Chiropractor Chandler AZ

Carson Robertson
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Rotator Cuff Syndrome

Pain in the back of the shoulder is often the result of muscle and tendon injuries. Several major muscles control how the shoulder moves, including the deltoid, teres minor, teres major, and infraspinatus muscles. These muscles are located on the back of the shoulder, and injuries produce pain that radiates down the shoulder to the elbow. The pain is often worse with reaching or pushing movements. It can be painful to reach above your head or lift a gallon of milk out of the fridge.

Shoulder model bicep origin labeled
Anatomy of the Rotator Cuff

Many people have heard of the supraspinatus muscle; of all the rotator cuff muscles, it is most often injured. The rotator cuff is actually made up of four muscles which include the subscapularis, supraspinatus, infraspinatus, and teres minor muscles. The muscles become very narrow tendons that attach to the shoulder. The most common places to develop shoulder injuries are where the tendon attaches onto the bone.

Symptoms of Rotator Cuff Syndrome

Injury to the teres minor and infraspinatus muscle often occur with overuse, lifting, pulling, or carrying movements. People often experience infraspinatus tendinitis or teres minor tendinitis when they increase their exercise activity or start intense workouts. We often see injuries causing pain in the back of the shoulder with CrossFit or explosion workouts. Shoulder injuries are more frequent with strength imbalances between muscles in the front and back of the shoulder. Many times, rotator cuff injuries are the result of weak stabilizers that contribute to tendon damage. Over time tendon tears can result in severe pain, limitation or surgery. Safe shoulder movements require strength and endurance to be balanced between the shoulder muscles; otherwise, the fatigued muscles cannot protect the shoulder and the tendons absorb excessive stress, leading to tendonitis. Lack of strength and endurance in the shoulder stabilizers causes many shoulder injuries.

Low Level Laser Treatments

1. ACCELERATED TISSUE REPAIR AND CELL GROWTH

Photons of light from lasers penetrate into tissue and accelerate cellular growth and reproduction. Laser therapy increases the energy available to the cell so it can work faster, better, and quickly get rid of waste products. When cells of tendons, ligaments, and muscles are exposed to laser light they repair and heal faster.

2. FASTER WOUND HEALING

Laser light increases collagen production by stimulating fibroblasts. Collagen is the building block of tissue repair and healing. Laser therapy increases fibroblast activity and therefore collagen production to speed healing.

3. REDUCED FIBROUS TISSUE FORMATION

Low level laser therapy decreases scar tissue formation. Scar tissue can be a source of chronic pain and poor healing. By eliminating excessive scar tissue and encouraging proper collagen production, painful scars and chronic pain is reduced.

anti inflammation
4. ANTI-INFLAMMATION

Laser therapy causes vasodilatation (increases size of capillaries) which increases blood flow. The treatments also increases lymphatic drainage to decrease swelling or edema. Therefore, laser therapy reduces swelling caused by bruising or inflammation while speeding the recovery process.

5. PAIN RELIEF

Cold laser therapy decreases pain by blocking pain signals to the brain. Some nerve cells sense pain and send signals to the brain. Chronic pain can be caused by overly active pain nerves. Specific wavelengths help "shut off" the pain signals, thereby; eliminating your pain.

Low level lasers are excellent at decreasing inflammation, which also increases pain nerve activity. Cold laser therapy also increases endorphins and enkephalins, which block pain signals and decrease pain sensation. Overall laser therapy reduces painful nerve signals and reducing your perceived pain.

6. INCREASED BLOOD FLOW

Blood carries nutrients and building blocks to the tissue, and carries waste products away. Increased blood flow to tissues increases and enhances cellular healing. Cold laser therapy increases the formation of capillaries in damaged tissue. Specific laser frequency also increases blood flow to the area treated, to enhance injury repair.

7. INCREASED REPAIR AND REGENERATION

Low level lasers increases enzyme activity to improve metabolic activity that affects cell repair and regeneration. The enzymes are turned on "high" to speed the healing.

8. NERVE FUNCTION AND REPAIR

Nerves heal very slowly. Lasers speed up this process. Damage to nerves causes numbness, pain, muscle weakness, and altered sensations. Laser therapy treatments enhance nerve function, healing, and reduce pain.

9. INCREASED ENERGY PRODUCTION - ATP

ATP is like gasoline for cells, it is the energy source that cells operate. Injured cells often have low levels of ATP, which decreases their ability to heal and repair. By increasing ATP and "gasoline storage levels," cells have more ATP for healing and repair. Increased mitochondrial production is very important with nerve pain.

10. ACUPRESSURE AND TRIGGER POINTS

Low level laser therapy decreases trigger points and stimulates acupuncture points to decrease muscle and joint pain.

We combine low level laser therapy with a variety of techniques and treatments. Cold laser therapy can be used alone as a single treatment modality, or in conjunction with other Chiropractic, Physical Therapy, massage therapy, or medical treatments.

Conservative Treatments

Therapeutic treatments for addressing soft tissue injuries involve massage therapy, manual therapy, trigger point therapy, Graston Technique, or Active Release Technique. These treatments increase blood flow, decrease muscle spasms, enhance flexibility, speed healing, and promote proper tissue repair.

soft tissue injuries

When these treatments are incorporated into a treatment plan patients heal faster and are less likely to have long-term pain or soft tissue fibrosis or scar tissue in the injured muscle. These soft tissue treatments are incorporated with cold laser, therapeutic exercise, and flexibility programs.

Treatment for shoulder injuries often requires a variety of exercises, stretches, conservative treatments, medical treatments, and home therapies. Shoulder injuries can become chronic if the appropriate steps are not taken.

Elbow injuries often occur in people with severe or chronic shoulder injuries. People begin trying to alter their shoulder motions to protect it. Unfortunately these altered body mechanics tend to overwhelm the muscles and tendons around the elbow. People often develop a secondary cubital tunnel syndrome, lateral epicondylitis, tricep tendonitis, medial epicondylitis, pronator teres syndrome, double crush, carpal sprains, wrist tendinitis, de quervain's tendonitis, finger extensor strains, or carpal tunnel syndrome.

Treatment for elbow injuries can be extensive if the tendinosis is severe. Mild strains can be treated at home with PRICE, home stretches, and exercises. Don't wait for damage to both the shoulder and elbow to seek treatment and therapy.

Medical Treatments

NSAIDs are often prescribed for the initial acute injury stages. In severe cases that involve multiple joint regions, muscle relaxers or oral steroids can be given. Trigger point injections, botox, or steroid injections can be treatment options. Pain management is not usually required unless stronger medications or joint injections are required for treatment.

MRI and X-rays will not usually be ordered to evaluate mild to moderate muscle, tendon, and ligament injuries. Severe cases may utilize advanced imaging to rule out bone fractures, edema, nerve entrapments, tendon or muscle ruptures. NCV testing may be utilized in cases that also involve muscle, sensory, or reflex loss which indicates nerve damage.

Spine model degeneration

Cervical spinal disc bulges and herniations onto the spinal cord or nerve root produce different symptoms and location of symptoms. Pain radiating in the hand is one symptom; along with numbness, weakness, fatigue, loss of sensation, or reduced reflexes. Your chiropractor, physical therapist, occupational therapist, or physician will evaluate your condition and make a proper diagnosis and treatment recommendations. Ask them any questions you might have about your injury.

Many people do have arthritis or degenerative changes in their elbow, wrist, finger, or thumb joints. Arthritis does not mean you will always have pain in the joints. Degenerative arthritis means the structural Integrity of the bones have changed which alters its gliding, sliding, and hinging motions. The more severe the arthritic changes the easier it becomes to aggravate the joint and produce pain. Low level laser therapy is excellent at decreasing pain and inflammation in arthritic hand and wrist joints.

Osteoarthritis and rheumatoid arthritis will also slow healing and recovery time. People with severe arthritis can have no pain in a joint. In fact many times people blame their arthritis pain on tendinosis or tendonitis of the tendons that attach around the joint. Conservative treatment can improve hand and wrist pain; and people will have dramatically less pain in joints that have arthritic changes.

In Conclusion

The upper extremity works as a comprehensive unit performing many of the repetitive tasks at home, work, and recreational sports. Injuries to one area of the musculature often indicate that additional damage has been incurred by other muscles.

Two hands On Exercise Ball Start Shoulder Stability Exercise

Many therapeutic exercises can help restore proper strength and endurance to the elbow flexor muscles. Isometric exercises are often the initial treatment exercises. Followed by single plane rubber band exercises for elbow flexion, extension, pronation, and supination movements. Dynamic exercises involving stability ball push-ups can be performed on the wall or floor. The more unstable of the surface the more effort and stabilization is required of all the upper extremity muscles.

Push-ups on a stability ball enhances neuromuscular learning throughout the neck, scapula, shoulder, upper arm, and lower arm muscles. Additional strength exercises can be found on the arm and shoulder strengthening pages.

Our Chandler Chiropractic and Physical Therapy clinic treats patients with a variety of muscle, tendon, joint, and ligament injuries with a combination of cold laser, physiotherapy, and advanced muscle techniques. The clinic provides treatment for runners, tri-athletes, and weekend warriors in addition to common headache, neck, and back patients traditionally seen in Chiropractic, Physical Therapy, Massage Therapy clinics. We work with all ages and abilities of the residents in Phoenix, Tempe, Gilbert, Mesa, and Chandler AZ.