Do you have seemingly never-ending shoulder pain? A painful niggle, weakness, catching and limited range of motion?
You're not alone! 22.1% of people over 18 years old have some form of rotator cuff degeneration or in worse cases a painful and persistent rotator cuff tendinopathy.(Journal of Shoulder and Elbow Surgery, 2018)
Thankfully, there is a solution! Osteopathy can help rehabilitate, manage and prevent these types of overuse injuries. Using a holistic approach that involves manual therapy, exercise prescription, lifestyle changes, and other preventative measures to limit the risk of re-injury.
What is rotator cuff tendinopathy
The rotator cuff, a group of four muscles and their tendons, wrap around the shoulder join and play a crucial role in providing stability and movement to the shoulder joint. But when these small muscles and their tendons become irritated and inflamed you can experience pain, stiffness, and weakness that limit your range of motion and can impact your quality of life. This pain can hav many diagnoses but the most common that we see is tendinopathy.
Tendonopathy is a common condition that affects the tendon tissue anywhere in the body. Often incorrectly called tendonitis (itis - meaning inflammation), tendons don’t always have to be inflamed to be in pain. Tendinopathy is what is known as an overuse injury, unlike a muscle strain which occurs in an instance, tendon pain is most commonly a gradual onset that comes from overuse and stress. In the case of the rotator cuff that is continuous and repetitive movements of the shoulder along with a variety of other factors including poor posture, trauma/injury and general aging.
Luckily, as much as tendinopathy is common, it is also highly treatable. Osteopathic treatment together with movement modifications an effective way to manage and prevent these types of injuries.
Osteopathy for shoulder pain and rotator cuff injuries
Osteopaths use a variety of techniques, such as soft tissue manipulation, joint mobilisation, and dry needling to treat rotator cuff tendinopathies. These techniques can help to reduce inflammation and improve blood flow to the affected area, which can aid in the healing process.
Manual therapy is a hands-on approach that osteopaths use to manipulate and mobilise the joints, muscles and tissues of the body. This therapy can help to improve range of motion, reduce pain and improve function in the shoulder joint.
Along with hands on treatment osteopaths use a wider range of management strategies to help aid in the healing process and strengthen the shoulder joint to provide stability and reduce future risk of injury. These strategies include exercise prescription, lifestyle changes and other preventative measures to limit the risk of re-injury.
Stages of rehabilitation for shoulder tendinopathy
Sometimes when we injure ourselves, we think rest it until it gets better. This is the opposite for tendon injuries. Exercise is actually the most important component of osteopathic treatment for shoulder tendinopathies. Osteopaths prescribe targeted exercises to help strengthen the rotator cuff and and improve function of the joint.
These exercises may include stretching, resistance training and functional activities that mimic the movements of daily activities or sports.
Stage 1 - Isometrics
The first step involves isometric strengthening which is a held continuous contraction. These are aimed to provide strength to the tendon in a non-compromised position and also provide pain relief to the tendon.
Stage 2 - Eccentrics
The next step is looking at eccentric loading of the tendon which involves lengthening the tendon while under load to strengthen the tissue. This aims to provide more strength building to the tendon while under load and also improve the function of the muscle itself
Stage 3 - Strength and power
Finally more explosive strength based exercises are prescribed to return the tissue to its pre injury strength levels and reduce the risk of future injuries. These are normally prescribed in accordance of the tasks the individual is completing. These may be geared towards common daily tasks or individuals sporting requirements.
Lifestyle changes to reduce rotator cuff stress
In addition to manual therapy and exercise, osteopaths can help you make adjustments to your lifestyle and habitual behaviours manage and prevent shoulder rotator cuff tendinopathies. These changes may include:
- Posture correction: Poor posture can put undue stress on the shoulder joint, leading to injury.
- Ergonomic adjustments: Patients who engage in repetitive overhead motions, such as painters or athletes may need to make ergonomic adjustments to their work or training environment to reduce the risk of injury.
- Getting the right pillow: Changing your pillow to make space for your shoulder can be so helpful. When you lie on your side, you can compress the structures and nerve supple surrounding your shoulder, sometimes making it even more sore after sleep. We recommend a memory foam contoured pillow to allow the perfect posture whilst sleeping.
Prevention is Key!
Preventing rotator cuff tendinopathies is integral to the longevity and stability of the shoulder post injury. As osteopaths we work with patients to identify risk factors and work together to limit the affect these have on our patients pain. These strategies may include:
- Proper warm-up and cool-down: patients who engage in sports or other activities that involve overhead motions should always warm up before activity and cool down afterward.
- Gradual progression: patients should gradually increase the intensity and duration of their activities to avoid overuse injuries.
- Avoid loading of the shoulder: avoid or reduce sustained shoulder loading such as overhead lifting and repetitive shoulder actions.
If it’s too late for you to prevent your shoulder pain, the sooner you take action the better. Early diagnosis and treatment leads to faster return to function and fewer weeks in pain.
If you are experiencing discomfort due to shoulder pain and a potential rotator cuff tendinopathy, get in touch and book an osteopathic treatment today. The holistic approach of manual therapy, exercise prescription, lifestyle changes and preventative measures will get you back on the path to recovery and improve your quality of life.
Book an appointment with us at Enso Osteopathy and let us help you manage and prevent these types of injuries.