Chiropractic CE

Chiropractic for the Rotator Cuff

            Chiropractors are all too familiar with rotator cuff issues when it comes to treating patients. This comes as no surprise, since rotator cuff tears are one of the most common shoulder disorders that chiropractors treat. Up to 70% of people over the age of 80 and 30% of people under the age of 70 have rotator cuff tears. Chiropractic care is a great treatment option for those that face rotator cuff issues, especially for those that want to avoid having surgery, carefully giving an in-depth treatment on the shoulder which we rely on much more than many patients realize.

The Rotator Cuff

            The rotator cuff is comprised of a group of four tendons and muscles which surround the shoulder joint providing the shoulder with stability and its ability to move. There are a multitude of ways in which a patient may find themselves with a rotator cuff injury or disorder suffering from chronic inflammation, stiffness, and discomfort. The great thing about the shoulder is that it’s one of the most limber joints in the body, however because of this flexibility and daily use, it is also how it is easily injured. When the same motion in the shoulder is constantly repeated on a regular basis, it causes inflammation leading to an injury in the rotator cuff.

Common occupations in which a rotator cuff may be injured:

  • Tennis – particularly in serving a tennis ball

  • Baseball – pitchers in particular

  • Swimming – those who swim a multitude of yards a day

  • Painters – painting for hours with repetitive motions

  • Washing windows
In addition to activities that can cause rotator cuff issues, there are also various chronic medical conditions that can also lead to rotator cuff problems.

Common chronic medical conditions:

  • Bursitis

  • Arthritis

  • Tendonitis (also known as impingement syndrome)
The major and most common injury dealing with the rotator cuff is a tear, which can be from a direct injury or can evolve from tendonitis. However, the way in which the rotator cuff issue will present will depend on the severity of the problem.

Common rotator cuff injury symptoms:

  • Disrupted or restless sleep

  • Aching in the back of the shoulder

  • Restricted range of motion

  • Arm weakness
While the shoulder depends so heavily on the muscular support of the rotator cuff, chiropractic providers are able to intervene and aid in strengthening the rotator cuff and restoring range of motion in the shoulder.

Chiropractic for the Rotator Cuff

            The main objective of chiropractic care in the treatment of the rotator cuff is to restore full function, relieve pain, and rehabilitate the area. The other major goal is to help the patient avoid the need for surgery if at all possible. It is vital to look at each rotator cuff injury on an individual basis.

Provider protocol:

  • Perform a comprehensive exam, and depending on the severity, include a bone scan, MRI, or X-ray to pinpoint the problem causing the rotator cuff discomfort.

  • Understand that if a patient presents with a grade I or II rotator cuff tear. This is treatable, but complete tears should be referred to surgery.

  • Be sure to use all tools available in your arsenal including ultrasound, heat and ice treatments, and electrical muscle stimulation.

  • Aim to restore mobility through chiropractic adjustments and exercises targeted for the rotator cuff for about 6 to 8 weeks of chiropractic care.

  • Review special exercises with the patient that aid in increasing range of motion, strength, and flexibility in the rotator cuff region.
Additionally, it is important to note that chiropractic care will reduce the possibility of scar tissue buildup which can further intensify the rotator cuff injury, pain or stiffness if left untreated. Ensuring that the ligaments, bones, and tendons are properly aligned, a treatment plan that will strengthen the supporting structures surrounding the rotator cuff for the best recovery possible, will be helpful.

Tools that can be used to help a patient recover from a rotator cuff injury:

  • Electrostimulation therapy

  • Ultrasound

  • Chiropractic adjustments

  • In-office and at-home exercises for patients that increase flexibility, strength, and range of motion

Chiropractic for the Rotator Cuff Research

            Although as chiropractic providers we know the benefits of chiropractic treatment, there are limited studies in regards to its benefits.

2011 Study “Manipulative Therapy for Shoulder Pain and Disorders: Expansion of a Systemic Review”:

  • The goal of this study was to review literature on manual and manipulative therapy for common shoulder pain and disorders.

  • Literature was searched using a cumulative index of Pubmed, Nursing Allied Health Literature, Physiotherapy Evidence Database, and Index to Chiropractic Literature from January 1983 to July 2010.

  • Out of the 211 citations collected, 35 were deemed appropriate and useful. They found evidence of positive results for the treatment of common rotator cuff disorders, shoulder disorders, soft tissue disorders, and adhesive capsulitis using manual and manipulative therapy to the shoulder, combined with or without exercise.

  • This study concluded that there is fair evidence for MMT for shoulder disorders, complaints, and pain.

Rotator Cuff Chiropractic Treatment

            A rotator cuff injury or disorder can lead to quality of life issues. Even if the patient may be considering surgery, it is important to delve deep into the condition at hand and discuss all options with them. We want to make sure that all of our patients receive a comprehensive chiropractic treatment that will avoid the need for rotator cuff surgery or further damage to the shoulder, neck, or back.