Managing Shoulder and Rotator Cuff Tendinitis in Greenville

 Managing Shoulder and Rotator Cuff Tendinitis Is One of the Most Difficult Cases to Manage, but it Doesn’t have to be.

Shoulder pain caused by tendinopathy can limit your range of motion and make everyday tasks challenging. At our chiropractic offices in Greenville, Greer, and Mauldin, we use photobiomodulation therapy (PBMT) combined with active release and sports chiropractic techniques to address shoulder tendinopathy at its source.

Understanding Shoulder Tendinopathy:

Repetitive overhead movements, poor posture, or injury can lead to inflammation and microtears in the shoulder’s tendons. Conditions like rotator cuff tendinopathy or biceps tendonitis are common culprits.

We break our Shoulder Reset Series into 5 Steps:

Step 1: A Closer Look at Shoulder Kinematics

1 Minute Summary:  By looking at the scapular motion with a trained eye and watch overhead and reaching motions, we can begin to diagnose the real cause.

The shoulder is a complex joint that relies on a precise sequence of movements and muscle activations to function optimally. During our assessment, we evaluate:

1. The Kinematic Sequence:

• We analyze the order in which the muscles around the scapula (shoulder blade) activate during movement. Proper firing of the scapular stabilizers—like the serratus anterior, rhomboids, and trapezius—is essential for pain-free and efficient motion.

• Dysfunctional patterns, such as over-reliance on compensatory muscles like the upper trapezius, can indicate nerve signaling issues or strength imbalances.

1. Spinal Joint Function:

• The thoracic spine and cervical spine play a critical role in shoulder health. During movements such as shoulder abduction, extension, and rotation, we observe how these spinal joints contribute to the motion. Proper rotation and extension of the spine ensure that nerve signals from the C5–C8 spinal nerves reach the muscles effectively.
• Misalignments or restricted movement in these areas can lead to dysfunctional muscle activation and increase strain on the shoulder joint.

Identifying Dysfunctional Patterns

Through this detailed functional exam, we can pinpoint:

• Nerve Signal Issues: Poor nerve communication can cause the scapular muscles to “default” to dysfunctional patterns, such as a winging scapula or limited upward rotation.
• Muscle Imbalances: Tight or overactive muscles (e.g., pectoralis minor) paired with weak or inhibited stabilizers (e.g., lower trapezius) can create instability and pain.
• Joint Restrictions: Limited motion in the thoracic spine or rib cage may force the shoulder to compensate, leading to overuse injuries.

Why Functional Assessment is Essential

This in-depth evaluation sets the stage for effective treatment. Understanding how the shoulder interacts with the entire kinetic chain allows us to:

• Customize care to each patient’s specific dysfunctions.
• Address the underlying issues rather than just masking pain.
• Build a solid foundation for lasting recovery and optimal performance.

Experience Pro-Level Shoulder Care in Greenville

Drawing on insights gained from working with pro surfers and volleyball players, we’ve developed a system of care that’s not only effective for elite athletes but also highly beneficial for patients dealing with everyday shoulder pain. This meticulous assessment process ensures that your treatment is both targeted and holistic, addressing every aspect of shoulder health.

If you’re struggling with shoulder pain in Greenville, Greer, or Mauldin, schedule an appointment today. Let us help you uncover the root cause of your pain and regain full, pain-free function.

Step 2: Laser Therapy for Shoulder Pain

1 Minute Summary:  Laser acts like a cortisone injection without the side effects by stimulating cells to “Reset” their immune function.  This breaks the cycle of inflammatory cytokines and exudate that plague tendon and muscle issues. 

Studies have shown PBMT to be highly effective in managing shoulder pain and dysfunction. Here are some key findings from relevant research:

1. Rotator Cuff Tendinopathy:
   • A systematic review published in Photomedicine and Laser Surgery found that PBMT significantly reduced pain and improved range of motion in patients with rotator cuff tendinopathy.
   • The therapy also demonstrated its ability to reduce pro-inflammatory markers, enhancing the healing environment.
2. Frozen Shoulder (Adhesive Capsulitis):
3. A study in Lasers in Medical Science highlighted that PBMT improved pain, range of motion, and functional outcomes in patients with frozen shoulder. The results were attributed to the therapy’s anti-inflammatory and regenerative effects.
4. Post-Surgical Recovery:
5. Research published in Journal of Orthopaedic Surgery and Research demonstrated that PBMT significantly reduced pain and swelling in patients recovering from shoulder surgeries, such as rotator cuff repair. PBMT also shortened the recovery time and improved strength restoration.
6. Tendinitis and Bursitis:
7. Studies have shown PBMT to be particularly effective in reducing inflammation in soft tissue injuries, including tendinitis and bursitis. This is achieved through its ability to downregulate pro-inflammatory cytokines and upregulate growth factors like TGF-β and VEGF.

Depth of Penetration: Why PBMT Excels

The MR5 ACTIV PRO LaserShower, used at our clinic in Greenville, delivers light energy at a wavelength that penetrates deeply into the shoulder’s complex structures. Its super-pulsed technology allows for:

• Deeper Tissue Penetration: Reaching muscles, tendons, and ligaments without generating heat, ensuring safety and efficacy.
• Multiphase Delivery: The MR5’s unique approach combines continuous wave and pulsed light, maximizing tissue stimulation and repair.

Comprehensive Care for Greenville, Greer, and Mauldin Patients

We complement PBMT with myofascial release and muscle activation techniques to address imbalances and restore proper movement patterns. Our goal is not just pain relief but long-term recovery and improved performance.

Residents of Greenville, Greer, and Mauldin, don’t let shoulder pain hold you back. Contact us today to explore how PBMT and chiropractic care can help you move freely again.

Step 3: Why Myofascial Therapy is Critical

1 Minute Summary: We are the best at Myofascial therapy in Greenville, and Greer because we traveled the world and worked backstage at the pro surfing tour learning from the best in the world.  

We have also traveled with other “gurus” who are known the world over in Myofascial. 

Fascial restrictions don’t just cause pain—they disrupt the body’s biomechanics and reduce overall performance. Active Release is a proven method to release these restrictions, making it a vital part of our holistic approach to care.

• Breaking Down Scar Tissue: Adhesions and scar tissue limit movement and cause discomfort. ART effectively breaks down these restrictions to restore freedom of movement.
• Improving Blood Flow: ART increases circulation to the treated area, accelerating the healing process.
• Enhancing Nerve Function: By reducing tension around nerves, ART helps restore proper signaling and reduces nerve-related pain.

By mimicking the native motion we can get the muscle to release faster than traditional massage. 

Common Shoulder Adhesion Sites

1. Supraspinatus:
   • This rotator cuff muscle is vital for lifting the arm and stabilizing the shoulder joint. Adhesions here can lead to impingement syndrome or difficulty with overhead movements.
2. Infraspinatus:
3. Responsible for external rotation of the shoulder, adhesions in this muscle can cause weakness and limited range of motion, often contributing to shoulder instability.
4. Teres Major:
5. While aiding in internal rotation and adduction, this muscle can develop adhesions that limit arm movement and create compensatory patterns, particularly during pulling motions.
6. Biceps Tendon:
7. The long head of the biceps tendon is prone to inflammation and adhesions, often resulting in biceps tendonitis or referred pain to the front of the shoulder.
8. Pectoralis Minor:
9. Tightness or adhesions in this small chest muscle can pull the shoulder into a forward, internally rotated position, compressing nerves and contributing to thoracic outlet syndrome.

The Bigger Picture: Shoulder and Neck Muscle Adhesions

Adhesions are not limited to these common sites. Any muscle in the shoulder girdle or neck can develop restrictions that impact shoulder function, including:

• Trapezius (upper, middle, lower): Tension and adhesions here can alter scapular positioning and disrupt overall shoulder mechanics.
• Levator Scapulae: Tightness can limit neck rotation and scapular movement, often contributing to shoulder pain.
• Sternocleidomastoid (SCM): Adhesions in this neck muscle can cause referred pain to the shoulder and reduce rotational capacity.

Step 4: Spinal Alignment & Shoulder Pain

1 Minute Summary:  Many treat the shoulder in isolation.  We have found that the spinal motion and neck health treated in our patented Chiropractic method holds the nerve signals to the shoulder hostage if it is misaligned.  Many PT offices in Greenville only teach your exercises, while many Chiropractors in Greenville only focus on the adjustment.

Shoulder pain often stems from issues that go beyond the shoulder joint itself. At our chiropractic clinic in Greenville, we frequently address dysfunctions in the first rib and lower neck joints, which play a pivotal role in shoulder mechanics. These areas act as critical “hinges” of motion and signal coordinators, influencing how the shoulder moves and communicates with the brain.

The First Rib: A Key Player in Shoulder Motion

The first rib is more than just a structural component—it’s integral to the shoulder’s ability to move freely.

1. Hinge of Motion:
   • The first rib moves subtly with each breath and arm movement. Restrictions here can impair shoulder abduction (lifting the arm sideways), leading to pain and compensatory motion.
2. Neuromuscular Coordination:
3. Located near the brachial plexus (a network of nerves controlling the arm and hand), dysfunction of the first rib can compress these nerves, causing pain, tingling, or weakness in the shoulder and arm.

Lower Neck Joints: The “Computer Chips” of Motion

The cervical spine, particularly the C6 to C8 segments, serves as the command center for shoulder and arm movement.

1. Coordinating Signals:
   • These joints relay messages between the brain and muscles, ensuring smooth and efficient shoulder motion. Misalignments or stiffness in the lower neck can disrupt this communication, leading to dysfunctional movement patterns.
2. Supporting Abduction:
3. Proper function of the lower neck joints is essential for the stages of shoulder abduction. Without their support, the shoulder may lack the stability and coordination needed for overhead activities.

Capsular Patterns and Compensations of the Shoulder Joint:

The shoulder capsule—a connective tissue structure surrounding the joint—can develop restrictions known as capsular patterns. This often occurs after injury, inflammation, or prolonged immobility, and presents as:

• Limited external rotation
• Difficulty lifting the arm overhead
• Pain during certain movements

When the shoulder is stuck in a capsular pattern, the body compensates by relying on other joints and muscles, such as:

• Overuse of the upper trapezius to lift the arm
• Altered movement in the mid-back or lower neck to create more range of motion

These compensations can lead to further pain and dysfunction in the shoulder and beyond.

Step 5: Movement Instruction – Mastering Shoulder and Spinal Balance

At our Greenville chiropractic clinic, we believe in empowering patients to take charge of their recovery and performance. That’s why the final step in our protocol focuses on movement instruction. By teaching you how to properly sequence shoulder and scapular movements while maintaining optimal spinal posture, we aim to create lasting improvements in your function and pain relief.

Step 5: Why Movement Matters

1 Minute Summary: Our Shoulder specializing Center in Greeville focuses on teaching your what to do to heal. Even after restoring joint alignment, reducing adhesions, and addressing inflammation, poor movement patterns can undo progress. Many shoulder issues are caused or worsened by imbalances in posture, muscle activation, and scapular mechanics. By correcting these patterns, we:

• Prevent reinjury
• Enhance strength and flexibility
• Optimize overall performance

Key Components of Movement Instruction for Shoulder Pain and Tendinitis:

1. Stretching for Flexibility:
   • Tight muscles around the shoulder girdle, such as the pectoralis minor, upper trapezius, and levator scapulae, can pull the shoulder into improper positions.
   • We guide you through stretches that improve flexibility and counteract the effects of daily posture or repetitive strain.
2. Example:
3. A chest opener stretch to release tension in the pectoralis muscles and promote an upright shoulder posture.

Activating Dormant Muscles for Shoulder Tendinitis:

1. Dysfunctional movement patterns often arise from underactive muscles, such as the serratus anterior, lower trapezius, or rotator cuff muscles.
2. We use activation techniques to reconnect these muscles with your nervous system, helping them function as intended.
3. Example:
4. Scapular retraction drills to engage the lower traps and improve scapular stabilization.
5. Strengthening for Stability:

1. Strengthening exercises target weak areas to ensure your shoulders and spine can handle the demands of daily life or athletic performance.
2. We prioritize movements that enhance balance between agonist and antagonist muscles, such as the rotator cuff and deltoids.
3. Example:
4. External rotation with resistance bands to strengthen the infraspinatus and teres minor, improving shoulder joint stability.

Proper Sequencing for Shoulder and Scapular Balance

We teach you how to sequence movements for efficient and pain-free motion. This includes:

• Coordinating the scapula and shoulder during activities like lifting or throwing.
• Maintaining spinal alignment to support healthy nerve signals and muscle activation.
• Reprogramming motor patterns for optimal movement, reducing compensations.

Read more about our approach :

Shoulder Impingement

 

Book your Discovery Visit with The Premier Office for Resetting your SHoulder Tendinitis in Greenville

If you would like to consult with us.  There is a no commitment 30 minute consult for us to analyze you and discuss your case at a very affordable price.  

Reach out to us with any questions you may have about your unique case.