Question
injury occurred when reaching between two bucket seats to bring a heavy item to the front of the car. Felt and tear this was back in April or May after months of heavy snow shoveling.
I see a chiropractor regularly for about 7 years now. I indicated some discomfort and was treated for my first rib 'being out'. After the adjustment the 'strange' feeling went away but not the problem. Months passed while being treated for 'first rib being out' and pain when from -1 to 9. The pain was more of burning in my bicep area and severe pain when moving it in certain situations. For example, throwing a towel around you after a shower, putting on shirt or blouse using my right arm last; which is typical as I am left handed and the issue is with my right should area. Finally went to orthopedic. I am active for my age, exercise 2-3 x weekly, I also enjoy spinning classes, and ride a bike. I am about 15 lbs overweight and am 55 yrs old.
MRI conducted; to rule out subclavicular(not sure of spelling) tear; no tear, bone spur detected causing impingement syndrome.  Given exercises with rubber band. and a shot of cortisone.
I still have pain, burning is gone, I sit at a desk and PC all day, I can feel involvement of the neck muscles on the right side. I have to put shirts and blouses on with right arm first.
any suggestions to help me recover more quickly. Bone spur diagnosed in October.

Answer
Rotator Cuff, rotator cuff weakness, Staten Island Rotator Cuff, rotator cuff tear, rotator cuff injury, rotator cuff tendon, rotator cuff bone spur, shoulder injury, shoulder sprain/strain, staten island shoulder injury, staten island chiropractor, staten island sports chiropractor



Hello Jean,

Thank You for your question.  I am sorry to hear of your pain and complaints.  Good luck with resolving your problem, regardless of the treatment approach you choose.

You state you are 55 years old,,, this is a factor.  Rotator Cuff injury can occur at any age, and can often be the result of sports trauma.  As we grow older,,, a Rotator Cuff Tear can come from the degenerative changes of aging.  As we age every insult our body ever experienced is remembered in our muscles, joints, tendons, ligaments, all of our tissues.  As we age, there is a decrease in efficiency- i.e.: in our circulation.  As we age, the body reacts-- for instance that Bone Spur that you report on the MRI-- is a REACTION.  Perhaps you injured your shoulder years ago, perhaps you have some repetitive motion that irritates that point on the bone;  the bone spur is a reaction to irritation of that area of bone.  As we age, Rotator Cuff Tendinopathy (Tendon damage, tendon degeneration/ deterioration) is actually quite common; and it seems to be almost a 'normal' consequence of 'normal' aging.
         While Rotator Cuff Tears, Shoulder impingment is very common as we are in our 5th and 6th and 7th decades of life,,,, a tear or impingement may or may NOT cause pain or dysfunction.
Some tears are 'silent' not causing any pain or dysfunction, and the same for spurs and impingments.
         IF this is causing you pain and/or dysfunction,,, you may first just wish to reduce pain, increase proper function.  Conservative treatment such as Chiropractic, Physical Therapy, Massage, Medication, perhaps moving up to a cortisone shot may bring down the pain, allow more function (range of motion, strength).  If these less invasive approaches help you, you do not need to progress to more invasive measures: surgery- whether arthroscopic or 'open' approaches.
         Before progressing to more invasive approaches- cortisone injections, surgery; I would 'shop around'.  I would talk to neighbors and friends about the good Orthopedic MDs or Physiatrist MDs or 'Shoulder Specialist' MDs in your town.

For your conservative treatments,,,, I would also ask around for recommendations.  It sounds like you have a good Doctor of Chiropractic; BUT does your DC (Chiropractic Doctor) treat shoulders, extremities?  Chiropractic Doctors (DCs), similar to Medical Doctors (MDs) do have different specialties- you can view some of our recognized specialties at: http://www.acatoday.org/pdf/ApprovedChiropracticSpecialtyPrograms.pdf  
         Often the public does not realize there are specialties that may be most suited for your complaints.  I am a DACBSP- a chiropractic sports injury specialist (see: http://acbsp.com/certificationdetails.htm ) .  I would recommend you see a Chiropractor with sports injury certification.  I would recommend that Doctor hold CCSP or DACBSP credentials as well as have training in A.R.T. or F.A.K.T.R. or Graston techniques (see: http://www.activerelease.com/ , http://www.faktr-pm.com/3.html ,  http://www.grastontechnique.com/ ).  These techniques are VERY helpful with soft tissue complaints such as rotator cuff injuries.

I would utilize a DC with the above credentials/approaches AND take proper nutritional supplementation:  i.e. joint/ tendon/ muscle support- glucosamine, chondroitin, SAMe, MSM, Hyaluronic Acid, Calcium, Magnesium, etc.

In my Staten Island Chiropractic office I utilize all of the above approaches.  Often these non-invasive approaches can repair/ restore the soft tissue complaints such as your rotator cuff complaint; and make the joint more functional and less painful without the more invasive approaches (injections, surgeries).

From a medical perspective I think this website:  http://orthoinfo.aaos.org/topic.cfm?topic=a00406  does a good job talking about your complaint.

You ask my suggestions:
See a local Doctor, such as a chiropractor with sports injury or rehab or orthopedic credentials. Check for approaches named above.  Implement proper nutritional supplementation.
Have an evaluation by a conservative practitioner.
If,
If evalution(s) by conservative practitioners say to move on towards more invasive approaches (injection, surgery); visit a couple (few) MDs for their evaluations, ask questions, proceed as you feel most comfortable and confident with.

I have hand-out sheets I utilize in my Staten Island Chiropractic office,  this information is snatched from one sheet on 'pinched nerves', but has some info on bone/ joint support:
( I *** ones that may be most helpful to YOU )

-----A multi-vitamin/mineral supplement is suggested for comprehensive support.******
-----Essential fatty acids are necessary for nerve health.  Essential fatty acids include omega-3 fatty acids (fish and flax oil) and omega-6 fatty acids (black currant seed oil, borage oil and evening primrose oil).****** anti-inflammatory
-----Proteolytic enzymes may be beneficial in neuritis for the inflammation.*****
-----Lecithin aids in nerve support.
-----Natural herbal remedies including passion flower, valerian, chamomile, scullcap and white willow bark may be helpful.
-----Eat a healthy diet.  Avoid foods that stimulate the nervous system such as caffeine, chocolate, refined sugars, soda pop and cigarettes.
-----Drink plenty of filtered water.
-----Chiropractic care is imperative to remove nerve irritation.
Joint Support:
-----Glucosamine sulfate ******** helps strengthen joint integrity.  Glucosamine is effective in relieving joint pain associated with osteoarthritis.  Glucosamine's pain-relieving effects may be due to its cartilage-rebuilding properties.  These disease-modifying effects are not seen with simple analgesics and are of particular benefit.
-----MSM ******* is known for its pain-relieving properties in such conditions as fibromyalgia, osteoarthritis, bursitis, tendonitis, back pain and muscle soreness.  Not many clinical trials have been done using MSM, but clinical observations support the theory that MSM is beneficial in pain managment.
-----White willow is an antiinflammatory******** and analgesic agent.  White willow was used as far back as the Middle Ages to reduce pain and fevers.  The salicylates found in the white willow bark are responsible for the anti-inflammatory and anti-fever effects.  Acetylsalicylic acid, otherwise known as aspirin, is chemically similar to the salicylates.
-----Boswellia and turmeric (curcumin) are potent antiinflammatory herbs.  Curcumin may have similar action to aspirin.


I hope these suggestions help.  If you need further information,,,, do not hesitate to REcontact me here at ALLexperts.com :  http://www.allexperts.com/ep/965-100794/Chiropractors/Victor-Dolan-DC-DACBSP.htm

Again, thanks for the question, your Staten Island Sports Chiropractor friend,

Dr. Vic Dolan, DC, DACBSP