It is a treatment that has built a reputation for treating the root cause of many shoulder injuries. In many cases, the area of the shoulder that is in pain isn’t necessarily the source of the problem. Prolotherapy doctors are trained in not only treating the area of pain, but also treating the underlying source as well.
The shoulder is a complex joint with many different structures that all have their own individual roles. To understand how prolotherapy works it is important to understand as much as possible about the function of the shoulder and what causes it problems. This is a breakdown of what is included in this article:
- Anatomy of the shoulder
- Shoulder symptoms
- Types of shoulder injuries
- Causes of shoulder injuries and how our treatment can help.
- Prolotherapy shoulder research
Meet Dean. He came to our clinic suffering from debilitating shoulder pain and experienced great results with the treatment:
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Anatomy Of the shoulder
The shoulder is a ‘ball and socket’ joint and is made up of three bones. This type of joint allows movement in all directions. There are eight muscles associated with the shoulder, four of which make up the ‘rotator cuff’. There are four main ligaments in the joint.
What our treatment can offer that other treatments can’t?
Some shoulder injuries struggle to heal with other treatments, primarily due to instability in the ligaments. Stable ligaments prevent a joint from over-working and help to create an environment for an injury to heal properly.
For example, if you’ve got a tear in one of your rotator cuff tendons then you want to make sure it is able to rest and repair. If the ligaments next to it are loose and unstable, then it means the injured tendon is having to over-work at the same time as attempting to heal.
There injections have been shown to be one of the most effective ways of strengthening and stabilising ligaments, helping to create an optimal environment for a shoulder injury to heal effectively.
It is also common for ligaments in more distant areas to be the source of the problem. Many movements require the shoulder to work together with other neighbouring structures. These structures include the AC (acromioclavicular) joint, SC (sternoclavicular) joint, neck, thoracic spine (upper back) and elbow.
Instability in one of these structures can prevent a shoulder injury from healing. For example, instability in the neck ligaments from a previous whiplash injury could be causing your shoulder to over-work and cause problems. In this case, both the neck and the shoulder need to be treated at the same time.
- Pain – this can be dull or sharp and be located internally in the joint or more superficial. It is common to experience associated referred pain down the arm.
- Instability – the joint can feel unstable during certain movements or is easily dislocated.
- Weakness – occurring predominantly in the muscles that attach into the joint.
- Stiffness – originating either in the muscles or inside the joint itself.
Types of shoulder conditions and how the injections help
Frozen shoulder (clinical name: adhesive capsulitis) –
A condition that occurs when small adhesions build up between the joint surfaces. This leads to stiffness and pain. Our treatment can help to reduce pain and inflammation. When combined with physical therapy it is also possible to improve mobility in the joint.
A diagnosed condition that involves the breakdown of cartilage within the joint. As a result, the bone surfaces start rubbing against each other, causing pain and stiffness.
Osteoarthritis also causes the joint to become unstable, so the supporting muscles have to work harder and can often end up in pain.
Our treatments can help in three ways. Firstly, it can help to stimulate cartilage growth. Secondly, it reduces pain and inflammation. Thirdly, it helps to strengthen the ligaments and tendons in the joint to improve stability.
Rotator cuff tendon tear –
A tear located in the tendon of any of the four muscles that make up the ‘rotator cuff’. These include the supraspinatus, infraspinatus, teres minor and sub-scapularis muscles. The supraspinatus is the most commonly affected muscle due to it’s vulnerability of getting trapped during certain movements.
Our treatment can help to both reduce inflammation and stimulate the healing compounds needed to repair the tear. It is important to note that the treatment can only help to repair partial tears, not full tears. Surgical intervention is needed to repair full tears.
Labral Tear –
A tear of the labrum in the shoulder. The labrum is a piece of soft cartilage that cups the ball in the socket. Depending on the character of the tear, our treatment can help to repair it in the same way that it repairs a rotator cuff tear.
This occurs when one of the bursa in the shoulder joint becomes inflamed. The most commonly effected bursa is the ‘sub-acromial’ bursa, due to it susceptibility to getting compressed during certain movements and with bad posture.
Our treatment can be very effective at reducing inflammation in a bursa. For long-lasting results, it is important that the injections are combined with physical therapy to address any underlying postural problems.
Occurs when the ball (head of the humerus bone) comes out of the socket of the scapula bone. This form of trauma can cause damage and instability in the ligaments and tendons of the joint.
Bad posture –
Regarded as the most common cause of shoulder pain, bad posture can be a direct cause of injury. It can also be an indirect cause through changing the angle that the shoulder operates, leaving it more vulnerable to experiencing an injury during certain movements.
The most common position of bad posture occurs when your shoulders are hunched over with a bad desk set-up. When an individual comes into our clinic with a shoulder problem, we always assess their posture. If a postural issue has been identified, then we prescribe specific exercises for that individual to perform in between each appointment of injections. This combined approach helps to enhance the results.
Sporting incidents, car accidents and falls are the most common traumatic causes. The trauma can often lead to long term instability in the shoulder which prolotherapy can help to address, alongside repair the damaged tissue.
As mentioned earlier on in the article, problems in other structures can have an influence on the shoulder. The biggest of those problems are misalignments, especially the thoracic spine.
The position of the thoracic spine will dictate the position of the shoulder. This causes many structures in the shoulder to over-work and eventually cause injury.
During each consultation and examination at our clinic, we assess for misalignments in the structures around the shoulder. If one is identified, then we include gentle massage and stretching techniques alongside the injections. This combined approach ensures that we can get rid of the root cause of the shoulder injury and prevent it from returning.
Previous injuries –
Past problems can cause either misalignments or instability in the shoulder joint. A previous injury may appear to have healed in terms of the pain having reduced, but it can often leave mild weakness in the injured area that over-time can leave an individual susceptible to reinjury.
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For more in-depth information about how our treatment works, head over to our post titled ‘what is prolotherapy?’