You’re in the kitchen, and you have to grab that mug from the top cupboard quickly. Does that thought put you into a cold sweat?
If you are like 1/5th of the Australian population, raising your arm above your head may be painful and impossible to do due to shoulder pain.
Inevitably, the most common shoulder injuries our clinic sees are rotator cuff tears, tendinopathies and bursitis. A study by Yamamoto (1) found 22.1 % of the population had a rotator cuff tear and that prevalence of rotator cuff tears increasing with age.
Even more concerning is the type of tear! Namely, an asymptomatic tear was twice as common as a symptomatic tear, meaning that some people did not know they had a tear in the shoulder. This could be seen in those patients that generally describe, “I didn’t do anything, the pain just began to get worse over time, and now it is just too painful”.
But first of all, what is the rotator cuff?
The rotator cuff is a collective name given to 4 muscles that help move the arm and provide strength and stability to the shoulder during movement.
Rotator Cuff Muscles and their primary action:
Supraspinatus- Lift arm away from the body (abduction)
Infraspinatus- To rotate the arm outwards (external rotation)
Teres Minor- To rotate the arm outwards (external rotation)
Subscapularis- To rotate the arm inwards (internal rotation)
What is a tendinopathy and bursitis of the rotator cuff?
Tendonitis or tendinopathy of the rotator cuff is when one or more tendons are inflamed on any of these four rotator cuff muscles.
Bursa, on the other hand, is a sac that is filled with liquid that can be found between tissues (bone, skin, tendons and muscle). Hence, a healthy bursa is used as a cushion to decrease friction and irritation between the tissues when they move over one another (2). When the bursa is not irritated, joints move smoothly and painlessly. But when it becomes inflamed and swollen, it causes pain when a shoulder is moved. This condition is called bursitis - the inflammation of a bursa.
Both of these injuries are often due to overuse and poor movement over time and is in:
people over the age of 40
people that do overhead movement frequently (i.e. carpenters, painters, electricians, etc.)
Without treatment, these injuries may lead to a permanent loss of shoulder and arm range of motion, weakness in affected limbs and progressive degeneration.
As with many different injuries, shoulder injuries are preventable. However, there is no point in crying over spilled milk. It is time for treatment, but there is a catch. Treatment is needed to reduce pain, but can be hard and sometimes impossible to treat the area because of the pain. This is a decade-old problem for practitioners and sadly not a well addressed one (unless you are a sucker for cliches like no pain, no gain).
So, the hard truth is that most people have a fear of pain during the treatment (for good reason), and no matter what their logical brain tells them, this fact is often a big hindrance to the treatment’s adherence and success. Still not convinced? Just think about surgery and the first thoughts that come to your mind.
Follow the light - Treatment
The good news is that there is a light at the end of the tunnel. As a chiropractor, I strongly believe in rehabilitation and improving the shoulder joint movement, but first things first. Let's reduce the pain.
At Balanced for Life, our ‘secret sauce’ for shoulder pain and therapy is a treatment called photobiomodulation. It is a medical laser, a cold laser, that uses a multi-wave locked system (MLS) technology, combining two types of laser light wavelengths. So during the treatment, light penetrates tissue and provides energy to the damaged cells. This (safe and painless) action stimulates the Intercellular activity that:
1. reduces pain in the treated area
2. reduces inflammation and
3. speeds up the recovery of damaged cells. (3)
An average treatment lasts about 15 minutes, and as I mentioned before, it is painless and has no side effects. It can be used on both chronic or acute pain. (4)
Does a laser session really not hurt?
Correct, if you were to get an MLS laser treatment, it would feel like taking a flashlight and moving it over the shoulder; however, unlike a flashlight, the laser penetrates the tissue (for up to 4 centimetres) and pumps it full of cell-stimulating energy.
Correspondingly, this type of treatment is accumulative. So each treatment builds on the last, providing your shoulder with more and more pain and inflammation reduction. As for the number of treatments, it depends on how long the pain and injury have been present. But we have good news there as well. For an acute injury, 4-6 treatments can do; however, for more chronic conditions like long term shoulder arthritis or old injuries that have never healed, usually 10-12 treatments are required.
So, now you have it. There is a way of reducing your pain, inflammation and working on your shoulder recovery before our experts even lay a finger on you making your treatments, at Balanced for Life, that much more pleasant and effective.
Why am I sharing all of this with you? Because I know that moving better matters.
1. "Prevalence and risk factors of a rotator cuff tear in the general ...." https://pubmed.ncbi.nlm.nih.gov/19540777/. Accessed 7 Mar. 2021.
2. “Clinical Management of Scapulothoracic Bursitis ... - SAGE Journals." https://journals.sagepub.com/doi/abs/10.1177/1941738109338359. Accessed 7 Mar. 2021.
3. "MLS Laser Therapy | Heal with Laser." https://www.healwithlaser.com.au/laser-therapy/. Accessed 7 Mar. 2021.
4. "Effects of a single treatment with two nonthermal laser ... - PubMed." https://pubmed.ncbi.nlm.nih.gov/31564998/. Accessed 7 Mar. 2021.