ray is often done to pinpoint the location and severity of the break. Then an assessment should be carried out by a medical trained practitioner.

Nonsurgical Treatment

• Most broken collarbones heal well without surgery.
• A simple arm sling will be used to immobilize the arm. A child may have to wear the sling for 4 to 6 weeks; an adult may have to wear it for 4 to 8 weeks. Depending on the location of the break
• Cold laser Therapy,Tendonitis, this therapy has a five star rating in the acceleration of the healing process, reducing convalescing periods
• Medications, such as aspirin or ibuprofen, will help reduce pain. But for a speedy recovery see our cold laser therapy section this is under inflammatory conditions on the home page  

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Scapula Fracture

The scapula is of triangular shape and mobile. It’s also protected by a complex system of surrounding muscles. The shoulder blade or scapula fractures are very rare. Scapular fractures are usually classified at the high end of the impact scale. Falling from a significant height or a major car accident are usually the types of impact that required the scapula to fracture and is usually associated with other major injuries including broken ribs, damage to the head, lugs or spinal cord. Without treatment fractured scapula may result in chronic shoulder pain.

 Symptoms

• Abrasions to the skin.
• Swelling at the back of the shoulder.
• Sever pain when moving the arm.

Diagnosis

For appropriate treatment, your Physiotherapist or Chiropractor will probably need to take X-rays of the chest and shoulder. This can determine if one or more parts of the scapula may be fractured. The parts of the scapula that are prone to fracture are:

• Scapular body
• Scapular neck
• Glenoid
• Acromion
• Coracoid

Treatment

Non-surgical treatment such as sling works for most fractures of the scapula. The immobilization due to the sling holds the shoulder in place while the bone heals. This type of fractures may need 2 to 6 weeks of immobilization.

The shoulder may feel stiff when the sling is removed. You should begin limited active use of your shoulder immediately

Cold laser Therapy, this therapy has a five star rating in the acceleration of the healing process and pain relief, thus reducing convalescing periods.

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Acromioclavicular Joint Injury

An acromioclavicular joint injury can result from a direct blow or fall on the “tip” of the unprotected shoulder or from direct force to the anterior or front of the outstretched arm (i.e. arm tackling), which can cause deformity or elevation of the far, or distal end of the clavicle, pain, and swelling.

Treatment

Treatment with ice and compression; refer to an emergency department to rule out a fracture.

Rehabilitation

Rehabilitation is similar to a clavicle fracture but does not take as long. Gradual range of motion exercises and strengthening can be done as soon as tolerated. Cold laser Therapy has a five star rating in the healing process and pain relief, thus reducing convalescing periods

Frozen Shoulder. 

Who gets Frozen Shoulder?

Frozen Shoulder or Adhesive capsulitis is a painful condition mostly affecting people aged 30-70. It is estimated that 3% of population will develop the condition in their lifetime. There is no known racial preference; however, adhesive capsulitis is associated with certain conditions, particularly insulin-dependent diabetis.

Predisposing Factors

There are multiple risk factors predisposing an individual to development of adhesive  capsulitis. These predisposing factors may include shoulder or neck surgery, diabetis, shoulder trauma, inflammatory conditions. Other systemic conditions such as cervical cancer, autoimmune diseases and hypotyriodosm (underactive thyroid) may also to be linked to the condition.

 Diagnosis of Frozen Shoulder

 Adhesive capsulitis is diagnosed basing on symptoms and on physical examination of the shoulder. The use of  X-rays may show abnormalities such as narrowing of the joint and reduced bone density; however in early phases of adhesive capsulitis shoulder joint appearance on  X-ray is normal. 

Treatment of Frozen Shoulder 

Cold laser therapy is now used in treating this condition and is utilized by us at Central Chiropractic & Physiotherapy Clinic. Physiotherapy treatment combined with Cold Laser Therapy is extremely effective in reducing both shoulder pain and restricted movement. At present this type of treatment is not available within NHS. Cold laser Therapy has a five star rating in the acceleration of the healing process and pain relief,thus reducing convalescing periods

Treatment usually combines   use of anti-inflammatory drugs to relieve pain and inflammation with intermittent applications of heat and ice packs. Exercises are prescribed to build strength and improve movement and it is important to persist at these because recovery is gradual but slow. In some cases steroid injections into the joint may be needed. In severe cases the affected shoulder may need to be manipulated under anaesthesia before an aggressive rehabilitation program can be commenced.

Probable Outcomes

The residual symptoms of pain or stiffness are often present even after completion of course of conservative therapy. However, functional disability is rare.

Low Level Cold Laser Therapy (LLLT) is a Handheld, non invasive, light-emitting medical device which is used over different areas of the body. It provides an unmatched advantage in the treatment of conditions such as 

• Frozen shoulder
• Athletic and sports Injuries
• Lower Back Pain
• Knee and Foot Pain
• Shoulder Injury
• Carpal Tunnel Syndrome
• Arthritic pain relief and Muscle Spasm 
• Relief of Muscle stiffness, Joints and muscles, Pain Relief 
• Promotion of Muscle Relaxation and Cell Restoration
  Wound Management and including Skin Ulcers, Pressure Sores and Burns
  Soft Tissue Injuries, Including Sprains and Strains, Tendonitis and Haematomas
• Joint Disorders and Conditions including Arthritic pain relief and Tenosynovitis
• Chronic pain including Trigeminal Neuralgia and Neck and Back Shoulder pain

Frozen Shoulder Pain relief, for treatment of ligaments, tendons, muscle sprain.Cold laser Therapy, this therapy has a five star rating in the acceleration and the healing process and pain relief, thus reducing convalescing periods

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Specific Shoulder Injury, conditions and disorders list include;  Shoulder Function,Shoulder Problems,Shoulder Dislocation,Shoulder Instability,Frozen Shoulder,Tendonitis,Tennis Elbow (Gofers Elbow),Rotator Cuff Tendonitis, Bursitis,Rotator Cuff Tear,Shoulder Joint Tear (Glenoid Labrum Tear),Labral Tears,Biceps Tendon Tear,Acromioclavicular Joint Injury, ”Burners” and “Stingers,Tendonitis,Tennis Elbow (Gofers Elbow),DeQuervain’s Tenosynovitis.Triceps,Trigger finger,Collarbone,Scapula Fracture.

Call 02476 222002.Registered with BUPA. AXA  PPP. HSA. AVIVA. Simplyhealth. Standard Life. Mercia health. BHSF. Pru health .Cigna Police health care scheme Medicare  Medisure. Medicash and all other healthcare insurers .

Cold/low level  laser Therapy/ Treatment this therapy has a five star rating in the acceleration and the healing process and pain relief, reducing convalescing periods

Shoulder

In human anatomy, the shoulder joint comprises the part of the body where the humerus attaches to the scapula. It is made up of three bones: the clavicle (collarbone), the scapula (shoulder blade), and the humerus (upper arm bone) as well as associated muscles, ligaments and tendons. The articulations between the bones of the shoulder make up the shoulder joints

There are two kinds of cartilage in the joint. The first type is the white cartilage on the ends of the bones (called articular cartilage) which allows the bones to glide and move on each other. When this type of cartilage starts to wear out (a process called arthritis), the joint becomes painful and stiff. The labrum is a second kind of cartilage in the shoulder which is distinctly different from the articular cartilage. This cartilage is more fibrous or rigid than the cartilage on the ends of the ball and socket.  The shoulder must be flexible for the wide range of motion required in the arms and hands and also strong enough to allow for actions such as lifting, pushing and pulling. The compromise between these two functions results in a large number of shoulder problems not faced by other joints such as the hip.

 How Common Are Shoulder Problems?

Throughout the UK people seek medical care each year for shoulder pain, sprain, strain, dislocation, or other associated conditions and disorders. Shoulder problems are ones of the most common, seen by Chiropractors, Physiotherapists and Doctors who treat disorders of the bones, muscles, and related structures.

What Are the Structures of the Shoulder and How Does the Shoulder Function?

The shoulder joint is composed of three bones: the clavicle (collarbone), the scapula (shoulder blade), and the humerus (upper arm bone) (see diagram). Two joints facilitate shoulder movement. The acromioclavicular (AC) joint is located between the acromion (part of the scapula that forms the highest point of the shoulder) and the clavicle. The glenohumeral joint, commonly called the shoulder joint, is a ball-and-socket type joint that helps move the shoulder forward and backward and allows the arm to rotate in a circular fashion or hinge out and up away from the body. (The ball is the top, rounded portion of the upper arm bone or humerus; the socket,” or glenoid, is a dish-shaped part of the outer edge of the scapula into which the ball fits.) The capsule is a soft tissue envelope that encircles the glenohumeral joint. It is lined by a thin, smooth synovial membrane.

The bones of the shoulder are held in place by muscles, tendons, and ligaments. Tendons are tough cords of tissue that attach the shoulder muscles to bone and assist the muscles in moving the shoulder. Ligaments attach shoulder bones to each other providing stability. For example, the front of the joint capsule is anchored by three glenohumeral ligaments.

The rotator cuff is a structure composed of tendons that, with associated muscles, holds the ball at the top of the humerus in the glenoid socket and provides mobility and strength to the shoulder joint. Two fluid sac-like structures called bursae permit smooth gliding between bone, muscle, and tendon. They cushion and protect the rotator cuff from the bony arch of the acromion.

What Are the Origins and Causes of Shoulder Problems?

The shoulder is the most movable joint in the body. However, it is an unstable joint because of the range of motion allowed. It is easily subject to injury because the ball of the upper arm is larger than the shoulder socket that holds it. To remain stable, the shoulder must be anchored by its muscles, tendons, and ligaments. Some shoulder problems arise from the disruption of these soft tissues as a result of injury or from overuse or under use of the shoulder. Other problems arise from a degenerative process in which tissues break down and no longer function well.

Shoulder pain may be localized or may be referred to areas around the shoulder or down the arm. Disease within the body (such as gallbladder, liver, or heart disease, or disease of the neck) also may generate pain that travels along nerves to the shoulder.

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Rotator Cuff Tendonitis or Bursitis Therapy and Treatment

The tendons of the Rotator Cuff rotate the upper shoulder bone (humerus) and help raise the arm by pulling the Humeral head down as the Deltoid muscle pulls the arm up. These tendons may be irritated by pressure from the Acromion process of the Scapula (the upper part of the shoulder blade) and the Coraco-Acromial Ligament. This irritation of the tendons or the lubricating Bursa (connective tissue sack) is referred to as “Tendonitis” or “Bursitis”. This is known collectively as the “Impingement syndrome.

The symptoms of Impingement syndrome present not only as pain on movement, but also as constant pain. This can be accompanied by snapping or cracking sensations on movement. Symptoms may start after an injury which may result in a weakening of the shoulder muscles caused by the pain from the injury.

A clinical diagnosis of Impingement Syndrome is made by physical examination, and X-rays. Sometimes an MRI. scan is necessary to exclude rotator cuff tears.

Cold laser Therapy has a five star rating in the healing process and pain relief, reducing convalescing periods

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Tendonitis

Tendon problems what are they?

Two main problems associated with tendons include Tendonitis and Tenosynovitis. Tendonitis is an inflammation of the tendons-the tough cords of tissue that connect muscles to bones. This inflammation can affect any tendon, but is most commonly seen in the wrist and fingers. As the tendons become irritated, pain and swelling will occur.

Tenosynovitis is the inflammation of the lining of the tendon sheaths which enclose the tendons. Sometimes both the sheath and the tendon may become inflamed. The cause of Tenosynovitis is usually strain, excessive use, or injury. Tendonitis may also be related to diseases such as Rheumatoid Arthritis or Diabetis can be implicated in this condition.

Common tendon disorders include:

Lateral Epicondylitis. (Known as Tennis Elbow)
This condition is characterised by pain in the back of the elbow and forearm, and along the thumb side of the forearm when the arm is alongside the body when the thumb is turned out. The cause of pain is the damage to the tendons that bend the wrist backwards away from the palm (wrist extensors).

Medical Epicondylitis. (Known as Golfer’s Elbow).
This is a condition characterised by pain from the elbow to the wrist on the palm side of the forearm the pain is caused by damage to the tendons that bend the wrist toward the palm (wrist flexors).

DeQuervain’s Tenosynovitis.
This is far the most common type of Tenosynovitis disorder, this is when the sheath of the tendons of the thumb become swollen.

Trigger Finger.
A Tenosynovitis condition in which the tendon sheath of one of the finger flexors becomes inflamed and thickens, preventing the smooth extension or flexion of the finger. The finger may lock or suddenly hence the name “Trigger Finger”.

What are the Symptoms of Tendonitis?

The most common symptoms of Tendonitis are:

• Pain in the tendon with movement
• Fluid accumulation, swelling and inflammation
• There may be grating sensation in absence of swelling

Diagnosis of Tendonitis

Tendonitis is usually diagnosed after careful medical history and physical examination. The diagnosis is established after  tests have been completed to rule out other conditions or diseases. Joint aspirations may help to rule out gout or an infection, while X-rays may help to rule out arthritis.

Treatment for Tendonitis:

• Modification of your activity
• Splinting or immobilization
• Steroid injections
• Anti-inflammatory medications
• Surgery

Cold laser Therapy: – Tendonitis,Cold Laser therapy has  five star rating in the acceleration of the healing process and pain relief,thus reducing convalescing periods

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Shoulder Joint Tear (Glenoid Labrum Tear) injury Treatment. 

Three bones make up the shoulder joint, the shoulder blade (scapula), the collarbone (clavicle), and the upper arm bone (humerus). The head of the upper arm bone (humeral head) rests in a socket in the shoulder blade called the glenoid. The upper arm bone called the head is larger than the socket; a soft fibrous rim of tissue rim called the labrum surrounds the socket to help stabilize the joint. This rim deepens the socket, so that the head of the upper arm bone fits better. They also serve as an attachment site for several ligaments. Injuries to the tissue rim surrounding the shoulder socket can occur from acute trauma or repetitive shoulder motion.

Examples of traumatic injury include:

• Falling on an outstretched arm
• A blow to the shoulder
• A sudden jerk, as in trying to lift to heavy an object
• A violent overhead stretch or reach, as in when trying to stop a fall

Symptoms of a Shoulder Tear.

• Pain, in overhead activities
• Pulling locking, cracking or grinding
• Occasional pain with daily activities
• Perhaps a sense of instability in the shoulder
• Decreased range in movement
• Lack of strength

Cold laser Therapy: this therapy has a five star rating in the acceleration of the healing process and pain relief,thus reducing convalescing periods

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Labral Tears

Labral tears are injuries to the labrum surrounding the shoulder socket that can occur from acute trauma or repetitive shoulder motion. Examples of acute trauma include falling on an outstretched arm; a direct blow to the shoulder; a sudden violent pull, as when trying to lift a heavy object or a sudden overhead reach.

Tears can be located either above (superior) or below (inferior) the middle of the glenoid socket. A SLAP lesion (superior labrum, anterior [front] to posterior [back]) is a tear of the labrum above the middle of the socket that may also involve the biceps tendon. A tear of the labrum below the middle of the glenoid socket involving the inferior glenohumeral ligament is called a Bankart lesion. Tears of the labrum often occur with other shoulder injuries, such as a dislocated shoulder (full or partial dislocation).

The symptoms of a tear in the shoulder socket rim, which are similar to those of other shoulder injuries, include pain, usually with overhead activities; catching, locking, popping, or grinding; occasional night pain, or pain with daily activities; a sense of instability in the shoulder; decreased range of motion; or loss of strength.

Treatment

Anti-inflammatory medication and rest to relieve symptoms may be prescribed initially. Rehabilitation exercises to strengthen the rotator cuff muscles also may be recommended. If these conservative measures are insufficient, arthroscopic surgery may be prescribed.

During arthroscopic surgery, the doctor will examine the rim and the biceps tendon. If the injury is confined to the rim itself, without involving the tendon, the shoulder is still stable. The surgeon will remove the torn flap and correct any other associated problems. If the tear extends into the biceps tendon, or if the tendon is detached, the shoulder is unstable. The surgeon will need to repair and reattach the tendon using absorbable tacks, wires, or sutures.

Tears below the middle of the socket also are associated with shoulder instability. The surgeon will reattach the ligament and tighten the shoulder socket by folding over and “pleating” the tissues.

Rehabilitation

After surgery, a sling is used for three to four weeks. Your Chiropractor or Physiotherapist also will prescribe gentle, passive, and pain-free range-of-motion exercises. When the sling is removed, motion and flexibility exercises can be started. Athletes usually can begin doing sport-specific exercises six weeks after surgery, although it will be three to four months before the shoulder is fully healed.

Cold laser Therapy has a five star rating in the healing process and pain relief, thus reducing convalescing periods

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Biceps Tendon Tear at the Shoulder

The tendons attach muscle to bone. The biceps muscle in the upper arm divides into long head and a short heads near the shoulder both attach to the shoulder at different points. At the other end of the muscle the distal biceps tendon connects to the smaller bone in the lower arm called the radius. These connections help the muscle stabilize the shoulder and rotate the lower arm; it also controls the acceleration or deceleration of the arm during overhead motion.

The long head of the biceps tendon is vulnerable to injury because it travels through the shoulder joint to its point of attachment. The tears of the long head of biceps result in arm weakness; this could also affect arm further by being unable to turn the arm from palm down to palm up. Because the torn tendon can no longer keep the muscle taut, a bulge may also appear it eh upper arm. In case of the distal tendon tears the arm is unable to bed at the elbow.

Causes

Ruptures of the distal tendon near the elbow are not common. They usually occur when an unexpected or extreme force is applied to a bent arm.

The proximal biceps tendons ear the shoulder tear more readily. The tears can be partial or complete, more prevalent in people aged 35 or over and in people with previous shoulder injuries.

Symptoms

• Perhaps an audible snap.
• A bulge in the upper arm
• Bruising to the upper arm, down towards the elbow
• Sudden, sharp pain in the upper arm.
• Pain or tenderness at the shoulder

Diagnosis

A Chiropractor will examine the neck, shoulder and arm and ask you to bend the arm and tighten the biceps muscle. This is done to determine the extent of the injury.

Treatment

• Non-surgical treatment is usually all that is needed for tears in the proximal biceps tendon
• ice applications 20 minutes every hour keep down the swelling
• Anti-inflammatory medications, such as ibuprofen will reduce the pain
• Rest the muscle completely
• Flexibility and strengthening exercises will keep the shoulder mobile
• Surgical repair of a complete tendon tear
• Complete tears of the distal biceps tendon require surgery to reattach the tendon to the bone
• Partial tears of the distal biceps tendon may be treated either non- surgically or surgically
• Cold laser Therapy,Tendonitis, this therapy has a five star rating in the acceleration of the healing process, reducing convalescing periods

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 “Burners” and “Stingers”

“Burners” and “stingers” are injuries to the nerve supply of the upper limb, either at the neck or shoulder, most commonly caused by traction forces to the neck during contact or collision sports. A burning or “electric shock” sensation usually accompanies the injury followed  by immediate numbness or weakness. In most cases, the injuries are temporary and symptoms resolve quickly within seconds or minutes, although in 8 percent of cases, they can last hours, days, or even longer.

Treatment

Treatment begins by removing the athlete from the activity. Athletes are not allowed to return to sports activity until symptoms are completely gone. This can take a few minutes or several days. Athletes should never be allowed to return to sports if they have weakness or neck pain.

Although the injury gets better with time, the athlete may need to work with a Chiropractor or physiotherapist to regain strength and motion if the symptoms last for several days.

Prevention

To prevent most shoulder injuries, use correct sporting technique, along with a stretching and strengthening program that also includes the muscles of the neck.

Cold laser Therapy- this therapy has a five star rating in the acceleration of the healing process thus reducing convalescing periods.

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Triceps Anatomy

The Triceps Brachii consists of three heads: the lateral, medial, and long heads. Triceps joins the Humerus (shoulder bone) and the Scapula (shoulder blade) to the ulna which is the forearm bone. If you working out in gym you must assure you implement Triceps exercises that target all three of the Triceps heads, as this will fully develop the heads of triceps muscle.

In Training the triceps muscles, you must keep constant tension throughout triceps isolation movements over the full range of motion. It is also imperative to flex the entire triceps muscle by simply extending the arms fully to get the most muscle fibre recruitment.

Triceps Injuries Treatment

Cold laser Therapy, this therapy has a five star rating in the acceleration of the healing process, reducing convalescing periods.

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Shoulder Dislocation

Shoulder dislocations occur when the head of the humerus which is the upper arm bone, slips out of the shoulder socket of the scapula, which is called the glenoid. This can happen during severe wrench pulling the shoulder upward or outward, or from combined over-extension and external rotation of the humerus.

Glenohumeral dislocations are generally classified by the direction of dislocation of the humerus.

A dislocation can be full or partial:

• A partial dislocation which also known as subluxation, when the head of the humerus slips out of the socket momentarily and then snaps back into place (socket)
• A full dislocation, when the head of the humerus comes completely out of the socket

Shoulder dislocations are normally associated with fractures to different parts of the shoulder; there may be a fracture and dislocation at the same time. Nerves and blood vessels can sometimes be damaged with a severe shoulder dislocation.

Causes

• Falling on an outstretched arm
• A direct or powerful blow to the shoulder area.
• Repetitive sports or activities i.e. throwing or lifting
• Any kind of force applied to an outstretched arm

Symptoms

•   Swelling
•   Bruising
•   Pain, often severe
•   Shoulder contour appears abnormal
•   Bruising Instability and weakness in the shoulder area
•   Inability to move the shoulder
•   Bruising Instability and weakness in the shoulder area
•   Numbness and tingling around the shoulder or in the arm or fingers
•   Seek immediate medical attention

Cold laser Therapy, this therapy has a five star rating in the acceleration of the healing process,thus reducing convalescing periods

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Shoulder instability

Shoulder instability is a condition in which one of the bones in the shoulder joint moves partially or fully out of place. The head of the humerus, the upper arm bone, moves within the socket of the shoulder in more than one direction. Instability happens when the head of the humerus slips outside its normal position. The classification of this disorder is defined by the changes in degree of movement in the joint and by the change of direction in the movement of the joint.

Types of Shoulder Dislocation:

• Anterior
  when the humeral head moves forwards. This is a very common injury in young men. Men having great shoulder flexibility are more prone to this injury.
• Posterior
  when the humeral head moves backwards. This is due to severe muscle spasm during an electric shock or epileptic seizure.
• Multidirectional
  this occurs in people born with loose joints. Muscles contracting and relaxing may trigger a multidirectional instability episode. Also certain sports that require greater shoulder range of motion such as swimming may also lead to multidirectional instability.

Shoulder instability usually results from an old injury producing a dislocation that, even when healed, leads to stretching of the shoulder capsule and ligaments.  

 Diagnosis

 Symptoms of shoulder instability may include:

• Numb feeling down the arm
• Shoulder can slip out of place
• Pain in and around the shoulder area
• Shoulder or arm may feel weak
• Shoulder feels loose. (Slack)
• X-Ray may be needed

Treatment Options

• Cold laser Therapy, this therapy has a five star rating in the acceleration of the healing process,thus reducing convalescing periods
• Rest
• Ice will help control pain
• Nonsteroidal anti-inflammatory drugs These include: aspirin, ibuprofen (Motrin, Advil)

 Rehabilitation

Can last several months and may include: physical therapy to strengthen the muscles that control the shoulder joint.

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Collarbone fracture

The collarbone is a part of the shoulder. Its function is to connect the arm to the body. The collarbone sits directly above several important nerves and blood vessels. These vital soft tissues are rarely injured when the collarbone breaks. The collarbone is a long bone, and most breaks occur in the middle of the bone.

Causes 

A broken collarbone, or the medical term - fractured clavicle-  is a common injury. Many babies are born with a broken collarbone this is due to child birth trauma, it is also common in contacted sports such as rugby or just  as as result of general accidents where a fall results in a  severe blow or  a heavy fall to the shoulder .  

The collarbone doesn’t harden until a person is about 21 years old; a child’s collarbone can easily be broken from a direct blow or fall.

Symptoms include:

• A hump or “bump” over the fracture area
• Shoulder hanging down and forward
• Unable to lift the arm due to the pain
• A grinding sensation attempting to raise the arm

Diagnosis

There is always an obvious deformity, or “bump,” around the fractured area. A small amount of pressure over the fracture area will bring about pain. Also, a grinding feeling can be felt when the patient attempts to raise the arm. It’s rare for a fragment of bone to break through the skin, An X-ray is often done to pinpoint the location and severity of the break. Then an assessment should be carried out by a medical trained practitioner.

Nonsurgical Treatment

• Most broken collarbones heal well without surgery.
• A simple arm sling will be used to immobilize the arm. A child may have to wear the sling for 4 to 6 weeks; an adult may have to wear it for 4 to 8 weeks. Depending on the location of the break
• Cold laser Therapy,Tendonitis, this therapy has a five star rating in the acceleration of the healing process, reducing convalescing periods
• Medications, such as aspirin or ibuprofen, will help reduce pain. But for a speedy recovery see our cold laser therapy section this is under inflammatory conditions on the home page  

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Scapula Fracture

The scapula is of triangular shape and mobile. It’s also protected by a complex system of surrounding muscles. The shoulder blade or scapula fractures are very rare. Scapular fractures are usually classified at the high end of the impact scale. Falling from a significant height or a major car accident are usually the types of impact that required the scapula to fracture and is usually associated with other major injuries including broken ribs, damage to the head, lugs or spinal cord. Without treatment fractured scapula may result in chronic shoulder pain.

 Symptoms

• Abrasions to the skin.
• Swelling at the back of the shoulder.
• Sever pain when moving the arm.

Diagnosis

For appropriate treatment, your Physiotherapist or Chiropractor will probably need to take X-rays of the chest and shoulder. This can determine if one or more parts of the scapula may be fractured. The parts of the scapula that are prone to fracture are:

• Scapular body
• Scapular neck
• Glenoid
• Acromion
• Coracoid

Treatment

Non-surgical treatment such as sling works for most fractures of the scapula. The immobilization due to the sling holds the shoulder in place while the bone heals. This type of fractures may need 2 to 6 weeks of immobilization.

The shoulder may feel stiff when the sling is removed. You should begin limited active use of your shoulder immediately

Cold laser Therapy, this therapy has a five star rating in the acceleration of the healing process and pain relief, thus reducing convalescing periods.

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Acromioclavicular Joint Injury

An acromioclavicular joint injury can result from a direct blow or fall on the “tip” of the unprotected shoulder or from direct force to the anterior or front of the outstretched arm (i.e. arm tackling), which can cause deformity or elevation of the far, or distal end of the clavicle, pain, and swelling.

Treatment

Treatment with ice and compression; refer to an emergency department to rule out a fracture.

Rehabilitation

Rehabilitation is similar to a clavicle fracture but does not take as long. Gradual range of motion exercises and strengthening can be done as soon as tolerated. Cold laser Therapy has a five star rating in the healing process and pain relief, thus reducing convalescing periods

Frozen Shoulder. 

Who gets Frozen Shoulder?

Frozen Shoulder or Adhesive capsulitis is a painful condition mostly affecting people aged 30-70. It is estimated that 3% of population will develop the condition in their lifetime. There is no known racial preference; however, adhesive capsulitis is associated with certain conditions, particularly insulin-dependent diabetis.

Predisposing Factors

There are multiple risk factors predisposing an individual to development of adhesive  capsulitis. These predisposing factors may include shoulder or neck surgery, diabetis, shoulder trauma, inflammatory conditions. Other systemic conditions such as cervical cancer, autoimmune diseases and hypotyriodosm (underactive thyroid) may also to be linked to the condition.

 Diagnosis of Frozen Shoulder

 Adhesive capsulitis is diagnosed basing on symptoms and on physical examination of the shoulder. The use of  X-rays may show abnormalities such as narrowing of the joint and reduced bone density; however in early phases of adhesive capsulitis shoulder joint appearance on  X-ray is normal. 

Treatment of Frozen Shoulder 

Cold laser therapy is now used in treating this condition and is utilized by us at Central Chiropractic & Physiotherapy Clinic. Physiotherapy treatment combined with Cold Laser Therapy is extremely effective in reducing both shoulder pain and restricted movement. At present this type of treatment is not available within NHS. Cold laser Therapy has a five star rating in the acceleration of the healing process and pain relief,thus reducing convalescing periods

Treatment usually combines   use of anti-inflammatory drugs to relieve pain and inflammation with intermittent applications of heat and ice packs. Exercises are prescribed to build strength and improve movement and it is important to persist at these because recovery is gradual but slow. In some cases steroid injections into the joint may be needed. In severe cases the affected shoulder may need to be manipulated under anaesthesia before an aggressive rehabilitation program can be commenced.

Probable Outcomes

The residual symptoms of pain or stiffness are often present even after completion of course of conservative therapy. However, functional disability is rare.

Low Level Cold Laser Therapy (LLLT) is a Handheld, non invasive, light-emitting medical device which is used over different areas of the body. It provides an unmatched advantage in the treatment of conditions such as 

• Frozen shoulder
• Athletic and sports Injuries
• Lower Back Pain
• Knee and Foot Pain
• Shoulder Injury
• Carpal Tunnel Syndrome
• Arthritic pain relief and Muscle Spasm 
• Relief of Muscle stiffness, Joints and muscles, Pain Relief 
• Promotion of Muscle Relaxation and Cell Restoration
  Wound Management and including Skin Ulcers, Pressure Sores and Burns
  Soft Tissue Injuries, Including Sprains and Strains, Tendonitis and Haematomas
• Joint Disorders and Conditions including Arthritic pain relief and Tenosynovitis
• Chronic pain including Trigeminal Neuralgia and Neck and Back Shoulder pain

Frozen Shoulder Pain relief, for treatment of ligaments, tendons, muscle sprain.Cold laser Therapy, this therapy has a five star rating in the acceleration and the healing process and pain relief, thus reducing convalescing periods

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Shoulder Pain and Injuries. Call 024 7622 2002 

Specific Shoulder injury, conditions and disorders,the List include;Shoulder Function,Shoulder Problems,Shoulder Dislocation,Shoulder Instability,Frozen Shoulder,Tendonitis,Tennis Elbow, Gofers Elbow,DeQuervain’s Tenosynovitis, Rotator Cuff Tendonitis, Bursitis,Rotator Cuff Tear,Shoulder Joint Tear (Glenoid Labrum Tear),Labral Tears,Biceps Tendon Tear, Acromioclavicular Joint Injury,”Burners” and “Stingers, Triceps,  Trigger Finger,( Collarbone) Clavicle Fracture, Scapula Fracture,Cold/Low Level laser Therapy,Pain relief,injuries, conditions,and healing.

Registered with BUPA. AXA PPP. HSA. AVIVA. CIGNA. Simplyhealth. Standard life. Pru health. Mercia health.Medicash Medisure. All health insurance accepted.

Frozen Shoulder.

Who gets Frozen Shoulder?

Frozen Shoulder or Adhesive capsulitis is a painful condition mostly affecting people aged 30-70. It is estimated that 3% of population will develop the condition in their lifetime. There is no known racial preference; however, adhesive capsulitis is associated with certain conditions, particularly insulin-dependent diabetes.

Predisposing Factors.

There are multiple risk factors predisposing an individual to developing adhesive capsulitis. These predisposing factors may include, shoulder or neck surgery, diabetes, shoulder trauma, inflammatory conditions. Other systemic conditions such as cervical cancer, autoimmune diseases and hypotyriodosm (underactive thyroid) may also to be linked to the condition.

How Frozen Shoulder is Diagnosed.

Diagnosis of adhesive capsulitis is made basing on symptoms and on physical examination of the shoulder. The use of X-rays may show abnormalities such as narrowing of the joint and reduced bone density; however in early phases of adhesive capsulitis shoulder joint appearance in X-ray is normal.

Frozen Shoulder and treatment that includes other shoulder injuries and conditions.

Cold Laser Therapy/Treatment.

Cold laser therapy is now used in treating this condition and is employed by us at Central Chiropractic Clinic. Chiropractic treatment combined with Cold Laser Therapy is extremely effective in reducing both shoulder pain and restricted movement. At present this type of treatment is not available within N.H.S.

Treatment usually combines   use of anti-inflammatory drugs to relieve pain and inflammation with intermittent applications of heat and ice packs. Exercises are prescribed to build strength and improve movement and it is important to persist at these because recovery is gradual but slow. In some cases steroid injections into the joint may be needed. In severe cases the affected shoulder may need to be manipulated under anaesthesia before an aggressive rehabilitation program can be commenced.

Probable Outcomes.

The residual symptoms of pain or stiffness are often present even after completion of course of conservative therapy. However, functional disability is rare.

Low Level Cold Laser Therapy (LLLT) is a Handheld, non invasive, light-emitting medical device which is used over different areas of the body. It provides an unmatched advantage in the treatment of conditions such as Athletic Injuries;

Frozen shoulder, shoulder injuries and conditions.

Lower Back Pain
Knee and Foot Pain
Shoulder Injury
Carpal Tunnel Syndrome
Arthritis, Muscle Spasm
Relief of Muscle and Joint Pain
Skin infections, including cold sores,
Relief of Stiffness, the Promotion of Muscle Relaxation, and Cell Restoration
Wound Management, Including Skin Ulcers, Pressure Sores and Burns

Soft Tissue Injuries, including Sprains and Strains, Tendonitis and Haematomas. Ligaments and Tendons

Joint Disorders and Conditions, including Arthritis pain relief and Tenosynovitis
Chronic pain, including  Neck Shoulder and Back Pain, and Trigeminal Neuralgia

Frozen Shoulder, Pain Relief and Cold Laser Therapy/ treatment.

Cold Laser Therapy is used at our clinic for treatment of ligament and tendon injuries, muscle sprains by reducing pain and accelerating the healing processes. For further in depth information on “Pain”  “Conditions” or “Treatments” please go to top left corner.

Rotator Cuff Tendinitis or Bursitis Therapy and Treatment.

The tendons of the Rotator Cuff rotate the upper shoulder bone (humerus) and help raise the arm by pulling the Humeral head down as the Deltoid muscle pulls the arm up. These tendons may be irritated by pressure from the Acromion process of the Scapula (the upper part of the shoulder blade) and the Coraco-Acromial Ligament. This irritation of the tendons or the lubricating Bursa (connective tissue sack) is referred to as “Tendinitis” or “Bursitis”. This is known collectively as the “Impingement syndrome.

The symptoms of Impingement syndrome present not only as pain on movement, but also as constant pain. This can be accompanied by snapping or cracking sensations on movement. Symptoms may start after an injury which may result in a weakening of the shoulder muscles caused by the pain from the injury.

A clinical diagnosis of Impingement Syndrome is made by physical examination, and X-rays. Sometimes an M.R.I. scan is necessary to exclude rotator cuff tears.

Tendonitis.

Tendon problems what are they?

Two main problems associated with tendons include Tendonitis and Tenosynovitis. Tendonitis is an inflammation of the tendons-the tough cords of tissue that connect muscles to bones. This inflammation can affect any tendon, but is most commonly seen in the wrist and fingers. As the tendons become irritated, pain and swelling will occur.

Tenosynovitis is the inflammation of the lining of the tendon sheaths which enclose the tendons. Sometimes both the sheath and the tendon may become inflamed. The cause of Tenosynovitis is usually strain, excessive use, or injury. Tendonitis may also be related to diseases such as Rheumatoid Arthritis or Diabetes can be implicated in this condition.

Common tendon disorders include:

Lateral Epicondylitis. (Known as Tennis Elbow).

This condition is characterised by pain in the back of the elbow and forearm, and along the thumb side of the forearm when the arm is alongside the body when the thumb is turned out. The cause of pain is the damage to the tendons that bend the wrist backwards away from the palm (wrist extensors).

Medical Epicondylitis. (Known as Golfer’s Elbow).

This is a condition characterised by pain from the elbow to the wrist on the palm side of the forearm the pain is caused by damage to the tendons that bend the wrist toward the palm (wrist flexors).

DeQuervain’s Tenosynovits.

This is far the most common type of Tenosynovitis disorder, when the sheath of the tendons of the thumb gets swollen.

Trigger Finger.

A Tenosynovitis condition in which the tendon sheath of one of the finger flexors becomes inflamed and thickens, preventing the smooth extension or flexion of the finger. The finger may lock or suddenly hence the name “Trigger Finger”.

What are the Symptoms of Tendonitis?

The most common symptoms of Tendonitis are:

• Pain in the tendon with movement
• Fluid accumulation, swelling and inflammation
• There may be grating sensation in absence of swelling

Tendonitis Diagnose

Tendonitis is usually diagnosed after careful medical history and physical examination. The diagnosis is established after diagnostic tests have been completed to rule out other conditions or diseases. Joint aspirations may help to rule out gout or an infection, while X-rays may help to rule out arthritis.

Treatment for Tendonitis:

• Modification of your activity
• Splinting or immobilization
• Steroid injections
• Anti-inflammatory medications
• Surgery

(View our Cold Laser Therapy section under ‘Treatments’.) 

Shoulder Joint Tear (Glenoid Labrum Tear) injury Treatment. 

Three bones make up the shoulder joint, the shoulder blade (scapula), the collarbone (clavicle), and the upper arm bone (humerus). The head of the upper arm bone (humeral head) rests in a socket in the shoulder blade called the glenoid. The upper arm bone called the head is larger than the socket; a soft fibrous rim of tissue rim called the labrum surrounds the socket to help stabilize the joint. This rim deepens the socket, so that the head of the upper arm bone fits better. They also serve as an attachment site for several ligaments. Injuries to the tissue rim surrounding the shoulder socket can occur from acute trauma or repetitive shoulder motion.

Examples of traumatic injury include:

• Falling on an outstretched arm
• A blow to the shoulder
• A sudden jerk, as in trying to lift to heavy an object
• A violent overhead stretch or reach, as in when trying to stop a fall

Symptoms of a Shoulder Tear.

• Pain, in overhead activities
• Pulling locking, cracking or grinding
• Occasional pain with daily activities
• Perhaps a sense of instability in the shoulder
• Decreased range in movement
• Lack of strength

Orthopaedic consultant is available at Central Chiropractic Clinic. 

Acromioclavicular Joint .

Anacromioclavicular  joint injury can result from a direct blow or fall on the “tip” of the unprotected shoulder or from direct force to the anterior or front of the outstretched arm (i.e. arm tackling), which can cause deformity or elevation of the far, or distal end of the clavicle, pain, and swelling.

Treatment.

Treatment with ice and compression; refer to an emergency department to rule out a fracture.

Rehabilitation.

Rehabilitation is similar to a clavicle fracture but does not take as long. Gradual range of motion exercises and strengthening can be done as soon as tolerated.

“Burners” and “Stingers”

“Burners” and “stingers” are injuries to the nerve supply of the upper limb, either at the neck or shoulder, most commonly caused by traction forces to the neck during contact or collision sports. A burning or “electric shock” sensation usually accompanies the injury, then, immediate numbness or weakness. In most cases, the injuries are temporary and symptoms resolve quickly, within seconds or minutes, although in 8 percent of cases, they can last hours, days, or even longer.

Treatment.

Treatment begins by removing the athlete from the activity. Athletes are not allowed to return to sports activity until symptoms are completely gone. This can take a few minutes or several days. Athletes should never be allowed to return to sports if they have weakness or neck pain.

Although the injury gets better with time, the athlete may need to work with a Chiropractor or physiotherapist to regain strength and motion if the symptoms last for several days.

Prevention.

To prevent most shoulder injuries, use correct technique at all times, along with a stretching and strengthening program that also includes the muscles of the neck.

Biceps Tendon Tear at the Shoulder.

The tendons attach muscle to bone. The biceps muscle in the upper arm divides into long head and a short heads near the shoulder both attach to the shoulder at different points. At the other end of the muscle the distal biceps tendon connects to the smaller bone in the lower arm called the radius. These connections help the muscle stabilize the shoulder and rotate the lower arm; it also controls the acceleration or deceleration of the arm during overhead motion.

 The long head of the biceps tendon is vulnerable to injury because it travels through the shoulder joint to its point of attachment. The tears of the long head of biceps result in arm weakness; this could also affect arm further by being unable to turn the arm from palm down to palm up. Because the torn tendon can no longer keep the muscle taut, a bulge may also appear it eh upper arm. In case of the distal tendon tears the arm is unable to bed at the elbow.

Causes.

Ruptures of the distal tendon near the elbow are not common. They usually occur when an unexpected or extreme force is applied to a bent arm.

The proximal biceps tendons ear the shoulder tear more readily. The tears can be partial or complete, more prevalent in people aged 35 or over and in people with previous shoulder injuries.

Symptoms.

• Perhaps an audible snap.
• A bulge in the upper arm
• Bruising to the upper arm, down towards the elbow
• Sudden, sharp pain in the upper arm.
• Pain or tenderness at the shoulder

Diagnosis.

A Chiropractor or Physiotherapist will examine the neck, shoulder and arm and ask you to bend the arm and tighten the biceps muscle. This is done to determine the extent of the injury.

Treatment

• Non-surgical treatment is usually all that is needed for tears in the proximal biceps tendon
• ice applications 20 minutes every hour keep down the swelling
• Anti-inflammatory medications, such as ibuprofen will reduce the pain
• Rest the muscle completely
• Flexibility and strengthening exercises will keep the shoulder mobile
• Surgical repair of a complete tendon tear
• Complete tears of the distal biceps tendon require surgery to reattach the tendon to the bone
• Partial tears of the distal biceps tendon may be treated either non surgically or surgically

Triceps Anatomy.

The Triceps Brachii consists of three heads: the lateral, medial, and long heads. Triceps joins the Humerus (shoulder bone) and the Scapula (shoulder blade) to the ulna which is the forearm bone. If you working out in gym you must assure you implement Triceps exercises that target all three of the Triceps heads, as this will fully develop the heads of triceps muscle.

In Training the triceps muscles, you must keep a constant tension throughout triceps isolation movements over the full range of motion. It is also imperative to flex the entire triceps muscle by simply extending the arms fully to get the most muscle fibre recruitment.

Triceps Injury and Treatment

Chiropractic treatment including Cold Laser Therapy (used by professional weight lifters and body builders and football clubs such as Chelsea FC.)

For further information on shoulder pain, triceps, Biceps, and other shoulder conditions, go to top left under “Pain” or “Conditions” and “Treatments” for Cold Laser Therapy,  

Shoulder Dislocation.

West Midlands shoulder dislocations occur when the head of the humerus which is the upper arm bone, jumps out of the shoulder socket of the scapula, which is called the glenoid. This can happen during severe wrench pulling the shoulder upward or outward, or from combined over-extension and external rotation of the humerus.

Glenohumeral dislocations are generally classified by the direction of dislocation of the humerus.

A dislocation can be full or partial:

• A partial dislocation which also known as subluxation, when the head of the humerus slips out of the socket momentarily and then snaps back into place (socket)
• A full dislocation, when the head of the humerus comes completely out of the socket

Shoulder dislocations are normally associated with fractures to different parts of the shoulder; there may be a fracture and dislocation at the same time. Nerves and blood vessels can sometimes be injured with a severe shoulder dislocation.

Causes.

• Falling on an outstretched arm
• A direct or powerful blow to the shoulder area.
• Repetitive sports or activities i.e. throwing or lifting
• Any kind of force applied to an outstretched arm

Symptoms.

•   Swelling
•   Bruising
•   Pain, often severe
•   Shoulder contour appears abnormal
•   Bruising Instability and weakness in the shoulder area
•   Inability to move the shoulder
•   Bruising Instability and weakness in the shoulder area
•   Numbness and tingling around the shoulder or in the arm or fingers
•    Seek immediate medical attention.

Shoulder instability.

Shoulder instability is a condition in which one of the bones in the shoulder joint moves partially or fully out of place. The head of the humerus, the upper arm bone, moves within the socket of the shoulder in more than one direction. Instability happens when the head of the humerus slips outside its normal position. The classification of this disorder is defined by the changes in degree of movement in the joint and by the change of direction in the movement of the joint.

Dislocation.

When the humeral head moves completely out of the socket

Subluxation.

Humeral head moves partially out of the shoulder socket.

• Anterior
  when the humeral head moves forwards. This is a very common injury in young men. Men having great shoulder flexibility are more prone to this injury.
• Posterior
  when the humeral head moves backwards. This is due to severe muscle spasm during an electric shock or epileptic seizure.
• Multidirectional
  this occurs in people born with loose joints. Muscles contracting and relaxing may trigger a multidirectional instability episode. Also certain sports that require greater shoulder range of motion such as swimming may also lead to multidirectional instability.

Shoulder instability usually results from an old injury producing a dislocation that, even when healed, leads to stretching of the shoulder capsule and ligaments.  

 Diagnosis.

 Symptoms of shoulder instability may include:

• Numb feeling down the arm
• Shoulder can slip out of place
• Pain in and around the shoulder area
• Shoulder or arm may feel weak
• Shoulder feels loose. (Slack)
• X-Ray may be needed
• Treatment Options
• Rest
• Ice will help control pain
• Nonsteroidal anti-inflammatory drugs these include: aspirin, ibuprofen (Motrin, Advil)

 Rehabilitation

Can last several months and may include: physical therapy to strengthen the muscles that control the shoulder joint.

Collarbone fracture.

The collarbone is a part of the shoulder. Its function is to connect the arm to the body. The collarbone sits directly above several important nerves and blood vessels. These vital soft tissues are rarely injured when the collarbone breaks. The collarbone is a long bone, and most breaks occur in the middle of the bone.

Causes. 

A broken collarbone, or the medical term a fractured clavicle is a common injury. Many babies are born with a broken collarbone this is due to child birth, also to people in contacted sports such as rugby or just general accidents where a fall results in a severe blow or a heavy fall to the shoulder .  

The collarbone doesn’t harden until a person is about 21 years old; a child’s collarbone can easily be broken from a direct blow or fall.

Symptoms include.

• A hump or “bump” over the fracture area
• Shoulder hanging down and forward
• Unable to lift the arm due to the pain
• A grinding sensation attempting to raise the arm

Diagnosis.

There is always an obvious deformity, or “bump,” around the fractured area. A small amount of pressure over the fracture area will bring about pain. Also, a grinding feeling can be felt when the patient attempts to raise the arm. It’s rare for a fragment of bone to break through the skin; An X-ray is often done to pinpoint the location and severity of the break. Then an assessment should be carried out by a medical trained practitioner.

Nonsurgical Treatment.

• Most broken collarbones heal well without surgery.
• A simple arm sling will be used to immobilize the arm. A child may have to wear the sling for 4 to 6 weeks; an adult may have to wear it for 4 to 8 weeks. Depending on the location of the break
• Medications, such as aspirin or ibuprofen, will help reduce pain. But for a speedy recovery see our cold laser therapy section this is under inflammatory conditions on the home page   

Scapula Fracture.

The scapula is of triangular shape and mobile. It’s also protected by a complex system of surrounding muscles. The shoulder blade or scapula fractures are very rare. Scapular fractures are usually classified at the high end of the impact scale. Falling from a significant height or a major car accident are usually the types of impact that required the scapula to fracture and is usually associated with other major injuries including broken ribs, damage to the head, lugs or spinal cord. Without treatment fractured scapula may result in chronic shoulder pain.

 Symptoms.

• Abrasions to the skin.
• Swelling at the back of the shoulder.
• Sever pain when moving the arm.

Diagnosis.

For appropriate treatment, your Chiropractor or Physiotherapy will probably need to take X-rays of the chest and shoulder. This can determine if one or more parts of the scapula may be fractured. The parts of the scapula that are prone to fracture are:

• Scapular body
• Scapular neck
• Glenoid
• Acromion
• Coracoid

Treatment.

Non-surgical treatment such as sling works for most fractures of the scapula. The immobilization due to the sling holds the shoulder in place while the bone heals. This type of fractures may need 2 to 6 weeks of immobilization.

The shoulder may feel stiff when the sling is removed. You should begin limited active use of your shoulder immediately

(Visit our cold laser therapy section for treatment and  recovery ).

For further in depth information please go to top left corner under “Pain” or “Conditions” and “Treatments” for Cold Laser Therapy.

Specific Shoulder injury, conditions and disorders,the List include;Shoulder Function,Shoulder Problems,Shoulder Dislocation,Shoulder Instability,Frozen Shoulder,Tendonitis,Tennis Elbow, Gofers Elbow,DeQuervain’s Tenosynovitis, Rotator Cuff Tendonitis, Bursitis,Rotator Cuff Tear,Shoulder Joint Tear (Glenoid Labrum Tear),Labral Tears,Biceps Tendon Tear, Acromioclavicular Joint Injury,”Burners” and “Stingers, Triceps,  Trigger Finger,( Collarbone) Clavicle Fracture, Scapula Fracture,Cold/Low Level laser Therapy,Pain relief,injuries, conditions,and healing. Cold/Low level  laser Therapy/ Treatment this therapy has a five star rating in the acceleration and the healing process and pain relief, reducing  time convalescing .

Call 02476 222002.Registered with BUPA. AXA  PPP. HSA. AVIVA. Simplyhealth. Standard Life. Mercia health. BHSF. Pru health .Cigna Police health care scheme Medicare  Medisure. Medicash and all other healthcare insurers .

Shoulder

In human anatomy, the shoulder joint comprises the part of the body where the humerus attaches to the scapula. It is made up of three bones: the clavicle (collarbone), the scapula (shoulder blade), and the humerus (upper arm bone) as well as associated muscles, ligaments and tendons. The articulations between the bones of the shoulder make up the shoulder joints

There are two kinds of cartilage in the joint. The first type is the white cartilage on the ends of the bones (called articular cartilage) which allows the bones to glide and move on each other. When this type of cartilage starts to wear out (a process called arthritis), the joint becomes painful and stiff. The labrum is a second kind of cartilage in the shoulder which is distinctly different from the articular cartilage. This cartilage is more fibrous or rigid than the cartilage on the ends of the ball and socket.  The shoulder must be flexible for the wide range of motion required in the arms and hands and also strong enough to allow for actions such as lifting, pushing and pulling. The compromise between these two functions results in a large number of shoulder problems not faced by other joints such as the hip.

 How Common Are Shoulder Problems?

Throughout the UK people seek medical care each year for shoulder pain, sprain, strain, dislocation, or other associated conditions and disorders. Shoulder problems are ones of the most common, seen by Chiropractors, Physiotherapists and Doctors who treat disorders of the bones, muscles, and related structures.

What Are the Structures of the Shoulder and How Does the Shoulder Function?

The shoulder joint is composed of three bones: the clavicle (collarbone), the scapula (shoulder blade), and the humerus (upper arm bone) (see diagram). Two joints facilitate shoulder movement. The acromioclavicular (AC) joint is located between the acromion (part of the scapula that forms the highest point of the shoulder) and the clavicle. The glenohumeral joint, commonly called the shoulder joint, is a ball-and-socket type joint that helps move the shoulder forward and backward and allows the arm to rotate in a circular fashion or hinge out and up away from the body. (The ball is the top, rounded portion of the upper arm bone or humerus; the socket,” or glenoid, is a dish-shaped part of the outer edge of the scapula into which the ball fits.) The capsule is a soft tissue envelope that encircles the glenohumeral joint. It is lined by a thin, smooth synovial membrane.

The bones of the shoulder are held in place by muscles, tendons, and ligaments. Tendons are tough cords of tissue that attach the shoulder muscles to bone and assist the muscles in moving the shoulder. Ligaments attach shoulder bones to each other providing stability. For example, the front of the joint capsule is anchored by three glenohumeral ligaments.

The rotator cuff is a structure composed of tendons that, with associated muscles, holds the ball at the top of the humerus in the glenoid socket and provides mobility and strength to the shoulder joint. Two fluid sac-like structures called bursae permit smooth gliding between bone, muscle, and tendon. They cushion and protect the rotator cuff from the bony arch of the acromion.

What Are the Origins and Causes of Shoulder Problems?

The shoulder is the most movable joint in the body. However, it is an unstable joint because of the range of motion allowed. It is easily subject to injury because the ball of the upper arm is larger than the shoulder socket that holds it. To remain stable, the shoulder must be anchored by its muscles, tendons, and ligaments. Some shoulder problems arise from the disruption of these soft tissues as a result of injury or from overuse or under use of the shoulder. Other problems arise from a degenerative process in which tissues break down and no longer function well.

Shoulder pain may be localized or may be referred to areas around the shoulder or down the arm. Disease within the body (such as gallbladder, liver, or heart disease, or disease of the neck) also may generate pain that travels along nerves to the shoulder.

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Rotator Cuff Tendonitis or Bursitis Therapy and Treatment

The tendons of the Rotator Cuff rotate the upper shoulder bone (humerus) and help raise the arm by pulling the Humeral head down as the Deltoid muscle pulls the arm up. These tendons may be irritated by pressure from the Acromion process of the Scapula (the upper part of the shoulder blade) and the Coraco-Acromial Ligament. This irritation of the tendons or the lubricating Bursa (connective tissue sack) is referred to as “Tendonitis” or “Bursitis”. This is known collectively as the “Impingement syndrome.

The symptoms of Impingement syndrome present not only as pain on movement, but also as constant pain. This can be accompanied by snapping or cracking sensations on movement. Symptoms may start after an injury which may result in a weakening of the shoulder muscles caused by the pain from the injury.

A clinical diagnosis of Impingement Syndrome is made by physical examination, and X-rays. Sometimes an MRI. scan is necessary to exclude rotator cuff tears.

Cold laser Therapy has a five star rating in the healing process and pain relief, reducing convalescing periods

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Tendonitis

Tendon problems what are they?

Two main problems associated with tendons include Tendonitis and Tenosynovitis. Tendonitis is an inflammation of the tendons-the tough cords of tissue that connect muscles to bones. This inflammation can affect any tendon, but is most commonly seen in the wrist and fingers. As the tendons become irritated, pain and swelling will occur.

Tenosynovitis is the inflammation of the lining of the tendon sheaths which enclose the tendons. Sometimes both the sheath and the tendon may become inflamed. The cause of Tenosynovitis is usually strain, excessive use, or injury. Tendonitis may also be related to diseases such as Rheumatoid Arthritis or Diabetis can be implicated in this condition.

Common tendon disorders include:

Lateral Epicondylitis. (Known as Tennis Elbow)
This condition is characterised by pain in the back of the elbow and forearm, and along the thumb side of the forearm when the arm is alongside the body when the thumb is turned out. The cause of pain is the damage to the tendons that bend the wrist backwards away from the palm (wrist extensors).

Medical Epicondylitis. (Known as Golfer’s Elbow).
This is a condition characterised by pain from the elbow to the wrist on the palm side of the forearm the pain is caused by damage to the tendons that bend the wrist toward the palm (wrist flexors).

DeQuervain’s Tenosynovitis.
This is far the most common type of Tenosynovitis disorder, this is when the sheath of the tendons of the thumb become swollen.

Trigger Finger.
A Tenosynovitis condition in which the tendon sheath of one of the finger flexors becomes inflamed and thickens, preventing the smooth extension or flexion of the finger. The finger may lock or suddenly hence the name “Trigger Finger”.

What are the Symptoms of Tendonitis?

The most common symptoms of Tendonitis are:

• Pain in the tendon with movement
• Fluid accumulation, swelling and inflammation
• There may be grating sensation in absence of swelling

Diagnosis of Tendonitis

Tendonitis is usually diagnosed after careful medical history and physical examination. The diagnosis is established after  tests have been completed to rule out other conditions or diseases. Joint aspirations may help to rule out gout or an infection, while X-rays may help to rule out arthritis.

Treatment for Tendonitis:

• Modification of your activity
• Splinting or immobilization
• Steroid injections
• Anti-inflammatory medications
• Surgery

Cold laser Therapy: – Tendonitis,Cold Laser therapy has  five star rating in the acceleration of the healing process and pain relief,thus reducing convalescing periods

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Shoulder Joint Tear (Glenoid Labrum Tear) injury Treatment. 

Three bones make up the shoulder joint, the shoulder blade (scapula), the collarbone (clavicle), and the upper arm bone (humerus). The head of the upper arm bone (humeral head) rests in a socket in the shoulder blade called the glenoid. The upper arm bone called the head is larger than the socket; a soft fibrous rim of tissue rim called the labrum surrounds the socket to help stabilize the joint. This rim deepens the socket, so that the head of the upper arm bone fits better. They also serve as an attachment site for several ligaments. Injuries to the tissue rim surrounding the shoulder socket can occur from acute trauma or repetitive shoulder motion.

Examples of traumatic injury include:

• Falling on an outstretched arm
• A blow to the shoulder
• A sudden jerk, as in trying to lift to heavy an object
• A violent overhead stretch or reach, as in when trying to stop a fall

Symptoms of a Shoulder Tear.

• Pain, in overhead activities
• Pulling locking, cracking or grinding
• Occasional pain with daily activities
• Perhaps a sense of instability in the shoulder
• Decreased range in movement
• Lack of strength

Cold laser Therapy: this therapy has a five star rating in the acceleration of the healing process and pain relief,thus reducing convalescing periods

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Labral Tears

Labral tears are injuries to the labrum surrounding the shoulder socket that can occur from acute trauma or repetitive shoulder motion. Examples of acute trauma include falling on an outstretched arm; a direct blow to the shoulder; a sudden violent pull, as when trying to lift a heavy object or a sudden overhead reach.

Tears can be located either above (superior) or below (inferior) the middle of the glenoid socket. A SLAP lesion (superior labrum, anterior [front] to posterior [back]) is a tear of the labrum above the middle of the socket that may also involve the biceps tendon. A tear of the labrum below the middle of the glenoid socket involving the inferior glenohumeral ligament is called a Bankart lesion. Tears of the labrum often occur with other shoulder injuries, such as a dislocated shoulder (full or partial dislocation).

The symptoms of a tear in the shoulder socket rim, which are similar to those of other shoulder injuries, include pain, usually with overhead activities; catching, locking, popping, or grinding; occasional night pain, or pain with daily activities; a sense of instability in the shoulder; decreased range of motion; or loss of strength.

Treatment

Anti-inflammatory medication and rest to relieve symptoms may be prescribed initially. Rehabilitation exercises to strengthen the rotator cuff muscles also may be recommended. If these conservative measures are insufficient, arthroscopic surgery may be prescribed.

During arthroscopic surgery, the doctor will examine the rim and the biceps tendon. If the injury is confined to the rim itself, without involving the tendon, the shoulder is still stable. The surgeon will remove the torn flap and correct any other associated problems. If the tear extends into the biceps tendon, or if the tendon is detached, the shoulder is unstable. The surgeon will need to repair and reattach the tendon using absorbable tacks, wires, or sutures.

Tears below the middle of the socket also are associated with shoulder instability. The surgeon will reattach the ligament and tighten the shoulder socket by folding over and “pleating” the tissues.

Rehabilitation

After surgery, a sling is used for three to four weeks. Your Chiropractor or Physiotherapist also will prescribe gentle, passive, and pain-free range-of-motion exercises. When the sling is removed, motion and flexibility exercises can be started. Athletes usually can begin doing sport-specific exercises six weeks after surgery, although it will be three to four months before the shoulder is fully healed.

Cold laser Therapy has a five star rating in the healing process and pain relief, thus reducing convalescing periods

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Biceps Tendon Tear at the Shoulder

The tendons attach muscle to bone. The biceps muscle in the upper arm divides into long head and a short heads near the shoulder both attach to the shoulder at different points. At the other end of the muscle the distal biceps tendon connects to the smaller bone in the lower arm called the radius. These connections help the muscle stabilize the shoulder and rotate the lower arm; it also controls the acceleration or deceleration of the arm during overhead motion.

The long head of the biceps tendon is vulnerable to injury because it travels through the shoulder joint to its point of attachment. The tears of the long head of biceps result in arm weakness; this could also affect arm further by being unable to turn the arm from palm down to palm up. Because the torn tendon can no longer keep the muscle taut, a bulge may also appear it eh upper arm. In case of the distal tendon tears the arm is unable to bed at the elbow.

Causes

Ruptures of the distal tendon near the elbow are not common. They usually occur when an unexpected or extreme force is applied to a bent arm.

The proximal biceps tendons ear the shoulder tear more readily. The tears can be partial or complete, more prevalent in people aged 35 or over and in people with previous shoulder injuries.

Symptoms

• Perhaps an audible snap.
• A bulge in the upper arm
• Bruising to the upper arm, down towards the elbow
• Sudden, sharp pain in the upper arm.
• Pain or tenderness at the shoulder

Diagnosis

A Chiropractor will examine the neck, shoulder and arm and ask you to bend the arm and tighten the biceps muscle. This is done to determine the extent of the injury.

Treatment

• Non-surgical treatment is usually all that is needed for tears in the proximal biceps tendon
• ice applications 20 minutes every hour keep down the swelling
• Anti-inflammatory medications, such as ibuprofen will reduce the pain
• Rest the muscle completely
• Flexibility and strengthening exercises will keep the shoulder mobile
• Surgical repair of a complete tendon tear
• Complete tears of the distal biceps tendon require surgery to reattach the tendon to the bone
• Partial tears of the distal biceps tendon may be treated either non- surgically or surgically
• Cold laser Therapy,Tendonitis, this therapy has a five star rating in the acceleration of the healing process, reducing convalescing periods

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 “Burners” and “Stingers”

“Burners” and “stingers” are injuries to the nerve supply of the upper limb, either at the neck or shoulder, most commonly caused by traction forces to the neck during contact or collision sports. A burning or “electric shock” sensation usually accompanies the injury followed  by immediate numbness or weakness. In most cases, the injuries are temporary and symptoms resolve quickly within seconds or minutes, although in 8 percent of cases, they can last hours, days, or even longer.

Treatment

Treatment begins by removing the athlete from the activity. Athletes are not allowed to return to sports activity until symptoms are completely gone. This can take a few minutes or several days. Athletes should never be allowed to return to sports if they have weakness or neck pain.

Although the injury gets better with time, the athlete may need to work with a Chiropractor or physiotherapist to regain strength and motion if the symptoms last for several days.

Prevention

To prevent most shoulder injuries, use correct sporting technique, along with a stretching and strengthening program that also includes the muscles of the neck.

Cold laser Therapy- this therapy has a five star rating in the acceleration of the healing process thus reducing convalescing periods.

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Triceps Anatomy

The Triceps Brachii consists of three heads: the lateral, medial, and long heads. Triceps joins the Humerus (shoulder bone) and the Scapula (shoulder blade) to the ulna which is the forearm bone. If you working out in gym you must assure you implement Triceps exercises that target all three of the Triceps heads, as this will fully develop the heads of triceps muscle.

In Training the triceps muscles, you must keep constant tension throughout triceps isolation movements over the full range of motion. It is also imperative to flex the entire triceps muscle by simply extending the arms fully to get the most muscle fibre recruitment.

Triceps Injuries Treatment

Cold laser Therapy, this therapy has a five star rating in the acceleration of the healing process, reducing convalescing periods.

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Shoulder Dislocation

Shoulder dislocations occur when the head of the humerus which is the upper arm bone, slips out of the shoulder socket of the scapula, which is called the glenoid. This can happen during severe wrench pulling the shoulder upward or outward, or from combined over-extension and external rotation of the humerus.

Glenohumeral dislocations are generally classified by the direction of dislocation of the humerus.

A dislocation can be full or partial:

• A partial dislocation which also known as subluxation, when the head of the humerus slips out of the socket momentarily and then snaps back into place (socket)
• A full dislocation, when the head of the humerus comes completely out of the socket

Shoulder dislocations are normally associated with fractures to different parts of the shoulder; there may be a fracture and dislocation at the same time. Nerves and blood vessels can sometimes be damaged with a severe shoulder dislocation.

Causes

• Falling on an outstretched arm
• A direct or powerful blow to the shoulder area.
• Repetitive sports or activities i.e. throwing or lifting
• Any kind of force applied to an outstretched arm

Symptoms

•   Swelling
•   Bruising
•   Pain, often severe
•   Shoulder contour appears abnormal
•   Bruising Instability and weakness in the shoulder area
•   Inability to move the shoulder
•   Bruising Instability and weakness in the shoulder area
•   Numbness and tingling around the shoulder or in the arm or fingers
•   Seek immediate medical attention

Cold laser Therapy, this therapy has a five star rating in the acceleration of the healing process,thus reducing convalescing periods

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Shoulder instability

Shoulder instability is a condition in which one of the bones in the shoulder joint moves partially or fully out of place. The head of the humerus, the upper arm bone, moves within the socket of the shoulder in more than one direction. Instability happens when the head of the humerus slips outside its normal position. The classification of this disorder is defined by the changes in degree of movement in the joint and by the change of direction in the movement of the joint.

Types of Shoulder Dislocation:

• Anterior
  when the humeral head moves forwards. This is a very common injury in young men. Men having great shoulder flexibility are more prone to this injury.
• Posterior
  when the humeral head moves backwards. This is due to severe muscle spasm during an electric shock or epileptic seizure.
• Multidirectional
  this occurs in people born with loose joints. Muscles contracting and relaxing may trigger a multidirectional instability episode. Also certain sports that require greater shoulder range of motion such as swimming may also lead to multidirectional instability.

Shoulder instability usually results from an old injury producing a dislocation that, even when healed, leads to stretching of the shoulder capsule and ligaments.  

 Diagnosis

 Symptoms of shoulder instability may include:

• Numb feeling down the arm
• Shoulder can slip out of place
• Pain in and around the shoulder area
• Shoulder or arm may feel weak
• Shoulder feels loose. (Slack)
• X-Ray may be needed

Treatment Options

• Cold laser Therapy, this therapy has a five star rating in the acceleration of the healing process,thus reducing convalescing periods
• Rest
• Ice will help control pain
• Nonsteroidal anti-inflammatory drugs These include: aspirin, ibuprofen (Motrin, Advil)

 Rehabilitation

Can last several months and may include: physical therapy to strengthen the muscles that control the shoulder joint.

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Collarbone fracture

The collarbone is a part of the shoulder. Its function is to connect the arm to the body. The collarbone sits directly above several important nerves and blood vessels. These vital soft tissues are rarely injured when the collarbone breaks. The collarbone is a long bone, and most breaks occur in the middle of the bone.

Causes 

A broken collarbone, or the medical term - fractured clavicle-  is a common injury. Many babies are born with a broken collarbone this is due to child birth trauma, it is also common in contacted sports such as rugby or just  as as result of general accidents where a fall results in a  severe blow or  a heavy fall to the shoulder .  

The collarbone doesn’t harden until a person is about 21 years old; a child’s collarbone can easily be broken from a direct blow or fall.

Symptoms include:

• A hump or “bump” over the fracture area
• Shoulder hanging down and forward
• Unable to lift the arm due to the pain
• A grinding sensation attempting to raise the arm

Diagnosis

There is always an obvious deformity, or “bump,” around the fractured area. A small amount of pressure over the fracture area will bring about pain. Also, a grinding feeling can be felt when the patient attempts to raise the arm. It’s rare for a fragment of bone to break through the skin, An X-ray is often done to pinpoint the location and severity of the break. Then an assessment should be carried out by a medical trained practitioner.

Nonsurgical Treatment

• Most broken collarbones heal well without surgery.
• A simple arm sling will be used to immobilize the arm. A child may have to wear the sling for 4 to 6 weeks; an adult may have to wear it for 4 to 8 weeks. Depending on the location of the break
• Cold laser Therapy,Tendonitis, this therapy has a five star rating in the acceleration of the healing process, reducing convalescing periods
• Medications, such as aspirin or ibuprofen, will help reduce pain. But for a speedy recovery see our cold laser therapy section this is under inflammatory conditions on the home page  

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Scapula Fracture

The scapula is of triangular shape and mobile. It’s also protected by a complex system of surrounding muscles. The shoulder blade or scapula fractures are very rare. Scapular fractures are usually classified at the high end of the impact scale. Falling from a significant height or a major car accident are usually the types of impact that required the scapula to fracture and is usually associated with other major injuries including broken ribs, damage to the head, lugs or spinal cord. Without treatment fractured scapula may result in chronic shoulder pain.

 Symptoms

• Abrasions to the skin.
• Swelling at the back of the shoulder.
• Sever pain when moving the arm.

Diagnosis

For appropriate treatment, your Physiotherapist or Chiropractor will probably need to take X-rays of the chest and shoulder. This can determine if one or more parts of the scapula may be fractured. The parts of the scapula that are prone to fracture are:

• Scapular body
• Scapular neck
• Glenoid
• Acromion
• Coracoid

Treatment

Non-surgical treatment such as sling works for most fractures of the scapula. The immobilization due to the sling holds the shoulder in place while the bone heals. This type of fractures may need 2 to 6 weeks of immobilization.

The shoulder may feel stiff when the sling is removed. You should begin limited active use of your shoulder immediately

Cold laser Therapy, this therapy has a five star rating in the acceleration of the healing process and pain relief, thus reducing convalescing periods.

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Acromioclavicular Joint Injury

An acromioclavicular joint injury can result from a direct blow or fall on the “tip” of the unprotected shoulder or from direct force to the anterior or front of the outstretched arm (i.e. arm tackling), which can cause deformity or elevation of the far, or distal end of the clavicle, pain, and swelling.

Treatment

Treatment with ice and compression; refer to an emergency department to rule out a fracture.

Rehabilitation

Rehabilitation is similar to a clavicle fracture but does not take as long. Gradual range of motion exercises and strengthening can be done as soon as tolerated. Cold laser Therapy has a five star rating in the healing process and pain relief, thus reducing convalescing periods

Frozen Shoulder. 

Who gets Frozen Shoulder?

Frozen Shoulder or Adhesive capsulitis is a painful condition mostly affecting people aged 30-70. It is estimated that 3% of population will develop the condition in their lifetime. There is no known racial preference; however, adhesive capsulitis is associated with certain conditions, particularly insulin-dependent diabetis.

Predisposing Factors

There are multiple risk factors predisposing an individual to development of adhesive  capsulitis. These predisposing factors may include shoulder or neck surgery, diabetis, shoulder trauma, inflammatory conditions. Other systemic conditions such as cervical cancer, autoimmune diseases and hypotyriodosm (underactive thyroid) may also to be linked to the condition.

 Diagnosis of Frozen Shoulder

 Adhesive capsulitis is diagnosed basing on symptoms and on physical examination of the shoulder. The use of  X-rays may show abnormalities such as narrowing of the joint and reduced bone density; however in early phases of adhesive capsulitis shoulder joint appearance on  X-ray is normal. 

Treatment of Frozen Shoulder 

Cold laser therapy is now used in treating this condition and is utilized by us at Central Chiropractic & Physiotherapy Clinic. Physiotherapy treatment combined with Cold Laser Therapy is extremely effective in reducing both shoulder pain and restricted movement. At present this type of treatment is not available within NHS. Cold laser Therapy has a five star rating in the acceleration of the healing process and pain relief,thus reducing convalescing periods

Treatment usually combines   use of anti-inflammatory drugs to relieve pain and inflammation with intermittent applications of heat and ice packs. Exercises are prescribed to build strength and improve movement and it is important to persist at these because recovery is gradual but slow. In some cases steroid injections into the joint may be needed. In severe cases the affected shoulder may need to be manipulated under anaesthesia before an aggressive rehabilitation program can be commenced.

Probable Outcomes

The residual symptoms of pain or stiffness are often present even after completion of course of conservative therapy. However, functional disability is rare.

Low Level Cold Laser Therapy (LLLT) is a Handheld, non invasive, light-emitting medical device which is used over different areas of the body. It provides an unmatched advantage in the treatment of conditions such as 

• Frozen shoulder
• Athletic and sports Injuries
• Lower Back Pain
• Knee and Foot Pain
• Shoulder Injury
• Carpal Tunnel Syndrome
• Arthritic pain relief and Muscle Spasm 
• Relief of Muscle stiffness, Joints and muscles, Pain Relief 
• Promotion of Muscle Relaxation and Cell Restoration
  Wound Management and including Skin Ulcers, Pressure Sores and Burns
  Soft Tissue Injuries, Including Sprains and Strains, Tendonitis and Haematomas
• Joint Disorders and Conditions including Arthritic pain relief and Tenosynovitis
• Chronic pain including Trigeminal Neuralgia and Neck and Back Shoulder pain

Frozen Shoulder Pain relief, for treatment of ligaments, tendons, muscle sprain.Cold laser Therapy, this therapy has a five star rating in the acceleration and the healing process and pain relief, thus reducing convalescing periods

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Neck Shoulder & Back Pain Cervicalgia. Cervicogenic Headaches. Symptoms of Cervical Disc Injuries. Call 024 7622 2002. Reg’d with BUPA. AXA PPP. HSA. AVIVA. CIGNA. Simplyhealth. Standard life. Pru health. Mercia health.Medicash Medisure. All health insurance accepted. 

Neck and shoulder pain, including back pain, are very common medical conditions, and ones seen many times by Chiropractors and Physiotherapists. Neck pain can be caused by many different disorders and diseases which affect the tissues in the neck, such as degenerative disc disease, neck strain, “whiplash”(WAD), herniated disc, or pinched or trapped nerve/nerves. Neck pain is also referred to as cervical pain.  

Symptoms

Neck pain is associated with a dull ache or aching around the afflicted area and will become worse with neck movement.  Other symptoms associated with neck pain include numbness, tingling, tenderness, sharp and shooting pains, headaches, difficulty swallowing, pulsations, dizziness or light headedness. It is also possible for the neck glands to swell.

Treatments for Neck Shoulder and Back Pain

Neck pain treatment options include rest, ice applications, physical therapy chiropractic manipulation, local injections of cortisone or anaesthetics, muscle relaxants, analgesics and surgical procedures. Cold Laser Therapy is also a possible form of treatment.

Neck, shoulder and back pain are usually common after injuries to the neck Shoulder or back. The pain may come on gradually or it may be acute and come on suddenly. Bad posture is a common cause in the onset of this pain but it is not the only cause. Chiropractors and Physiotherapists understand the various causes of neck shoulder and back pain and can offer advice.

Cervicalgia

The neck muscles are constantly placed under tension, although this tension helps to keep the head in position i.e. upright. However, the muscles in the neck are more prone to becoming stiff and painful as a result of this tension and can be a result of violent movement or sudden impact (sometimes known as “whiplash” (WAD).
Cervicalgia is a localised pain that does not radiate through into other areas of the neck. Symptoms include:

• sharp pain in the neck
• neck ache
• pain resulting from head movement
• pain radiating to the shoulders, arms and fingers

 

Pain also may radiate pain into other areas; this is usually caused by a trapped nerve or nerves. Nerves can become compressed by tight muscles, disc damage or the formation of bony deposits. Radiating pain in the neck which affects the shoulders and arms may also affect the fingers.

Neck dysfunction can result in dizziness, nausea or headaches but it can be successfully treated by Cold Laser Therapy, one of the treatments offered by Central Chiropractic and Physiotherapy Clinic.

Cervical Disc Injuries

Most cervical disc injuries are caused by hyperextension, which results in compression of the neck area. 

Symptoms of Cervical Disc Injuries

The pain, loss of sensation or tingling/pins and needles to the arms and weakness are the main symptoms and signs of cervical disc injury. The pain is most noticeable symptom and it is usually the only one. Cervical disc injury can complicated by compression of either a cervical nerve root or by a compression of the spinal cord, but this reported injury is very infrequent.  When compression of the nervous tissue occurs, patients may report different sensations other than pain. Weakness to the legs/leg this is called spinal cord compression. If the arms/arm are affected this is called nerve root compression

Pain can be felt in the neck shoulder or arm. 

Pain is always in the area of the neck and upper back and between the shoulder blades. This is due to inflammation of the disc and the cervical vertebra joints. Sever inflammation can flare up after a minor added injury or for other unknown reasons. Neck shoulder and back pain are due to the disc bulges that herniate and stretch the posterior longitudinal ligament.  

Rarely, the pain will be felt down the arm.  This pain can be lightning, caused or aggravated by movements of the neck, or can be dull and persistent. Pre-existing neck pain is also present in many individuals. After the arm pain starts, some people report feeling less pain in their neck. When arm pain is present, it is usually because of a combination of disc herniation and bony spurs compressing a nerve root. A free disc fragment can also intrude on a cervical root and cause quite a bit of pain in shoulder or down the arm.

 Sensory symptoms other then pain.

When pain is felt in only one arm, it is usually due to compression of a cervical root and felt in the territory of the cervical root. The C4 root mainly supplies the shoulder with nerves, while the C5 root supplies primarily the arm. The C6 root supplies nerves to the radial side of the forearm, the C7 root addresses the arm and forearm, and the C8 and the T1 root handle mostly the hand. Broadly speaking, two types of sensory symptoms are felt: loss of sensation and new sensations. A loss of sensation is simply numbness. New sensations include tingling (pins and needles), heat, or cold sensations.

If the spinal cord is compressed, most patients will report losing sensation in their hand and in the lower part of their body.

Sometimes patients have difficulty feeling the floor when they walk and cannot feel that their bladder is full, this is an emergency and patients should be brought to the hospital right away.

Motor symptoms and signs.

Weakness of one arm (the other one being normal) only signals a compression of a nerve root. A compression of C4 results in a weak shoulder; C5 indicates a weak bicep muscle; C6 represents a weak wrist, thumb, and index finger; C7 is a weak triceps, extension of the fingers, and pectoralis muscles; C8 designates weak flexion of the fingers; and T1 corresponds to a weak hand.

When to seek emergency  treatment.

If the spinal cord is compressed, patients report having difficulty walking and weak legs and hands these can be the only symptoms and should be treated as an emergency.

Although neck pain can be caused by injury, such as ‘whiplash’ injuries, it is often caused by the cumulative effect of improper sitting posture, reading in bed, poor work habits, stomach sleeping, lack of proper exercise and other lifestyle-related factors. All of these factors cause misalignments in the spine and eventually pain. In fact, the most important factor producing neck pain appears to be spinal misalignments. Even for people who complain that “stress” is causing their pain, the great majority of those have significant spinal misalignments that are contributing to their condition.

Uncorrected chronic spinal misalignments can eventually cause neck shoulder and back pain. As a spinal misalignment worsens, pressure can be put on delicate nerves, sending the surrounding neck muscles go into painful and movement-limiting spasm, headache, even numbness, tingling or weakness in the arms or hands

Cervicogenic headaches  

Cervicogenic headaches are defined as headaches originating from the neck. The location is typically at the back of the head, sides and top of the head as well as around the forehead and eyes affecting one or more of the above regions at once. These headaches can be located on one or both sides of the head. Cervicogenic headaches are usually associated with dysfunction of the upper neck which can present itself as neck pain or local tenderness, reduced neck range of motion and exacerbation of the headaches by neck movement. The past history of neck trauma is typical for this type of headaches.

The cervicogenic headaches are caused by irritation of nerve endings of injured joints, ligaments, muscles and discs of the neck. The nerve endings in the injured areas send pain signals up the upper nerves of the neck to the brain causing “cross wiring” with the fibres of the trigeminal nerve (one of the nerves in the head) which is responsible for perception of the head pain thus causing the headaches.

Neck pain as well as “whiplash” injuries (WAD) and both conditions can result in headaches and all three are commonly treated by Chiropractors and Physiotherapists
the treatment is focused on the small joints in the back of the neck called facet joints that are responsible for neck pain. When these joints dysfunction but injury to the muscles he nerve fibres that innervate / act as sensors for these facet joints also serve to act as sensors to parts of the head. With facet joints dysfunction these sensors become active, the brain cannot clearly differentiate between the facet joints and the mapping of the head and create the sensation of pain in a broader area- Headache.

Whiplash Associated Disorder (WAD) commonly known as “whiplash” (WAD).

Form the Journal of Orthopaedic Medicine 1999;   21 (1):   22–25 university Department of Orthopaedic Surgery. Bristol. UK

Conclusion: ”Whiplash” (WAD) and neck injuries are common. Chiropractic is the only proven effective treatment in chronic cases. Our study enables patients to be classified at initial assessment in order to target those patients who will benefit from such treatment.

Khan S, Cook J, Gargan M, Bannister G 

Objective:   To determine which patients with chronic “whiplash”(WAD) will benefit from chiropractic treatment.

Design:   Retrospective review by structured telephone interviews of 93 consecutive patients seen in chiropractic clinic.

Setting:   Independent chiropractic clinic in a large city.

Subjects:   93 patients, 68 female.

Main outcome measure:   Gargan and Bannister grading pre and post treatment.

Results:   Three groups of patients were recognised. Group 1 consisted of patients with isolated neck pain associated with a restricted range of neck movement. Group 2 consisted of patients with neurological symptoms or signs associated with a restricted range of movement. Group 3 comprised patients who described severe neck pain but all of whom had a full range of neck movement. Patients in this group often described an unusual group of symptoms, with a bizarre, non-dermatomal pain distribution. There was a significant difference in outcome between the three groups (p<0.001) with only groups 1 and 2 improving following chiropractic manipulation.

Conclusion:   “Whiplash”(WAD) and neck injuries are common. Chiropractic is the only proven effective treatment in chronic cases. Our study enables patients to be classified at initial assessment in order to target those patients who will benefit from such treatment.

Neck Anatomy

The head  weight of 12 lbs  not only does the neck fully support all that weight, it enables the  head to turn or move up or down No other part of the spine has the ability to move so much: in forward motion, and in backward motion, this also includes the  side-to-side motion, and from  shoulder to shoulder. 

The neck is called the cervical spine, and it begins at the base of your skull. It contains 7 small bones (vertebrae), which doctors label C1 to C7 (the ‘C’ means cervical). The numbers 1 to 7 indicate the level of the vertebrae. C1 is nearest to the skull, while C7 is nearest to the chest.

In between each vertebra are tough fibrous shock-absorbing discs called the intervertebral discs? Each disc is made up of a gel-like outer band (annulus fibrosus) and a gel-like inner substance (nucleus pulposus).

Besides the bones and the discs, the neck consists of joints, muscles, and ligaments these stabilize and give the neck its full range of movement.

The neck is the upper part of the spinal cord, and consists of nerve roots, and an elaborate system of arteries and veins. The nerves in the neck help the brain communicate with the shoulders, arms, and chest. The arteries and veins circulate blood to both the brain and the heart.

For Further in depth information on Neck Shoulder Pain including Back Pain or Headaches, please go to top left corner listed under “Pain” or “Conditions “and for Cold Laser Therapy, please go to top left corner under “Treatments”

Shoulder Pain and Injuries include;

Rotator Cuff Tendonitis, Bursitis, Rotator Cuff Tear, Shoulder Joint Tear (Glenoid Labrum Tear). Acromioclaviclavicular joint. Tendonitis, Tennis elbow, Biceps Tendon Tear, Triceps, Trigger finger, Shoulder Dislocation, Shoulder Instability, Collarbone, Scapula Fracture,”Burners & Stingers”,Frozen Shoulder, Cold laser Therapy & Treatment. There all listed below.  

Call 024 7622 2002. Registered with BUPA. AXA PPP. HSA. AVIVA. CIGNA. Simpleyhealth. Standard life. Pru health. Mercia health.Medicash Medisure. All health  insurance accepted

Rotator Cuff Tendonitis or Bursitis Therapy and Treatment

The tendons of the Rotator Cuff rotate the upper shoulder bone (humerus) and help raise the arm by pulling the Humeral head down as the Deltoid muscle pulls the arm up. These tendons may be irritated by pressure from the Acromion process of the Scapula (the upper part of the shoulder blade) and the Coraco-Acromial Ligament. This irritation of the tendons or the lubricating Bursa (connective tissue sack) is referred to as “Tendonitis” or “Bursitis”. This is known collectively as the “Impingement syndrome.

The symptoms of Impingement syndrome present not only as pain on movement, but also as constant pain. This can be accompanied by snapping or cracking sensations on movement. Symptoms may start after an injury which may result in a weakening of the shoulder muscles caused by the pain from the injury.

A clinical diagnosis of Impingement Syndrome is made by physical examination, and X-rays. Sometimes an M.R.I. scan is necessary to exclude rotator cuff tears.

Tendonitis

Tendon problems what are they?

Two main problems associated with tendons include Tendonitis and Tenosynovitis. Tendonitis is an inflammation of the tendons-the tough cords of tissue that connect muscles to bones. This inflammation can affect any tendon, but is most commonly seen in the wrist and fingers. As the tendons become irritated, pain and swelling will occur.

Tenosynovitis is the inflammation of the lining of the tendon sheaths which enclose the tendons. Sometimes both the sheath and the tendon may become inflamed. The cause of Tenosynovitis is usually strain, excessive use, or injury. Tendonitis may also be related to diseases such as Rheumatoid Arthritis or Diabetes can be implicated in this condition.

Common tendon disorders include:

Lateral Epicondylitis. (Known as Tennis Elbow)
This condition is characterised by pain in the back of the elbow and forearm, and along the thumb side of the forearm when the arm is alongside the body when the thumb is turned out. The cause of pain is the damage to the tendons that bend the wrist backwards away from the palm (wrist extensors).

Medical Epicondylitis. (Known as Golfer’s Elbow).
This is a condition characterised by pain from the elbow to the wrist on the palm side of the forearm the pain is caused by damage to the tendons that bend the wrist toward the palm (wrist flexors).

DeQuervain’s Tenosynovitis.
This is far the most common type of Tenosynovitis disorder, when the sheath of the tendons of the thumb become swollen.

Trigger Finger.
A Tenosynovitis condition in which the tendon sheath of one of the finger flexors becomes inflamed and thickens, preventing the smooth extension or flexion of the finger. The finger may lock or suddenly hence the name “Trigger Finger”.

What are the Symptoms of Tendonitis?

The most common symptoms of Tendonitis are:

• Pain in the tendon with movement
• Fluid accumulation, swelling and inflammation
• There may be grating sensation in absence of swelling

Tendonitis Diagnose

Tendonitis is usually diagnosed after careful medical history and physical examination. The diagnosis is established after diagnostic tests have been completed to rule out other conditions or diseases. Joint aspirations may help to rule out gout or an infection, while X-rays may help to rule out arthritis.

Treatment for Tendonitis:

• Modification of your activity
• Splinting or immobilization
• Steroid injections
• Anti-inflammatory medications
• Surgery

Shoulder Joint Tear (Glenoid Labrum Tear) injury Treatment. 

Three bones make up the shoulder joint, the shoulder blade (scapula), the collarbone (clavicle), and the upper arm bone (humerus). The head of the upper arm bone (humeral head) rests in a socket in the shoulder blade called the glenoid. The upper arm bone called the head is larger than the socket; a soft fibrous rim of tissue rim called the labrum surrounds the socket to help stabilize the joint. This rim deepens the socket, so that the head of the upper arm bone fits better. They also serve as an attachment site for several ligaments. Injuries to the tissue rim surrounding the shoulder socket can occur from acute trauma or repetitive shoulder motion.

Examples of traumatic injury include:

• Falling on an outstretched arm
• A blow to the shoulder
• A sudden jerk, as in trying to lift to heavy an object
• A violent overhead stretch or reach, as in when trying to stop a fall

Symptoms of a Shoulder Tear.

• Pain, in overhead activities
• Pulling locking, cracking or grinding
• Occasional pain with daily activities
• Perhaps a sense of instability in the shoulder
• Decreased range in movement
• Lack of strength

(View our Cold Laser Therapy Section under inflammatory conditions.)

Orthopaedic consultant is available at Central Chiropractic Clinic.

Acromioclavicular Joint

An acromioclavicular joint injury can result from a direct blow or fall on the “tip” of the unprotected shoulder or from direct force to the anterior or front of the outstretched arm (i.e. arm tackling), which can cause deformity or elevation of the far, or distal end of the clavicle, pain, and swelling.

Treatment

Treatment with ice and compression; refer to an emergency department to rule out a fracture.

Rehabilitation

Rehabilitation is similar to a clavicle fracture but does not take as long. Gradual range of motion exercises and strengthening can be done as soon as tolerated.

“Burners” and “Stingers”

“Burners” and “stingers” are injuries to the nerve supply of the upper limb, either at the neck or shoulder, most commonly caused by traction forces to the neck during contact or collision sports. A burning or “electric shock” sensation usually accompanies the injury, then, immediate numbness or weakness. In most cases, the injuries are temporary and symptoms resolve quickly, within seconds or minutes, although in 8 percent of cases, they can last hours, days, or even longer.

Treatment

Treatment begins by removing the athlete from the activity. Athletes are not allowed to return to sports activity until symptoms are completely gone. This can take a few minutes or several days. Athletes should never be allowed to return to sports if they have weakness or neck pain.

Although the injury gets better with time, the athlete may need to work with a Chiropractor or physiotherapist to regain strength and motion if the symptoms last for several days.

Prevention

To prevent most shoulder injuries, use correct technique at all times, along with a stretching and strengthening program that also includes the muscles of the neck.

Biceps Tendon Tear at the Shoulder

The tendons attach muscle to bone. The biceps muscle in the upper arm divides into long head and a short heads near the shoulder both attach to the shoulder at different points. At the other end of the muscle the distal biceps tendon connects to the smaller bone in the lower arm called the radius. These connections help the muscle stabilize the shoulder and rotate the lower arm; it also controls the acceleration or deceleration of the arm during overhead motion.

 The long head of the biceps tendon is vulnerable to injury because it travels through the shoulder joint to its point of attachment. The tears of the long head of biceps result in arm weakness; this could also affect arm further by being unable to turn the arm from palm down to palm up. Because the torn tendon can no longer keep the muscle taut, a bulge may also appear it eh upper arm. In case of the distal tendon tears the arm is unable to bed at the elbow.

Causes

Ruptures of the distal tendon near the elbow are not common. They usually occur when an unexpected or extreme force is applied to a bent arm.

The proximal biceps tendons ear the shoulder tear more readily. The tears can be partial or complete, more prevalent in people aged 35 or over and in people with previous shoulder injuries.

Symptoms

• Perhaps an audible snap.
• A bulge in the upper arm
• Bruising to the upper arm, down towards the elbow
• Sudden, sharp pain in the upper arm.
• Pain or tenderness at the shoulder

Diagnosis

A Chiropractor will examine the neck, shoulder and arm and ask you to bend the arm and tighten the biceps muscle. This is done to determine the extent of the injury.

Treatment

• Non-surgical treatment is usually all that is needed for tears in the proximal biceps tendon
• ice applications 20 minutes every hour keep down the swelling
• Anti-inflammatory medications, such as ibuprofen will reduce the pain
• Rest the muscle completely
• Flexibility and strengthening exercises will keep the shoulder mobile
• Surgical repair of a complete tendon tear
• Complete tears of the distal biceps tendon require surgery to reattach the tendon to the bone
• Partial tears of the distal biceps tendon may be treated either non surgically or surgically

Cold Laser Therapy is extremely effective in treating this type of injury, accelerating the healing process considerably. (View top left corner for further information on shoulder pain under “Pain” and “conditions” for “Cold Laser Therapy” please go to “Treatments”.

Triceps Anatomy

The Triceps Brachii consists of three heads: the lateral, medial, and long heads. Triceps joins the Humerus (shoulder bone) and the Scapula (shoulder blade) to the ulna which is the forearm bone. If you working out in gym you must assure you implement Triceps exercises that target all three of the Triceps heads, as this will fully develop the heads of triceps muscle.

In Training the triceps muscles, you must keep a constant tension throughout triceps isolation movements over the full range of motion. It is also imperative to flex the entire triceps muscle by simply extending the arms fully to get the most muscle fibre recruitment.

Triceps Injuries Treatment

Chiropractic treatment including Cold Laser Therapy (used by professional weight lifters and body builders and football clubs such as Chelsea FC.)

For further information on shoulder pain, triceps, Biceps, and other shoulder conditions, go to top left under “Pain” or “Conditions” and “Treatments” for Cold Laser Therapy,  

Shoulder Dislocation

West Midlands shoulder dislocations occur when the head of the humerus which is the upper arm bone, jumps out of the shoulder socket of the scapula, which is called the glenoid. This can happen during severe wrench pulling the shoulder upward or outward, or from combined over-extension and external rotation of the humerus.

Glenohumeral dislocations are generally classified by the direction of dislocation of the humerus.

A dislocation can be full or partial:

• A partial dislocation which also known as subluxation, when the head of the humerus slips out of the socket momentarily and then snaps back into place (socket)
• A full dislocation, when the head of the humerus comes completely out of the socket

Shoulder dislocations are normally associated with fractures to different parts of the shoulder; there may be a fracture and dislocation at the same time. Nerves and blood vessels can sometimes be injured with a severe shoulder dislocation.

Causes

• Falling on an outstretched arm
• A direct or powerful blow to the shoulder area.
• Repetitive sports or activities i.e. throwing or lifting
• Any kind of force applied to an outstretched arm

Symptoms

•   Swelling
•   Bruising
•   Pain, often severe
•   Shoulder contour appears abnormal
•   Bruising Instability and weakness in the shoulder area
•   Inability to move the shoulder
•   Bruising Instability and weakness in the shoulder area
•   Numbness and tingling around the shoulder or in the arm or fingers
•   Seek immediate medical attention.

Shoulder instability

Shoulder instability is a condition in which one of the bones in the shoulder joint moves partially or fully out of place. The head of the humerus, the upper arm bone, moves within the socket of the shoulder in more than one direction. Instability happens when the head of the humerus slips outside its normal position. The classification of this disorder is defined by the changes in degree of movement in the joint and by the change of direction in the movement of the joint.

Dislocation

when the humeral head moves completely out of the socket

Subluxation.

Humeral head moves partially out of the shoulder socket.

• Anterior
  when the humeral head moves forwards. This is a very common injury in young men. Men having great shoulder flexibility are more prone to this injury.
• Posterior
  when the humeral head moves backwards. This is due to severe muscle spasm during an electric shock or epileptic seizure.
• Multidirectional
  this occurs in people born with loose joints. Muscles contracting and relaxing may trigger a multidirectional instability episode. Also certain sports that require greater shoulder range of motion such as swimming may also lead to multidirectional instability.

Shoulder instability usually results from an old injury producing a dislocation that, even when healed, leads to stretching of the shoulder capsule and ligaments.  

 Diagnosis

 Symptoms of shoulder instability may include:

• Numb feeling down the arm
• Shoulder can slip out of place
• Pain in and around the shoulder area
• Shoulder or arm may feel weak
• Shoulder feels loose. (Slack)
• X-Ray may be needed
• Treatment Options
• Cold laser therapy: this treatment is excellent for this type of injury reducing the healing time and inflammation. See our section on Cold Laser Therapy.
• Rest
• Ice will help control pain
• Nonsteroidal anti-inflammatory drugs These include: aspirin, ibuprofen (Motrin, Advil)

 Rehabilitation

Can last several months and may include: physical therapy to strengthen the muscles that control the shoulder joint.

For further in depth information on shoulder pain or conditions please go to top left corner under “Pain” or “Conditions” and “treatments” for Cold laser Therapy.

Collarbone fracture

The collarbone is a part of the shoulder. Its function is to connect the arm to the body. The collarbone sits directly above several important nerves and blood vessels. These vital soft tissues are rarely injured when the collarbone breaks. The collarbone is a long bone, and most breaks occur in the middle of the bone.

Causes 

A broken collarbone, or the medical term a fractured clavicle is a common injury. Many babies are born with a broken collarbone this is due to child birth, also to people in contacted sports such as rugby or just  general accidents where a fall results in a  severe blow or  a heavy fall to the shoulder .  

The collarbone doesn’t harden until a person is about 21 years old; a child’s collarbone can easily be broken from a direct blow or fall.

Symptoms include.

• A hump or “bump” over the fracture area
• Shoulder hanging down and forward
• Unable to lift the arm due to the pain
• A grinding sensation attempting to raise the arm

Diagnosis

There is always an obvious deformity, or “bump,” around the fractured area. A small amount of pressure over the fracture area will bring about pain. Also, a grinding feeling can be felt when the patient attempts to raise the arm. It’s rare for a fragment of bone to break through the skin, An X-ray is often done to pinpoint the location and severity of the break. Then an assessment should be carried out by a medical trained practitioner.

Nonsurgical Treatment

• Most broken collarbones heal well without surgery.
• A simple arm sling will be used to immobilize the arm. A child may have to wear the sling for 4 to 6 weeks; an adult may have to wear it for 4 to 8 weeks. Depending on the location of the break
• Medications, such as aspirin or ibuprofen, will help reduce pain. But for a speedy recovery see our cold laser therapy section this is under inflammatory conditions on the home page   

Scapula Fracture

The scapula is of triangular shape and mobile. It’s also protected by a complex system of surrounding muscles. The shoulder blade or scapula fractures are very rare. Scapular fractures are usually classified at the high end of the impact scale. Falling from a significant height or a major car accident are usually the types of impact that required the scapula to fracture and is usually associated with other major injuries including broken ribs, damage to the head, lugs or spinal cord. Without treatment fractured scapula may result in chronic shoulder pain.

 Symptoms

• Abrasions to the skin.
• Swelling at the back of the shoulder.
• Sever pain when moving the arm.

Diagnosis

For appropriate treatment, your Physiotherapist/ Chiropractor will probably need to take X-rays of the chest and shoulder. This can determine if one or more parts of the scapula may be fractured. The parts of the scapula that are prone to fracture are:

• Scapular body
• Scapular neck
• Glenoid
• Acromion
• Coracoid

Treatment

Non-surgical treatment such as sling works for most fractures of the scapula. The immobilization due to the sling holds the shoulder in place while the bone heals. This type of fractures may need 2 to 6 weeks of immobilization.

The shoulder may feel stiff when the sling is removed. You should begin limited active use of your shoulder immediately

Frozen Shoulder. 

Predisposing Factors, Frozen Shoulder Cold Laser Therapy Pain Relief and recovery. Frozen Shoulder Diagnosed,also including most other common types of Shoulder Pain these are below   

Who gets Frozen Shoulder?

Frozen Shoulder or Adhesive capsulitis is a painful condition mostly affecting people aged 30-70. It is estimated that 3% of population will develop the condition in their lifetime. There is no known racial preference; however, adhesive capsulitis is associated with certain conditions, particularly insulin-dependent diabetes.

Predisposing Factors

There are multiple risk factors predisposing an individual to developing adhesive capsulitis. These predisposing factors may include, shoulder or neck surgery, diabetes, shoulder trauma, inflammatory conditions. Other systemic conditions such as cervical cancer, autoimmune diseases and hypotyriodosm (underactive thyroid) may also to be linked to the condition.

 How Frozen Shoulder is Diagnosed

Diagnosis of adhesive capsulitis is made basing on symptoms and on physical examination of the shoulder. The use of Digital X-rays may show abnormalities such as narrowing of the joint and reduced bone density; however in early phases of adhesive capsulitis shoulder joint appearance in Digital X-ray is normal. 

Treatment of Frozen Shoulder 

Cold laser therapy is now used in treating this condition and is employed by us at Central Chiropractic & Physiotherapy Clinic. Physiotherapy treatment combined with Cold Laser Therapy is extremely effective in reducing both shoulder pain and restricted movement. At present this type of treatment is not available within N.H.S.

Treatment usually combines   use of anti-inflammatory drugs to relieve pain and inflammation with intermittent applications of heat and ice packs. Exercises are prescribed to build strength and improve movement and it is important to persist at these because recovery is gradual but slow. In some cases steroid injections into the joint may be needed. In severe cases the affected shoulder may need to be manipulated under anaesthesia before an aggressive rehabilitation program can be commenced.

Probable Outcomes

The residual symptoms of pain or stiffness are often present even after completion of course of conservative therapy. However, functional disability is rare.

Low Level Cold Laser Therapy (LLLT) is a Handheld, non invasive, light-emitting medical device which is used over different areas of the body. It provides an unmatched advantage in the treatment of conditions such as ,

Frozen shoulder.

Shoulder Injury

Athletic Injuries;

Lower Back Pain
Knee and Foot Pain
Carpal Tunnel Syndrome
Arthritic pain relief and Muscle Spasm 

Relief of Muscles,  Joints and Pain relief, Skin infections. 

Relief of Stiffness and the Promotion of Muscle Relaxation and Cell Restoration
Wound Management and including Skin Ulcers, Pressure Sores and Burns
Soft Tissue Injuries, Including Sprains and Strains, Tendonitis and Haematomas
Joint Disorders and Conditions including Arthritic pain relief and Tenosynovitis
Chronic pain including Trigeminal Neuralgia and Neck and Back Shoulder pain

Frozen Shoulder Pain Relief

For treatment of ligaments, tendons, muscle sprain Cold Laser Therapy is use at our clinic, reducing pain and accelerating the healing process

For further information please go to top left corner under “Pain” or “Conditions” and “Treatments” for Cold Laser Therapy.

Shoulder Pain and Injuries include;

Frozen Shoulder, Rotator Cuff Tendonitis, Bursitis, Rotator Cuff Tear, Shoulder Joint Tear (Glenoid Labrum Tear). Acromioclaviclavicular joint. Tendonitis, Tennis elbow, Biceps Tendon Tear, Triceps, Trigger finger, Shoulder Dislocation, Shoulder Instability, Collarbone, Scapula Fracture,”Burners & Stingers”, Cold laser Therapy & Treatment. There all listed below.  

Call 024 7622 2002. Registered with BUPA. AXA PPP. HSA. AVIVA. CIGNA. Simpleyhealth. Standard life. Pru health. Mercia health.Medicash Medisure. All health  insurance accepted

Frozen Shoulder. 

Predisposing Factors, Frozen Shoulder Cold Laser Therapy Pain Relief and recovery. Frozen Shoulder Diagnosed,also including most other common types of Shoulder Pain these are below   

Who gets Frozen Shoulder?

Frozen Shoulder or Adhesive capsulitis is a painful condition mostly affecting people aged 30-70. It is estimated that 3% of population will develop the condition in their lifetime. There is no known racial preference; however, adhesive capsulitis is associated with certain conditions, particularly insulin-dependent diabetes.

Predisposing Factors

There are multiple risk factors predisposing an individual to developing adhesive capsulitis. These predisposing factors may include, shoulder or neck surgery, diabetes, shoulder trauma, inflammatory conditions. Other systemic conditions such as cervical cancer, autoimmune diseases and hypotyriodosm (underactive thyroid) may also to be linked to the condition.

 How Frozen Shoulder is Diagnosed

Diagnosis of adhesive capsulitis is made basing on symptoms and on physical examination of the shoulder. The use of Digital X-rays may show abnormalities such as narrowing of the joint and reduced bone density; however in early phases of adhesive capsulitis shoulder joint appearance in Digital X-ray is normal. 

Treatment of Frozen Shoulder 

Cold laser therapy is now used in treating this condition and is employed by us at Central Chiropractic & Physiotherapy Clinic. Physiotherapy treatment combined with Cold Laser Therapy is extremely effective in reducing both shoulder pain and restricted movement. At present this type of treatment is not available within N.H.S.

Treatment usually combines   use of anti-inflammatory drugs to relieve pain and inflammation with intermittent applications of heat and ice packs. Exercises are prescribed to build strength and improve movement and it is important to persist at these because recovery is gradual but slow. In some cases steroid injections into the joint may be needed. In severe cases the affected shoulder may need to be manipulated under anaesthesia before an aggressive rehabilitation program can be commenced.

Probable Outcomes

The residual symptoms of pain or stiffness are often present even after completion of course of conservative therapy. However, functional disability is rare.

Low Level Cold Laser Therapy (LLLT) is a Handheld, non invasive, light-emitting medical device which is used over different areas of the body. It provides an unmatched advantage in the treatment of conditions such as ,

Frozen shoulder.

Shoulder Injury

Athletic Injuries;

Lower Back Pain
Knee and Foot Pain
Carpal Tunnel Syndrome
Arthritic pain relief and Muscle Spasm 

Relief of Muscles,  Joints and Pain relief, Skin infections. 

Relief of Stiffness and the Promotion of Muscle Relaxation and Cell Restoration
Wound Management and including Skin Ulcers, Pressure Sores and Burns
Soft Tissue Injuries, Including Sprains and Strains, Tendonitis and Haematomas
Joint Disorders and Conditions including Arthritic pain relief and Tenosynovitis
Chronic pain including Trigeminal Neuralgia and Neck and Back Shoulder pain

Frozen Shoulder Pain Relief

For treatment of ligaments, tendons, muscle sprain Cold Laser Therapy is use at our clinic, reducing pain and accelerating the healing process.

Shoulder Pain and Injuries.

Rotator Cuff Tendinitis, Bursitis, Rotator Cuff Tear, Shoulder Joint Tear (Glenoid Labrum Tear) Tendonitis, Tennis elbow, Biceps Tendon Tear, Triceps, Trigger finger, Shoulder Dislocation, Shoulder Instability, Collarbone, Scapula Fracture, Cold laser Treatment. There all listed below. 

Rotator Cuff Tendinitis or Bursitis Therapy and Treatment

The tendons of the Rotator Cuff rotate the upper shoulder bone (humerus) and help raise the arm by pulling the Humeral head down as the Deltoid muscle pulls the arm up. These tendons may be irritated by pressure from the Acromion process of the Scapula (the upper part of the shoulder blade) and the Coraco-Acromial Ligament. This irritation of the tendons or the lubricating Bursa (connective tissue sack) is referred to as “Tendinitis” or “Bursitis”. This is known collectively as the “Impingement syndrome.

The symptoms of Impingement syndrome present not only as pain on movement, but also as constant pain. This can be accompanied by snapping or cracking sensations on movement. Symptoms may start after an injury which may result in a weakening of the shoulder muscles caused by the pain from the injury.

A clinical diagnosis of Impingement Syndrome is made by physical examination, and X-rays. Sometimes an M.R.I. scan is necessary to exclude rotator cuff tears.

Tendonitis

Tendon problems what are they?

Two main problems associated with tendons include Tendonitis and Tenosynovitis. Tendonitis is an inflammation of the tendons-the tough cords of tissue that connect muscles to bones. This inflammation can affect any tendon, but is most commonly seen in the wrist and fingers. As the tendons become irritated, pain and swelling will occur.

Tenosynovitis is the inflammation of the lining of the tendon sheaths which enclose the tendons. Sometimes both the sheath and the tendon may become inflamed. The cause of Tenosynovitis is usually strain, excessive use, or injury. Tendonitis may also be related to diseases such as Rheumatoid Arthritis or Diabetes can be implicated in this condition.

Common tendon disorders include:

Lateral Epicondylitis. (Known as tennis elbow)
This condition is characterised by pain in the back of the elbow and forearm, and along the thumb side of the forearm when the arm is alongside the body when the thumb is turned out. The cause of pain is the damage to the tendons that bend the wrist backwards away from the palm (wrist extensors).

Medical Epicondylitis. (Known as Golfer’s Elbow).
This is a condition characterised by pain from the elbow to the wrist on the palm side of the forearm the pain is caused by damage to the tendons that bend the wrist toward the palm (wrist flexors).

DeQuervain’s Tenosynovitis.
This is far the most common type of Tenosynovitis disorder, when the sheath of the tendons of the thumb become swollen.

Trigger Finger.
A Tenosynovitis condition in which the tendon sheath of one of the finger flexors becomes inflamed and thickens, preventing the smooth extension or flexion of the finger. The finger may lock or suddenly hence the name “Trigger Finger”.

What are the Symptoms of Tendonitis?

The most common symptoms of Tendonitis are:

• Pain in the tendon with movement
• Fluid accumulation, swelling and inflammation
• There may be grating sensation in absence of swelling

Tendonitis Diagnose

Tendonitis is usually diagnosed after careful medical history and physical examination. The diagnosis is established after diagnostic tests have been completed to rule out other conditions or diseases. Joint aspirations may help to rule out gout or an infection, while X-rays may help to rule out arthritis.

Treatment for Tendonitis:

• Modification of your activity
• Splinting or immobilization
• Steroid injections
• Anti-inflammatory medications
• Surgery

Shoulder Joint Tear (Glenoid Labrum Tear) injury Treatment. 

Three bones make up the shoulder joint, the shoulder blade (scapula), the collarbone (clavicle), and the upper arm bone (humerus). The head of the upper arm bone (humeral head) rests in a socket in the shoulder blade called the glenoid. The upper arm bone called the head is larger than the socket; a soft fibrous rim of tissue rim called the labrum surrounds the socket to help stabilize the joint. This rim deepens the socket, so that the head of the upper arm bone fits better. They also serve as an attachment site for several ligaments. Injuries to the tissue rim surrounding the shoulder socket can occur from acute trauma or repetitive shoulder motion.

Examples of traumatic injury include:

• Falling on an outstretched arm
• A blow to the shoulder
• A sudden jerk, as in trying to lift to heavy an object
• A violent overhead stretch or reach, as in when trying to stop a fall

Symptoms of a Shoulder Tear.

• Pain, in overhead activities
• Pulling locking, cracking or grinding
• Occasional pain with daily activities
• Perhaps a sense of instability in the shoulder
• Decreased range in movement
• Lack of strength

(View our Cold Laser Therapy Section under inflammatory conditions.)

Orthopaedic consultant is available at Central Chiropractic Clinic.

Acromioclavicular Joint

An acromioclavicular joint injury can result from a direct blow or fall on the “tip” of the unprotected shoulder or from direct force to the anterior or front of the outstretched arm (i.e. arm tackling), which can cause deformity or elevation of the far, or distal end of the clavicle, pain, and swelling.

Treatment

Treatment with ice and compression; refer to an emergency department to rule out a fracture.

Rehabilitation

Rehabilitation is similar to a clavicle fracture but does not take as long. Gradual range of motion exercises and strengthening can be done as soon as tolerated.

“Burners” and “Stingers”

“Burners” and “stingers” are injuries to the nerve supply of the upper limb, either at the neck or shoulder, most commonly caused by traction forces to the neck during contact or collision sports. A burning or “electric shock” sensation usually accompanies the injury, then, immediate numbness or weakness. In most cases, the injuries are temporary and symptoms resolve quickly, within seconds or minutes, although in 8 percent of cases, they can last hours, days, or even longer.

Treatment

Treatment begins by removing the athlete from the activity. Athletes are not allowed to return to sports activity until symptoms are completely gone. This can take a few minutes or several days. Athletes should never be allowed to return to sports if they have weakness or neck pain.

Although the injury gets better with time, the athlete may need to work with a Chiropractor or physiotherapist to regain strength and motion if the symptoms last for several days.

Prevention

To prevent most shoulder injuries, use correct technique at all times, along with a stretching and strengthening program that also includes the muscles of the neck.

Biceps Tendon Tear at the Shoulder

The tendons attach muscle to bone. The biceps muscle in the upper arm divides into long head and a short heads near the shoulder both attach to the shoulder at different points. At the other end of the muscle the distal biceps tendon connects to the smaller bone in the lower arm called the radius. These connections help the muscle stabilize the shoulder and rotate the lower arm; it also controls the acceleration or deceleration of the arm during overhead motion.

 The long head of the biceps tendon is vulnerable to injury because it travels through the shoulder joint to its point of attachment. The tears of the long head of biceps result in arm weakness; this could also affect arm further by being unable to turn the arm from palm down to palm up. Because the torn tendon can no longer keep the muscle taut, a bulge may also appear it eh upper arm. In case of the distal tendon tears the arm is unable to bed at the elbow.

Causes

Ruptures of the distal tendon near the elbow are not common. They usually occur when an unexpected or extreme force is applied to a bent arm.

The proximal biceps tendons ear the shoulder tear more readily. The tears can be partial or complete, more prevalent in people aged 35 or over and in people with previous shoulder injuries.

Symptoms

• Perhaps an audible snap.
• A bulge in the upper arm
• Bruising to the upper arm, down towards the elbow
• Sudden, sharp pain in the upper arm.
• Pain or tenderness at the shoulder

Diagnosis

A Chiropractor will examine the neck, shoulder and arm and ask you to bend the arm and tighten the biceps muscle. This is done to determine the extent of the injury.

Treatment

• Non-surgical treatment is usually all that is needed for tears in the proximal biceps tendon
• ice applications 20 minutes every hour keep down the swelling
• Anti-inflammatory medications, such as ibuprofen will reduce the pain
• Rest the muscle completely
• Flexibility and strengthening exercises will keep the shoulder mobile
• Surgical repair of a complete tendon tear
• Complete tears of the distal biceps tendon require surgery to reattach the tendon to the bone
• Partial tears of the distal biceps tendon may be treated either non surgically or surgically

Cold Laser Therapy is extremely effective in treating this type of injury, accelerating the healing process considerably. (View top left corner for further information on shoulder pain under “Pain” and “conditions” for “Cold Laser Therapy” please go to “Treatments”.

Triceps Anatomy

The Triceps Brachii consists of three heads: the lateral, medial, and long heads. Triceps joins the Humerus (shoulder bone) and the Scapula (shoulder blade) to the ulna which is the forearm bone. If you working out in gym you must assure you implement Triceps exercises that target all three of the Triceps heads, as this will fully develop the heads of triceps muscle.

In Training the triceps muscles, you must keep a constant tension throughout triceps isolation movements over the full range of motion. It is also imperative to flex the entire triceps muscle by simply extending the arms fully to get the most muscle fibre recruitment.

Triceps Injuries Treatment

Chiropractic treatment including Cold Laser Therapy (used by professional weight lifters and body builders and football clubs such as Chelsea FC.)

For further information on shoulder pain, triceps, Biceps, and other shoulder conditions, go to top left under “Pain” or “Conditions” and “Treatments” for Cold Laser Therapy,  

Shoulder Dislocation

West Midlands shoulder dislocations occur when the head of the humerus which is the upper arm bone, jumps out of the shoulder socket of the scapula, which is called the glenoid. This can happen during severe wrench pulling the shoulder upward or outward, or from combined over-extension and external rotation of the humerus.

Glenohumeral dislocations are generally classified by the direction of dislocation of the humerus.

A dislocation can be full or partial:

• A partial dislocation which also known as subluxation, when the head of the humerus slips out of the socket momentarily and then snaps back into place (socket)
• A full dislocation, when the head of the humerus comes completely out of the socket

Shoulder dislocations are normally associated with fractures to different parts of the shoulder; there may be a fracture and dislocation at the same time. Nerves and blood vessels can sometimes be injured with a severe shoulder dislocation.

Causes

• Falling on an outstretched arm
• A direct or powerful blow to the shoulder area.
• Repetitive sports or activities i.e. throwing or lifting
• Any kind of force applied to an outstretched arm

Symptoms

•   Swelling
•   Bruising
•   Pain, often severe
•   Shoulder contour appears abnormal
•   Bruising Instability and weakness in the shoulder area
•   Inability to move the shoulder
•   Bruising Instability and weakness in the shoulder area
•   Numbness and tingling around the shoulder or in the arm or fingers
•   Seek immediate medical attention.

Shoulder instability

Shoulder instability is a condition in which one of the bones in the shoulder joint moves partially or fully out of place. The head of the humerus, the upper arm bone, moves within the socket of the shoulder in more than one direction. Instability happens when the head of the humerus slips outside its normal position. The classification of this disorder is defined by the changes in degree of movement in the joint and by the change of direction in the movement of the joint.

Dislocation
when the humeral head moves completely out of the socket

Subluxation.

Humeral head moves partially out of the shoulder socket.

• Anterior
  when the humeral head moves forwards. This is a very common injury in young men. Men having great shoulder flexibility are more prone to this injury.
• Posterior
  when the humeral head moves backwards. This is due to severe muscle spasm during an electric shock or epileptic seizure.
• Multidirectional
  this occurs in people born with loose joints. Muscles contracting and relaxing may trigger a multidirectional instability episode. Also certain sports that require greater shoulder range of motion such as swimming may also lead to multidirectional instability.

Shoulder instability usually results from an old injury producing a dislocation that, even when healed, leads to stretching of the shoulder capsule and ligaments.  

 Diagnosis

 Symptoms of shoulder instability may include:

• Numb feeling down the arm
• Shoulder can slip out of place
• Pain in and around the shoulder area
• Shoulder or arm may feel weak
• Shoulder feels loose. (Slack)
• X-Ray may be needed
• Treatment Options
• Cold laser therapy: this treatment is excellent for this type of injury reducing the healing time and inflammation. See our section on Cold Laser Therapy.
• Rest
• Ice will help control pain
• Nonsteroidal anti-inflammatory drugs These include: aspirin, ibuprofen (Motrin, Advil)

 Rehabilitation

Can last several months and may include: physical therapy to strengthen the muscles that control the shoulder joint.

For further in depth information on shoulder pain or conditions please go to top left corner under “Pain” or “Conditions” and “treatments” for Cold laser Therapy.

Collarbone fracture

The collarbone is a part of the shoulder. Its function is to connect the arm to the body. The collarbone sits directly above several important nerves and blood vessels. These vital soft tissues are rarely injured when the collarbone breaks. The collarbone is a long bone, and most breaks occur in the middle of the bone.

Causes 

A broken collarbone, or the medical term a fractured clavicle is a common injury. Many babies are born with a broken collarbone this is due to child birth, also to people in contacted sports such as rugby or just  general accidents where a fall results in a  severe blow or  a heavy fall to the shoulder .  

The collarbone doesn’t harden until a person is about 21 years old; a child’s collarbone can easily be broken from a direct blow or fall.

Symptoms include.

• A hump or “bump” over the fracture area
• Shoulder hanging down and forward
• Unable to lift the arm due to the pain
• A grinding sensation attempting to raise the arm

Diagnosis

There is always an obvious deformity, or “bump,” around the fractured area. A small amount of pressure over the fracture area will bring about pain. Also, a grinding feeling can be felt when the patient attempts to raise the arm. It’s rare for a fragment of bone to break through the skin, An X-ray is often done to pinpoint the location and severity of the break. Then an assessment should be carried out by a medical trained practitioner.

Nonsurgical Treatment

• Most broken collarbones heal well without surgery.
• A simple arm sling will be used to immobilize the arm. A child may have to wear the sling for 4 to 6 weeks; an adult may have to wear it for 4 to 8 weeks. Depending on the location of the break
• Medications, such as aspirin or ibuprofen, will help reduce pain. But for a speedy recovery see our cold laser therapy section this is under inflammatory conditions on the home page   

Scapula Fracture

The scapula is of triangular shape and mobile. It’s also protected by a complex system of surrounding muscles. The shoulder blade or scapula fractures are very rare. Scapular fractures are usually classified at the high end of the impact scale. Falling from a significant height or a major car accident are usually the types of impact that required the scapula to fracture and is usually associated with other major injuries including broken ribs, damage to the head, lugs or spinal cord. Without treatment fractured scapula may result in chronic shoulder pain.

 Symptoms

• Abrasions to the skin.
• Swelling at the back of the shoulder.
• Sever pain when moving the arm.

Diagnosis

For appropriate treatment, your Physiotherapist/ Chiropractor will probably need to take X-rays of the chest and shoulder. This can determine if one or more parts of the scapula may be fractured. The parts of the scapula that are prone to fracture are:

• Scapular body
• Scapular neck
• Glenoid
• Acromion
• Coracoid

Treatment

Non-surgical treatment such as sling works for most fractures of the scapula. The immobilization due to the sling holds the shoulder in place while the bone heals. This type of fractures may need 2 to 6 weeks of immobilization.

The shoulder may feel stiff when the sling is removed. You should begin limited active use of your shoulder immediately

For further information please go to top left corner under “Pain” or “Conditions” and “Treatments” for Cold Laser Therapy.