Often I see patients in my clinic at Qi Integrated Health who have suffered from debilitating shoulder pain that has been ignored or inappropriately treated. Desperate for results, some of these people have progressed to the point where something as simple as getting a mug out of an overhead cupboard, or putting on a jacket, becomes impossible. While a seemingly minor complaint at first, shoulder pain can progress secondary to altered kinematics, leading to muscle imbalances, instability, additional pain, and ultimately, loss of function.
As one of the most intricate joints in the body, obtaining the correct diagnosis and beginning an appropriate treatment regime requires a thorough clinical examination. Given the complexity of the shoulder, it’s easy to appreciate the number of causes for shoulder pain, so today we will focus on the rotator cuff.
The Rotator Cuff – What is it?
The rotator cuff is made up of 4 key muscles that are responsible for – as you guessed it – providing rotation and movement of the shoulder joint, but more importantly, dynamic joint stabilization. One of these four muscles is called the Supraspinatus. It is also the muscle most prone to injury.
Where is the Pain?
The supraspinatus muscle sits in the supraspinous fossa, or above the boney ridge on the shoulder blade. It attaches to the head of the humerus and is responsible for ABDucting the arm, or moving your arm straight out to the side. An injury to the supraspinatus may cause pain directly at the shoulder, or the pain may be referred down the front or back of the arm, sometimes even as far as the wrist.
There can be several different causes, but some of the most common include:
- A fall on an outstretched arm
- Sports that involve repetitive, strenuous movements of the shoulder such as baseball, softball, tennis, volleyball, and swimming.
- Household chores such as washing windows or painting.
- Degeneration associated with advancing age.
My Treatment Approach
One of the reasons the supraspinatus muscle is difficult to treat is that it sits below the trapezius muscle. Acupuncture is a great way to treat this injury because it can target specific points deep to the trapezius muscle that things like massage cannot reach as well. For all you acupuncture buffs, SI12 is one of the key points.
Activity will likely only aggravate the muscle and slow the healing process. Trying to limit the activity that causes pain, as difficult as that may be for some, it is very important.
Rotator Cuff Exercises
Rehabilitative exercises for the rotator cuff muscles that are gentle and controlled will help with the recovery and prevent the formation of scar tissue.
Stop guessing what’s causing your pain, and hoping it will disappear. Speak to an acupuncturist trained in musculoskeletal health, and see what acupuncture can do for you.