Re-thinking the Rotator Cuff and Shoulder Pain

Old habits die hard. Improperly diagnosing and treating shoulder pain is just one of those things. Let me explain.

If you are reading this, and have no shoulder pain, you get recruited for an MRI study. 100 other people do the same. Remember, your group has no shoulder pain.  Your results are interpreted and measured against a different group of people that DID have pain. Lo and behold, it’s hard to tell a difference between groups (on paper)! The asymptomatic (no pain) crowd had a strikingly similar list of “diagnoses” as the symptomatic group. Pain or no pain, all had a remarkably similar prevalence of rotator cuff tendonitis, bursitis, labral tears, etc. That type of research continues to pour in, as you saw in the video above. Below is another research example of pain free individuals with surprisingly high rates of bursitis, AC joint degeneration, and rotator cuff tendinopathy.

The point is, we have to re-think how we are diagnosing and treating shoulder pain. No longer can science support mere imaging for proper diagnostics and treatment prescription. Even “special tests” are not sufficient to rule in or rule out different shoulder pathologies.

“I actually had a tear that needed to be repaired.” Me too. I’ve had cartilage in my knee and shoulder that required surgery. But the flip side is also true, namely, that millions of orthopedic surgeries are performed when the “problem” area could have been treated just as effectively with a Doctor of Physical Therapy at a fraction of the cost. As you see in the video, PT for impingement and rotator cuff tearing is either “as effective as” surgery or “significantly reduces the risk of” surgery depending on how bad the pathology is.

The first part of the video is helpful in answering how this could possibly be. As you saw, our shoulders are capable of a phenomenal amount of dynamic mobility, speed, strength, and stability. (That’s not even to mention the intimate roll of the spine and scapula, but that’s a topic for a different post.) When one part of the shoulder stops functioning as it should, we have a recipe for trouble. It takes skill to restore the normal function of the shoulder, and Physical Therapy is the most specialized field in the world of orthopedic conservative care to do so.  We need more than the bandaids of Ibuprofen, oral Prednisone, and injected Cortisone for our aches and pains. We need a specialty profession that treats the dysfunction in each body region, and we have it in Physical Therapy.

If you have any questions about your shoulder (pain or no pain!) we would love to talk with you. Feel free to drop me, or one of our other Physical Therapists an email, call our office, or even drop a comment or post on our facebook page. At Northwest, we are 100% into the restoration of your function and thus reduction in your pain!

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