Sometimes inflammation is important
Sometimes inflammation is a good thing. When there is a trauma or an injury to the body there is an instantaneous reaction of the immune system to develop inflammation.The part of the immune system that produces this type of inflammation is quick acting and nonspecific. Inflammation is part of the healing process.
In the case of an injury to the rotator cuff, overuse is usually the main cause. The shoulder joint has the greatest range of motion than any other joint in the body and because of this it is subject to injury. To permit this amount of motion, the ball and socket joint is very shallow. It’s the job of the rotator cuff to keep the ball in the socket and move the arm in all different directions. One peculiar aspect of shoulder joint is that there is only one bone to bone connection with the body. The collar bone (Clavicle) attaches the shoulder to the breastbone (Sternum). There is another area of support for the shoulder joint and it is also the socket of the shoulder joint, the shoulder blade (Scapula).
Before an MRI is ordered There is a sequence of tests performed in the office that should be followed. Information from these tests should be conveyed to the Radiologist if nessary.
The tests begin visualization of the joint and comparing it with non-affected side. Passive range of motion of the shoulder in which the doctor moves the upper arm in different directions followed by active range of motion where the patient moves the upper arm. The next step is to check the strength of each rotator cuff muscle; there are 4 muscles. Evaluation of scapula movement is important followed by specific orthopedic tests.
The MRI is an Important tool, especially in shoulder injuries. Let me explain what a torn rotator cuff is. There are 4 rotated cuff muscles and with injuries to these muscles, some of the fibers might be torn especially near the tendons of the muscle. What is not conveyed to the patient is how much of a tear there is. There is a full thickness tear where the muscle is ruptured completely. There is an infinite number of degrees of tears.
Most rotator cuff injuries can be rehabilitated providing the patient is compliant with the home care and office visits. Another factor that must be considered is the patient’s tolerance to discomfort and pain. Natural products and pharmaceuticals are used in the initial inflammatory stages of care.
A note about cortisone injections and prednisone. They are very useful in eliminating inflammation however, as I mentioned earlier, inflammation is the initial phase of healing. Especially cortisone injections, which may be necessary at times, will stop the healing process. In fact, cortisone injections are not recommended in certain areas of the body such as the Achilles tendon.
Chiropractic rehabilitation of the rotator cuff involves the evaluation and coordination of muscles controlling the shoulder blade and the rotator cuff muscles as well as making sure the spine is compliant, so the shoulder blade can glide over the rib cage. Evaluation of ball and socket and articulation points of the clavicle are evaluated for their ability move the shoulder joint without restriction.
