Sports Chiropractic and Shoulder Problems
Summer activities often involve movements of the shoulder that can cause a variety of problems because of the increased stress placed on the connective tissues. Recreational sports such as tennis, baseball, softball, golf, swimming and even tossing the Frisbee can cause, or be limited by shoulder problems. Potential diagnoses (the cause of the problem) include bursitis, tendinitis, impingement syndrome, rotator cuff tears, joint subluxation, nerve impingement and a wide variety of muscular problems. Proper diagnosis is imperative to determine activity restrictions, proper treatment, recovery time and thorough rehabilitation. One of the main challenges with shoulder problems is not “over-doing-it” as function improves; these set backs can happen weeks or even months later. So where does someone with a shoulder problem begin?
First, it is imperative to avoid ALL painful movements and activities including sports, exercise and even usual activities of daily living that evoke pain. Pain is always a warning sign and failure to heed this red flag will result in more problems down the road. Second, proper home care is reasonable if the problem isn’t severe. This usually includes treatments such as ice, alternating ice/heat, stretching and pain-free movement. Following the correct sequence of treatment and home management is extremely important in achieving a complete recovery as quickly as possible! Third, if the problem persists for more than 2 weeks, it is a sign that professional evaluation is indicated.
As a chiropractic doctor with a specialty in sports medicine, I have special training and expertise that helps me identify the specific area(s) of involvement and appropriate treatment options. The shoulder joint is a very shallow “ball and socket” design that has very little bony stability which means it depends primarily on the rotator cuff musculature for proper stability and function. The “rotator cuff” is a complex design of 4 separate muscles that surround the joint and share a common tendon. This tendon is very susceptible to inflammation, impingement and gradual deterioration because of the complex biomechanics of the shoulder. This combination of factors means that most shoulder problems have a significant muscular and soft tissue component which complicates the healing process and makes it very susceptible to “flare-ups”. Consequently, a customized exercise program is extremely important in restoring normal movement, strength and pain-free function. Additional treatments such as massage, stretching, ice, heat, ultrasound and electrotherapy are also often helpful in restoring proper function. In addition, specific manipulation of joints and soft tissues by a sports chiropractor can be very beneficial in relieving pain, restoring mobility and resuming normal activities in addition to helping prevent future problems.
In general, overhead movements are the most stressful on the shoulder, particularly the rotator cuff tendon. Furthermore, humans are very “flexor-oriented” which means we tend to do more forward movements like reaching, hugging, gripping and desk work, than the opposite. How often do you actually open your fingers against resistance? Consequently, we develop muscular imbalances and compensations that set the stage for postural distortions that often lead to other problems such as impingement of the rotator cuff tendon and/or tendinitis. Impingement syndrome is an irritation or entrapment of the rotator cuff tendon under the arch of the clavicle where it joins with a portion of the shoulder blade. This can eventually lead to erosion of the tendon resulting in a partial tear, tendinopathy (disease of the tendon) or even a complete rupture requiring surgical repair. However, it often possible to avoid such invasive procedures with early assessment and proper management using conservative treatments such as corrective exercise, sports chiropractic, acupuncture, physical therapy, massage and home treatments. Sports chiropractic focuses on both the joints and soft tissues of the shoulder including the sternoclavicular joint (between the sternum and clavicle), the acromioclavicular joint (the other end of the clavicle at the shoulder), the glenohumeral joint (the main ball and socket), the biceps tendon and the rotator cuff tendon as well as proper scapulothoracic rhythm which includes the functional relationship of the scapulae, rib cage and thoracic spine.
Successful treatment of shoulder problems begins with a thorough history and examination to determine a proper diagnosis. Imaging studies such as MRI are often necessary to rule out more serious conditions and get a comprehensive assessment of shoulder anatomy. Only then can a successful treatment regimen be designed to restore normal function of all the joints and various soft tissues of the shoulder. Specific stretches and exercises designed to isolate specific muscle groups are a critical aspect of restoring normal mechanics and function of the shoulder. Even after the problem seems to be resolved, supportive treatments may be indicated to prevent recurrence or future injury. If you have questions about a shoulder problem, or any other nagging sports injury, call Dr. Keuhn at (303) 934-3600 to schedule a complimentary consultation to find out if we can help.
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