The human shoulder is capable of a wide degree of movement. Unfortunately, this comes with a price. The shoulder is very prone to injury. Couple this with poor posture, prolonged periods of time sitting in front of a computer and sedentary lifestyles and you begin to understand why shoulder problems are so common.
Tendonitis? Or something else….
While we have traditionally viewed most shoulder problems as a version of tendonitis, as our understanding has increased we’ve realized that this is not really the case. Rather, “tendonosis” is the condition that contributes to most shoulder problems. This is NOT an inflammatory condition, and so anti-inflammatories and most prescriptions will have little effect. Tendonosis refers to the presence of scar tissue within the soft tissues of the tendons. When we suffer any type of injury, there is inflammation created. As the body heals, it is not going to heal at 100%. There will be some residual scar tissue remaining. In turn, this scar tissue is more prone to re-injury, recycling the process and depositing more and more scar tissue as time goes on. Given enough time, tearing of the rotator cuff muscles becomes much more likely, and even quite common.
My rotator cuff is torn. I need surgery.
Not even close to true in most cases. As a matter of fact, a large percentage of women over 50 have rotator cuff tears that they aren’t even aware of!! That means that it is likely that a rotator cuff tear may have been present even before an injury, and that an injury just worsened what was already present. Just because an MRI shows a tear does not mean that it wasn’t already present a year ago when you had no pain. So, does this sound like surgery is the only option?
Why doesn’t rehab really fix a shoulder problem?
If tendonosis with scar tissue is present, no amount of stretching, strengthening, ultrasound, massage or interferential will change that. Unless the scar tissue is addressed the shoulder isn’t really fixed. Tendonosis requires a different soft tissue approach.
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