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.

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.  

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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.

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/Low Level laser Therapy & Treatment. There all listed below.  

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

Frozen Shoulder. 

Frozen Shoulder Cold/low level Laser Therapy Pain Relief and Recovery. Frozen Shoulder Diagnosed, including most other common types of Shoulder Pain and injuries  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/low level laser therapy is now used in treating this condition and is employed by us at Central Chiropractic & Physiotherapy Clinic. Physiotherapy treatment combined with Cold/low level 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.

Cold /Low Level 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 humer

Shoulder Pain and Injuries include; 

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

Call 024 7622 2002. 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 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 Injuries and conditions
 Sports Injuries 

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

Relief of Muscle and Joint Pain, 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, 

 Cold laser therapy/  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 include; 

Rotator Cuff Tendonitis, Bursitis, Rotator Cuff Tear, Shoulder Joint Tear (Glenoid Labrum Tear). Acomioclavicular Joint. Tendonitis, Tennis elbow, “Burners & Stingers” 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 “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

(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

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

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. l

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

View our “Cold Laser therapy” section.  

Cold Laser 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. 

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 

(View 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.

Shoulder Pain and Injuries. Call 024 7622 2002 

Frozen Shoulder, Rotator Cuff Tendinitis, Bursitis, Rotator Cuff Tear, Shoulder Joint Tear (Glenoid Labrum Tear). Acromioclavicular Joint. “Burners & Stingers”,Tendonitis, Tennis elbow,Golfers elbow, Biceps Tendon Tear, Sprains Tears,  Triceps, Trigger finger, Shoulder Dislocation, Shoulder Instability, Collarbone, Scapula Fracture, Cold/Low Level Laser Therapy and Treatment. There all listed below. 

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.

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

Back Neck Shoulder Pain. Cold Laser Therapy for Pain Relief and Recovery  

Back Pain.  People do not realize how much they move their neck, until they are unable to do so. The neck has the least amount of muscular stabilization to support and move your 12 lbs head, which makes it very susceptible to injury. It doesn’t take much force to disrupt that fine balance.

The spinal cord passes through a space in the vertebrae sending nerve impulses to every part of the body. Between each pair of cervical vertebrae, the spinal cord sends bundles of nerves that pass down the arms and to the upper back, and if your arm is hurting, it may be a problem in the neck! Symptoms in the arms can include numbness, tingling, cold, aching, and “pins and needles”.

The neck can also contribute to headaches, muscle spasms in the shoulders and upper back, ringing ears, otitis media (inflammation in the middle ear, temporomandibular joint dysfunction, TMJ or jaw joint). Dysfunction of the neck also causes restricted range of motion and chronic tightness in the upper back.

Causes of Neck and Upper Back Pain

Neck and upper back pain is caused by a combination of factors, including injury, poor posture, stress, and disc problems.

Injuries

The most common injury to the neck is a “whiplash” (WAD) injury. “Whiplash” is caused by a sudden movement of the head.

(“Whiplash” (WAD) neck pain and Lower Back Pain are listed in the top left corner under “Pain” or “Conditions”)

Much more common causes of neck pain and headaches are poor posture. It’s easy to get into bad posture habits, can eventually lead to pain and headaches. The rule is simple: keep your neck in a “neutral” position whenever possible. Don’t bend or hunch your neck forward for extended periods. Also, do not to sit in one position for extended period of time. If you must sit for an extended period, make sure your posture is good: Keep your head in a neutral position, make sure your back is always supported, and keep your knees slightly lower than your hips.

Stress

When people become stressed, they unconsciously contract their muscles, Particular the muscles in their back. This ‘Muscle guarding’ or Defence posture is a response designed to guard against injury. Muscle guarding occurs whenever we become emotionally stressed. The area’s most affected are the muscles of the neck, upper back and low back.

Disc Herniations

Discs in your neck may herniated or bulge and put pressure on the nerves that lead from the spine into your shoulders, arms and hands. Although cervical discs do not bulge nearly as often as lumbar discs do, they occasionally can still get damaged, especially when damage sustained from a whiplash (WAD) injury. 

(Lower Back Pain and Sciatica are listed in the top left corner under “Pain” or “Conditions”)

Cold laser Therapy/Treatment

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 and sports injuries;

Upper Back Pain and injuries.

Lower back Pain.

Slipped disc.

Prolapsed disc.

Herniated disc.

Bulging disc.

Sciatica. 

Trapped Nerves.

Stiff Back.

 Shoulder Neck Injuries

Knee Ankle and Foot injuries

Carpal Tunnel Syndrome
Arthritic pain relief and Muscle Spasm
Relief of Muscle and Joint Pain
Skin infections
Relief of Stiffness and 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.

Joint Disorders and Conditions including Arthritic pain relief and Tenosynovitis

Chronic pain including Trigeminal Neuralgia and Chronic Neck and Back pain

Cold Laser Therapy is used at our clinic for pain relief and treatment of ligament and tendon injuries, muscle sprains by reducing pain and accelerating the healing process.

For further in depth information on “Pain” or “Conditions” and “Treatments” for cold Laser Therapy. Please go to top left corner. 

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.

Back Neck Shoulder Pain. Cold Laser Therapy for Pain Relief and Recovery  

Back Pain. 

People do not realize how much they move their neck, until they are unable to do so. The neck has the least amount of muscular stabilization to support and move your 12 lbs head, which makes it very susceptible to injury. It doesn’t take much force to disrupt that fine balance.

The spinal cord passes through a space in the vertebrae sending nerve impulses to every part of the body. Between each pair of cervical vertebrae, the spinal cord sends bundles of nerves that pass down the arms and to the upper back, and if your arm is hurting, it may be a problem in the neck! Symptoms in the arms can include numbness, tingling, cold, aching, and “pins and needles”.

The neck can also contribute to headaches, muscle spasms in the shoulders and upper back, ringing ears, otitis media (inflammation in the middle ear, temporomandibular joint dysfunction, TMJ or jaw joint). Dysfunction of the neck also causes restricted range of motion and chronic tightness in the upper back.

Causes of Neck and Upper Back Pain

Neck and upper back pain is caused by a combination of factors, including injury, poor posture, stress, and disc problems.

Injuries

The most common injury to the neck is a “whiplash” (WAD) injury. “Whiplash” is caused by a sudden movement of the head.

(“Whiplash” (WAD) neck pain and Lower Back Pain are listed in the top left corner under “Pain” or “Conditions”)

Much more common causes of neck pain and headaches are poor posture. It’s easy to get into bad posture habits, can eventually lead to pain and headaches. The rule is simple: keep your neck in a “neutral” position whenever possible. Don’t bend or hunch your neck forward for extended periods. Also, do not to sit in one position for extended period of time. If you must sit for an extended period, make sure your posture is good: Keep your head in a neutral position, make sure your back is always supported, and keep your knees slightly lower than your hips.

Stress

When people become stressed, they unconsciously contract their muscles, Particular the muscles in their back. This ‘Muscle guarding’ or Defence posture is a response designed to guard against injury. Muscle guarding occurs whenever we become emotionally stressed. The area’s most affected are the muscles of the neck, upper back and low back.

Disc Herniations

Discs in your neck may herniated or bulge and put pressure on the nerves that lead from the spine into your shoulders, arms and hands. Although cervical discs do not bulge nearly as often as lumbar discs do, they occasionally can still get damaged, especially when damage sustained from a whiplash (WAD) injury. 

(Lower Back Pain and Sciatica are listed in the top left corner under “Pain” or “Conditions”)

Cold laser Therapy/Treatment

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 and sports injuries;

Upper Back Pain and injuries.

Lower back Pain.

Slipped disc.

Prolapsed disc.

Herniated disc.

Bulging disc.

Sciatica. 

Trapped Nerves.

Stiff Back.

Knee and Foot Pain
Shoulder Injury
Carpal Tunnel Syndrome
Arthritic pain relief and Muscle Spasm
Relief of Muscle and Joint Pain
Skin infections including cold sores

Relief of Stiffness and 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.

Joint Disorders and Conditions including Arthritic pain relief and Tenosynovitis

Chronic pain including Trigeminal Neuralgia and Chronic Neck and Back pain

Cold Laser Therapy is used at our clinic for pain relief and treatment of ligament and tendon injuries, muscle sprains by reducing pain and accelerating the healing process.

For further in depth information on “Pain” or “Conditions” and “Treatments” for cold Laser Therapy. Please go to top left corner. 

 

Call  02476 222002. 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 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 anesthesia 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 Injuries;

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

Relief of Muscle and Joint Pain, 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 in depth information on “Shoulder Pain”  “Conditions” or “Treatments” please go to top left corner.

 

Call  024 7622 2002. Shoulder Pain Injuries include;

Frozen Shoulder, Rotator Cuff Tendinitis, Bursitis, Rotator Cuff Tear, Shoulder Joint Tear (Glenoid Labrum Tear) Tendonitis, Tennis elbow, Biceps TendonTear. Triceps, Trigger finger, Shoulder Dislocation, Shoulder Instability, Collarbone, Scapula Fracture. Cold/LowLevel Laser Therapy Pain Relief.  

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

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 including 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, inflammation, tears and conditions

Arthritic Pain relief

Muscle Spasm
Relief of Muscle and Joint Pain
Skin infections

Pain Relief and Stiffness and 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 Arthritic pain relief and Tenosynovitis

Chronic pain including Trigeminal Neuralgia.  

Back Neck Shoulder pain including Frozen Shoulder Pain relief

Cold Laser Therapy is used at our clinic for treatment of ligament and tendon injuries, muscle sprains by reducing pain and accelerating the healing process.

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 Digital- 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 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

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

Orthopaedic consultant is available at Central Chiropractic Clinic.

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 is extremely effective in treating this type of injury, accelerating the healing process considerably.

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,Please 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

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)
• Digital-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.
• 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 Digital- 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 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.

(Listed in our Cold Laser Therapy section for treatment recovery).

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