Rotator Cuff Tendonitis and Impingement Syndrome Treatment

Rotator Cuff

What is Tendonitis?
Tendonitis is an injury or irritation of the fibrous, thick tendons that connect muscles to bones. Tendonitis is also called tendinosis because little inflammation is present when the tendon is biopsied. During the first stage of tendonitis, patients experience a dull ache after an activity that involves using the tendon. The ache decreases with rest. In stage 2, the patients experience pain during minor movements of the affected area. During the final stage, patients are in constant pain.

What Causes Tendonitis?
Tendonitis can occur through sports participation when certain joints are overused, or when the athlete is undertrained or uses poor technique in sports. In certain occupations, repetitive movement, such as typing, can cause tendons to inflame. Injuries and repeated trauma also can contribute, as can autoimmune disorders (such as diabetes), some inflammatory conditions, and some infections. Tendonitis shows up mostly in the shoulder, elbow, wrist, thumb, hip, knee, and ankle.

Signs of Tendonitis:
Pain that worsens when the affected limb is moved
Stiffness and loss of range of motion
Swelling
Tenderness
Warmth and redness
Crackling

How can your Chiropractor or Osteopath Help?
The first goal of a chiropractor or Osteopath in treating tendonitis is to make an accurate diagnosis of the problem, ruling out any other possible underlying causes of the pain. This is necessary because the joint pain and stiffness of tendonitis are similar to the experience of bursitis or arthritis. X-rays, CAT (Computerized Axial Tomography) scans (an x-ray procedure used to create cross-sectional or three-dimensional images) and MRIs (magnetic resonance imaging) are tools a chiropractor might use to obtain an accurate diagnosis for tendonitis pain.
After the diagnosis, a chiropractor will select a natural treatment plan that addresses the cause of the tendonitis, rather than simply treating symptoms. Initially, the chiropractor may support and protect the injured tendons by bracing those portions of the tendon that were pulled. The tendon needs to be loosened and the inflammation reduced. Treatments that follow might include ultrasound, ice, rest, temporary immobilization, electrical muscle stimulation, manual trigger point therapy (applying firm pressure by hand on a trigger point for several seconds and then stretching the muscle afterward), strengthening exercises, physical therapy, and/or massage. Joint manipulation may also be performed on individuals with diminished joint mobility.
With proper treatment, the pain and inflammation in the tendon should decrease during the first three weeks. Full healing, however, will not be achieved until at least six weeks have passed. During these six weeks, scar tissue is formed, which initially helps bond the tissue back together.
The scar tissue needs to be broken down so the tendon and muscle regain flexibility, which lessens the chance of further injury. At first, a chiropractor may treat scar tissue with ultrasound and massage. Ultrasound involves using sound waves to soften the scar tissue, enabling it to break down. It also helps increase circulation to the tissue. Ultrasound may also be used to assist with moving topical nutrient and pain solutions deeper into the tissues. Mild stretches that do not irritate the tendons can be incorporated. Once the tissues have healed, exercise can help further break down scar tissue. During this period, longer stretches should target only the muscles, not the affected tendons.

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