Spinal Therapeutic Services, Inc. Gerald Snider, M.D.

Shoulder/Rotator Cuff Pain: Most shoulder problems stem from the rotator cuff which includes the tendons of the supraspinatus, infraspinatus, teres and subscapularis muscles.  Sometimes, the problem involves the bursa sac, which cushions the muscles and bones next to the shoulder joint, and can also involve the ligaments of the shoulder and/or acromioclavicular joint (AC).  The majority of patients with shoulder and rotator cuff pain suffer from dysfunction which leads to inflammation, swelling and spasm in the affected tissues.  Some patients also experience arthritic changes which can involve bone spurs and calcification to impinge upon the bursa and tendons.  Adhesive Capsulitis, otherwise known as "Frozen Shoulder Syndrome" when a patient has had a long standing shoulder problem.  This is a condition which involves Adhesions to build up in the shoulder and limit the range of free movement of the shoulder.  Regardless of whether or not there is a tear or impingement, the overall status of the shoulder is usually compromised in it's ability to function normally. Therefore, passive therapy and active rehabilitation is vital in almost all situation.  In addition to therapy and rehab, medical care such as anti-inflammatory medications and steroid injections can also be helpful.

In some cases, the patient can experience a tear in one or more of the tendons, ligaments or bursa.  However, if the tear is less than 3/4 of the thickness of the tendon, treatment can usually prevent surgery.  For those who have had or ultimately will need surgery, then post-surgical rehabilitative treatment is necessary in order to restore strength, range of motion and function.