The shoulder problems our office sees fall into two categories, acute - usually traumatic, from a fall or over-exertion and gradual, a slow onset. The acute injury is much more easy to diagnose and treat. Repetitive micro-trauma or cumulative trauma disorders (CTD's) require more careful evaluation to determine the underlying cause of injury. Whether it is from over-training in the gym without enough rest between workouts or a little league pitcher throwing too many pitches during a tournament. Whether it is from bowling, raking, swimming, tennis, volleyball or yard work, once we have determined the mechanism of injury we put together a treatment program to correct the problem. This may include working with a golf or tennis pro to analyze a swing or having a patient reproduce the movement that initiated the pain.

Rotator cuff injuries have become an overly used "buzzword" in reading the sports pages. The rotator cuff is a group of four muscles, the supraspinatus, infraspinatus, teres minor and subscapularis. They comprise the stabilizing muscles of the shoulder. An evaluation of the shoulder includes looking for restrictions in range of motion, noting if pain limits motion and if so at what point in the range of motion does the pain occur. Manual muscle testing to pinpoint which of the muscles of the shoulder are involved.

Unique to sports chiropractic is looking at the whole kinetic chain, that is does the neck, sterno-clavicular, acromial-clavicular gleno-humeral, elbow or wrist cause problems which may relate back to the shoulder?

Is the nerve supply to the shoulder intact (from the cervical spine nerve roots or brachial plexus or peripheral nerves being irritated? Is there instability in the shoulder joint, has this occurred before, if so when was the last time, and how many times has this occured and what treatment was rendered? Was the treatment successful? These are all important questions that need to be answered before any treatment can occur.

Treatment may include spinal manipulation to the cervical and thoracic spine, Manipulation of the shoulder joint or related joints. Active Release Technique may be performed in conjunction with post isometric relaxation stretches. Progressive resistance strengthening using either rubber tubing for a home based program or various medicine balls to return functional strength and range of motion. In times where there is instability Specific Response Proprioceptive Taping (SPRT) may be used to limit excessive motion while providing proprioceptive feedback to the shoulder joint complex.

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