3 common shoulder injuries and recommended treatments

By Dr. Samantha de Castro, Doctor of Chiropractic

Shoulder pain is a common complaint seen in chiropractor and manual therapists’ offices.

They are typical in athletes, most often those who play sports that involve repetitive overhead motions. Top sports include tennis, swimming, and volleyball. Shoulder pain can also be seen in pitchers and weightlifters.

Shoulder injuries also occur from everyday and work-related activities that use the same repetitive overhead movements.

Shoulder injuries can also occur due to trauma, such as a car accident or fall. Most often it is over a longer time period that the pain develops.

Most of the time, shoulder injuries are due to the muscles, ligaments and tendons. It is rarer to see actual bone issues.

There are 3 major categories of injuries commonly seen in shoulders:

Rotator cuff
Impingement
Instability

Rotator cuff

These injuries are damage to the S.I.T.S muscles (Supraspinatus, Infraspinatus, Teres minor and Subscapularis). These are the muscles that make up the cuff and support the shoulder joint and help hold the arm to the trunk.

The bicep is also sometimes lumped into these injuries as it can cause shoulder pain as well. Things like sprains, strains, tendinopathy’s and tears can be seen with the rotator cuff.

Impingement

This is when either the tendons of one of the muscles or a bursa (a fluid filled sac to aid with friction) is pinched or rubbing against the bones of the shoulder. If untreated, this can lead to rotator cuff injuries.

Instability

This is what leads to shoulder dislocations. Some people are more prone to dislocations based on their body, or if they have something like a connective tissue disorder that causes loose joints. If the shoulder dislocates, it needs to be relocated by a professional.

However, it is in place, but instability continues to be a concern, that can be treated.

Treatment for Shoulder Injuries and Pain

Treatment for shoulder issues can include many different modalities depending on the injury and what the patient responds to.

Imaging is typically not needed immediately but will be considered if there is a structural concern that may require an orthopedic surgeon.

Manipulation of the thoracic spine, or midback, has been shown to help reduce shoulder pain by aiding in overall joint motion of the body.

Soft tissue techniques can be used to address any tightness or pain. These can include Active Release Techniques, Instrument assisted soft tissue mobilization (IASTM) such as Graston Technique, cupping, and massage therapy. Acupuncture can be integrated as well.

The main goal of the treatments is to help the patient complete rehabilitative exercises, increasing strength to the shoulder complex, and optimize the function. This can be done with tubing exercises into all the ranges of motion, stretches, body-weight exercises such as wall push-ups and free weight training.