Shoulder Pain Treatment by Warwickshire Chiropractors, and Warwickshire Physiotherapists, 3d animated models for (1) Neck Pain and Whiplash, (2) Bulging disc, Cervical disc injury and (3) TMJ Temporomandibular Jaw Disorders (4) Rotator Cuff Injury (5) Shoulder Pain and Injury Treatment (they can be found under the listing” Types of Pain” in our Neck and Shoulder Pain Sections). For the management of Shoulder and Neck Pain, here at Central Chiropractic and Physiotherapy Clinic we use the latest Low Level Lasers which provide Pain Relief, this also accelerates recovery, healing and significantly reduces the inflammatory process. A 5 star rating has been awarded to Low Level Laser Therapy, our laser section can be found listed under “Pain Relief”, please also view our “Low level Laser Testimonial Video”.
Shoulder Pain and Injuries.
Frozen Shoulder, Rotator Cuff Tendinitis, Bursitis, Rotator Cuff Tear, Shoulder Joint Tear (Glenoid Labrum Tear). Triceps, Acromioclavicular Joint. “Burners & Stingers”,Tendonitis, Tennis elbow,Golfers elbow, Biceps Tendon Tear, Sprains Tears, Shoulder Dislocation, Shoulder Instability, Collarbone, Scapula Fracture, Cold or Low Level Laser Therapy and Treatment. There all listed below.
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
