SEPARATED SHOULDER (A/C JOINT)

Symptoms: Symptoms of a rotator cuff injury are due to inflammation that results from the soft tissue injury associated with the strain. Shoulder pain, weakness, and reduced range of motion are the common symptoms. The swelling present in the rotator cuff is not usually visible due to how deep the rotator cuff is and the overlying musculature. Sharp pain with shoulder elevation possibly causing hiking or shrugging of the shoulder and dull/achy pain at rest is common. Some patients report a sensation of tearing or a sudden pop/click in the shoulder area accompanied by severe/sudden pain down the arm toward the elbow. Some chronic rotator cuff injury patients report no mechanism of injury but a gradual on-set of pain at night, and a gradual on-set of weakness and reduced motion.

Causes: Overuse is the most common reason for rotator cuff damage to occur. The rotator cuff is a group of four muscles that are responsible for keeping the ball of the humerus and the socket of the scapula in close connection during active motion of the arm. This group of muscles receive alot of stress during a lifetime and typically fray and wear throughout a lifetime.

Sudden trauma- can cause a quick stretch on the rotator cuff tissue, often combined with rotational forces, and/or shoulder dislocation.

Relief: Special testing by an Orthopedic physician or Physical Therapist can determine the presence of Rotator Cuff injury but the severity of the damage is most commonly assessed using MRI, Ultrasound, or CT scan. Surgical Intervention is often required for large rotator cuff tears and smaller tears are often treatable with a combination of anti-inflammatory medication, immobilization, and physical therapy intervention. Physical Therapy intervention includes manual therapy techniques to normalize the soft tissue and muscles that are limiting normal joint mechanics and putting excessive stress on the effected area of the rotator cuff. Pain relieving/anti-inflammatory modalities such as Ultrasound, Iontophoresis, laser, and Electric stimulation. Then a strengthening program is implimented that includes addressing the upper spine and shoulder complex to coordinate and normalize movement, to reduce stress and allow healing to occur.

If you’re experiencing shoulder pain, visit Neolife Physical Therapy & Wellness in D’Iberivlle, Mississippi today.

Causes: This condition is caused by compression of the median nerve at the wrist. The carpel bones of the wrist create a tunnel that allows the tendons of the forearm to the fingers and wrist pass through. This tunnel has a roof composed of a dense ligament that caps this tunnel. With excessive gliding of the tendons with the wrist out of a neutral position, friction can cause inflammation to build in this compartment putting pressure on the median nerve causing pain at and along the path of the nerve into the hand/fingers. Sleeping with wrist in “resting” flexed position also increases pressure exerted on this area

Symptoms: Shoulder pain and point tenderness at the junction of the clavical/collar bone and the front point of the scapula AKA acromioclavicular joint. It is usually accompanied by laxity of the joint which can be seen by pressing down on the collar bone and seeing a piano key effect, movement, and pain at the A/C joint. The collar bone portion of the A/C joint is usually high with visible inflammation present with acute injury. Shoulder pain with movement.

Causes: Traumatic injury is the most common mechanism of injury. Usually following a fall on the affected shoulder in which the ligaments that secure the collar bone to the shoulder blade partially or fully rupture and damage to the A/C joint capsule occurs. Sometimes damage can occur to the collar bone as well resulting in fracture.

Relief: The correct treatment approach is determined based on the level of severity of the injury. Shoulder seperations are classified into Grade I, II, or III. Grade 1 shoulder seperation is usually a sprain/strain senario where the soft tissue structures/ligaments are overstretched but still intact with possible partial tearing. Grade II shoulder seperation is usually a moderate to severe sprain/strain with definite partial tearing of ligamentous structures. And Grade III is severe sprain with complete tearing of ligamentous structures resulting in moderate to severe laxity. Grade III shoulder seperations are usually treated with surgical intervention although conservative treatment can sometimes be effective.

Initially immobilization, anti-inflammatory medication, and Physical Therapy intervention is the most common treatment. Anti-inflammatory injection is used during sub-acute phase. Physical Therapy intervention includes pain/inflammation reducing modalities incuding: ultrasound, laser, iontophoresis, and electric stimulation. Manual Therapy treatment that includes passive range of motion of the scapula and shoulder joint. Gravity reduced excercises to address posture and muscles that stabilize the shoulder girdle within pain free range to reduce inflammation, reduce stress to A/C joint and allow healing to occur