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Shoulder injury not getting better? Could it be the Rotator Cuff?

Have you injured your shoulder?

Whether it is the result of a crash, accident or repetitive use strain, shoulder pain is a common complaint for many of our patients at Doveston Health.

Traumatic shoulder injuries often result from a direct fall onto the shoulder, onto an outstretched hand or from a fall whereby the arm is hyper-extended backwards or sideways.

Of these types of falls, many studies have concluded that the most common resulting injuries are clavicle fractures followed closely by acromioclavicular joint dislocations and rotator cuff tears (1).

Jessica Bates | Physiotherapist at Doveston Health

Acute rotator cuff injuries are frequently left undiagnosed and mistreated and can sometimes end up causing months of pain and shoulder dysfunction later down the track. It is important to seek medical treatment for shoulder injuries from physiotherapists (initially) and exercise physiologists (afterwards) earlier rather than later to increase successful treatment outcomes and be able to return to pre-injury level as fast as possible.






What is the rotator cuff?

The rotator cuff is a term used to describe four key muscles and their tendons that work together as a synergy to move and control the ball and socket joint that is your shoulder.

The muscles help to secure the ball (arm bone) into the socket (shoulder) to stabilise the joint and allow for correct movement patterns when moving the arm.

When just one of these four muscles is damaged, it can lead to altered movement patterns, which can cause further issues and pain within the joint.

If you are experiencing pain or difficulty with lifting your arm out to the side, rotating it outwards or lowering it from out in front, a rotator cuff issue could be present.


How do you treat it?

Treatment of this injury depends on the severity of tear, level of pain and restriction it is causing.

Treatment approaches can be surgical or non-surgical in nature. Interestingly, a recent study has shown that at a five year follow up of patients with full thickness chronic rotator cuff tears, there was no difference seen in the outcomes between the two different approaches. Simply put, this means that no treatment approach was proven to be better than the other.

Allied health interventions such as Physiotherapy and Exercise Physiology can provide you with this successful non-surgical treatment approach.

Physiotherapy involves in depth assessment of your injury, hands on treatment progressing to Exercise Physiology which provides specific exercise therapy to strengthen weakness and return full function to your shoulder.

Stay tuned for a four-part break down of each rotator cuff muscle and it’s important role on our website blog soon. If you have any questions regarding this article or regarding treatment please visit our website at www.dovestonhealth.com.au.


1. Goldstein Y, Dolkart O, Kaufman E, Amar E, Sharfman Z.T, Rath E, Mozes G and Maman E., (2016) Bicycle-related shoulder injuries: etiology and the need for Protective gear. IMAJ, Vol 18.

(2) Sørensen AK, Bak K, Krarup AL, Thune CH, Nygaard M, Jørgensen U, Sloth C, Torp-Pedersen S., (2007). Acute rotator cuff tear: do we miss the early diagnosis? A prospective study showing a high incidence of rotator cuff tears after shoulder trauma. J Shoulder Elbow Surg; Volume 16(2):174-80

(3) Boorman RS, More KD, Hollinshead RM, Wiley JP, Mohtadi NG, Lo IKY, Brett KR. (2018).

What happens to patients when we do not repair their cuff tears? Five-year rotator cuff quality-of-life index outcomes following non-operative treatment of patients with full-thickness rotator cuff tears. J Shoulder Elbow Surg; Volume 27(3): 444–448.

First in Best Kept! – Why Early Medical Intervention Produces Better Outcomes for People Involved in a Motor Vehicle Accident

Having a motor vehicle accident is a stressful time, let alone dealing with the legal proceedings that may follow. Even more time consuming is when the accident has resulted in some form of personal injury. The sad news is that unfortunately, there are accidents every single day on our roads, and with those accidents comes paper work, stress, and short term lifestyle changes, but the most serious issue is the personal injury caused as a result.

Injuries caused by motor vehicle accidents can range from whiplash, muscular strains, trauma causing fractures/bruising/cuts as well as other soft tissue injuries. Minor injuries sustained from a motor vehicle accident will prompt most people to follow up with their General Practitioner for a Medical Evaluation (commonly referred to as a 'check up').

Nathan Rose | Author & Exercise Physiologist at Doveston Health

In most cases, however, it is rarely recommended that they undergo rehabilitation, and will often be passed off as just a “sore” back, knee, or shoulder etc, in the hope that it will just get better with time. This is a frequent occurrence, and prolonging the intervention will in most cases eventuate into something more serious. Often people are unable to continue working, lose mobility and have to reduce their level of recreational activity for example sport, exercise, fishing, gardening.

With all injuries minor or severe, rehabilitation is needed for recovery. Missing early rehabilitation time frames for any type of injury can drastically decrease the likelihood of complete recovery. It can also drastically decrease the full return to all active daily livings, recreational activities, and life as they know it.

Early Allied Health interventions such as Physiotherapy, Exercise Physiology, Occupational Therapy and Podiatry after an accident, have been shown to produce greater recovery rates and significantly decrease the risk of long-term health issues arising from accidents. These interventions are not solely utilised for major injuries causing hospitalisation, but also seemingly non-sinister injuries including but not limited to strains, fractures, whiplash etc. Things such as a stiff neck and even a sore back can cause movement issues as well as wear and tear, and these relatively small issues can lead to major concerns in the long run. 1,2

Rehabilitation treatments provided, do not have to be manual therapy “hands-on” treatment. Working on basic building block movements and providing education about injuries can be just as effective. Re-educating personal injury sufferers, on how to move correctly is vital when returning to normal daily activities pain-free. It is imperative that Mental stressors caused by injuries, can also play a vital role in recovery, and this needs to be addressed once again, as soon as possible. 3, 4

In today’s society, 1 in 3 adults are not achieving the recommended physical activity, as well as 1 in 3 being overweight or obese. These statistics also represent significant negative impacts on quality of life and general overall health. If you combine these statistics with people not seeking help after an accident, then this is a recipe for disaster. 5

In general, people need to be physically active to help with quality of life, and this should be no different after a motor vehicle accident. Prescribed rehabilitation and physical movements can be all the difference between returning to work, regular pain free living and a long term healthy life. Don’t increase your stress levels after an accident by not looking after yourself. Early Allied Health has proven to be effective for everyone, and should be sought after as soon as possible!


Thanks Nathan.

Stay tuned for another article from the Doveston Health Team in January. 

In the meantime, if you wish to get in touch with Nathan regarding this article, physiotherapy after an accident or any other health-related issues, please visit the Doveston Health website or click the button below. 


References

Long-term outcomes of individuals injured in motor vehicle crashes: A population-based study. Alghnam SWegener STBhalla KColantuoni ECastillo R., 2015

Outcomes of motor vehicle crashes with fracture: a pilot study of early rehabilitation interventions. Brooke KJ1, Faux SGWilson SFLiauw WBowman MKlein L., 2014

Predictors of non-return to work 2 years post-injury in road traffic crash survivors: Results from the UQ SuPPORT study., Heron-Delaney MWarren JKenardy JA, 2017

Delayed recovery in patients with whiplash-associated disorders.Dufton JA1, Bruni SGKopec JACassidy JDQuon J., 2012

The Lancet, Volume 384, Issue 9945 react-text: 64, Global, regional, and national prevalence of overweight and obesity in children and adults during 1980–2013: a systematic analysis for the Global Burden of Disease Study 2013: 65 30 August–5 September 2014 /react-text react-text: 66, Pages 766-781