ROTATOR CUFF SYNDROME

The rotator cuff is actually a group of four muscles and their tendons that wraps around the front, back and top of the shoulder. Together, the rotator cuff muscles help guide the shoulder through many motions, and also lend stability to the joint. The ends of the rotator cuff muscles form tendons that attach to the arm bone (humerus). It is the tendinous portion of the muscle that is usually involved in a rotator cuff injury. Like most orthopedic conditions, the most common mechanisms of a rotator cuff injury are separated into ‘repetitive use’ and ‘traumatic’.

1. Repetitive Use Injury: In repetitive use injuries to the rotator cuff, repeated activities cause damage to the rotator cuff tendons. Over time, the tendons wear thin and a tear can develop within the tendons of the rotator cuff. Patients with repetitive use injuries to the rotator cuff often have complaints of shoulder bursitis prior to developing a tear through the rotator cuff tendons.
2. Traumatic Injuries: Traumatic injuries to the rotator cuff are seen after events such as falling on to an outstretched hand. The traumatic event can cause a rotator cuff injury by tearing the rotator cuff tendons. This mechanism is much less common than repetitive use injuries. But, when a complete tear of the rotator cuff occurs in a patient younger than 60 years old, it is usually as a result of a traumatic injury.
   

FROZEN SHOULDER / ADHESIVE CAPSULITITS

Frozen shoulder, or adhesive capsulitis, is a condition that causes loss of motion in the shoulder joint. The diagnosis of frozen shoulder is often used for any painful shoulder condition associated with a loss of motion, but it is important to understand the cause of the symptoms in order for treatment to proceed effectively. Other conditions can also cause restricted motion and a stiff joint. Often people experience trauma to the shoulder prior to the onset of the frozen shoulder, and sometimes there is no known cause for developing a frozen shoulder.

Symptoms of frozen shoulder include a decrease in motion, primarily seen in lifting the arm and turning it inwards. Frozen shoulder is most common in the 40-60 year old age group and it is twice as common in women as men. People usually experience pain as the first symptom of frozen shoulder, followed by the loss of motion and a decrease in pain. Frozen shoulder responds extremely well to a multi-disciplinary approach which includes chiropractic manipulation, NMR and Physical Therapy.

SWIMMER'S SHOULDER

Swimmer’s shoulder is an inflammatory condition caused by the mechanical impingement of the supraspinatus muscle. This condition is most often caused by the repetitive overhead arm motion of the freestyle stroke. As a swimmer fatigues it will become more difficult for her to lift her arm out of the water, and the muscles of the rotator cuff which work to externally rotate and depress the head of the humerus against the glenoid become less efficient. When these muscles are not working properly the supraspinatus muscle may become mechanically impinged. Repeated impingement commonly leads to pain and inflammation. This condition responds extremely well to NMR and Physical Therapy.

BICIPIAL TENDINITIS

Bicipital tendinitis is an inflammatory process affecting the tendon of the long head of the biceps. It commonly causes shoulder pain due to its position and function. The tendon is exposed on the anterior shoulder as it passes through the humeral bicipital groove and inserts on the superior aspect of the labrum of the glenohumeral joint. Disorders can result from impingement or as an isolated inflammatory injury. Other causes are secondary to compensation to the rotator cuff disorders, labral tears, and intra-articular pathology.