The shoulder is made up of:
· The clavicle, or collar bone
· The scapula, or shoulder blade
· The humerus, which is the long bone between the shoulder and elbow that attaches to the scapula
· The four rotator cuff muscles
· The tendons that attach the muscles to the bones and the ligaments that attach bone to bone
· The shoulder bursa, which is a fluid filled sac that allows a smoother glide for the humerus’ articulation
There needs to be an ongoing “tensegrity” within and around the shoulder joint. This concept can be likened to a tent with lines attached from its four corners to ground pegs. If one of the lines is slack (inhibited or weaker), or too taut (hyper-active or stronger), the shape and design of the tent will be affected. So there is an inter-relationship between the structures of the shoulder, as well as the rest of the body, especially when compensation comes into play. Repetitive actions like raking, vacuuming or swinging a golf club may initially produce small tears that heal with a less giving adhesive tissue that can initiate inflammation along with a repetitive strain or cumulative injury cycle. So, if one muscle, say the subscapularis (on the underside of the scapula, or shoulder blade, and rotates the shoulder inward and pulls the shoulder and arm toward the body) is injured, being able to lift the arm becomes difficult, or impossible and the biomechanics are altered, including the counter-balancing muscles, which further inhibit normal motion.
If you have followed my previous articles, you are familiar with the procedures that we employ at my office. Utilizing Chiropractic Manipulative Procedures, Active Release (ART), Graston instruments, LLLT (cold laser), as well as other procedures have brought about extremely positive resolutions, with some exception, i.e. spurs that have produced tears that may need surgical repair. On occasion, it may be necessary to have an injection first if the inflammation and restriction are so chronic that little can be accomplished conservatively in the short term. Whatever it takes, I want to see your “function” restored, pain eliminated and strengthening accomplished. My ego will not be attacked if we need the assistance of other health care professionals to help us in the desired outcome. Sometimes, this will take diligence and patience!
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