We design programs to strenghten the entire shoulder complex. Minor shoulder problems that are left untreated often become major shoulder problems, sometimes requiring surgery.
Before we discuss how to correct the vaious shoulder problems we should discuss shoulder anatomy:
ROTATOR CUFF PROBLEMS
Looking at the shoulder complex reveals the Rotator Cuff. The cuff is made up of four major muscle groups. The Supraspinatus, Infraspinatus, teres minor, teres major. These muscles give major stabilility to the shoulder complex. When one of these major muscles is torn the shoulder loses its stability. There are different levels of tears.
Ligaments are graded according to the severity of muscle or tendon damage. Grade 1 strain is a mild strain in which the muscle tondons become stretched with few torn fibers. Grade 2 or second-degree sprains reflect stretching and tearing of some ligament fibers with minimal joint displacement. Grade 3 or third degree sprains involve full thickness tears (rupture) of ligament fibers that result in joint dislocation. More severe sprains may be graded from IV to VI reflecting increased displacement of bony antaomy.
Diagnosis: Grade 1 is usually has minimal brusing and no displacement of the boney anatomy. Grade 2 often has brusing and edema but not boney displacement. Grade 3 usually has brusing, edema and boney displacement.
Radiographs will help determine a Grade 3 but not a Grade1 or 2. MRI will better view the soft tissues for a grade 1 or 2.
Treatment: Grade 1 and 2 shoulder sprains and strains are initially treated with Physical Therapy modalities. Ultrasound, Electrical Stimulation, Massage, Ice Massage, Gentle Mobiliztion and rest. Range of motion exercises should be started fairly soon to prevent scar tissue formation. Evntually exercises should be done to strength the shouder complex.
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Grade 3 shoulder sprains and stains should be put in a sling and checked for possible surgical intervention. Surgical repair of the ligaments and tendons may be necessary.