Shoulder Injuries

Dear MendMeShop,

Dear Paul, I wanted to e-mail you and let you know how things are going. In your last e-mail to me you made a very profound statement that I had never heard before. I have been to several doctors over the past 10 years and not any one of them ever told me that snapping hip syndrome was a manifestation of short leg syndrome. I truly think that many of my problems are layers that have had to have been slowly peeled away to find out what the problem is that is causing each and every one of them. I thought about the statement that you made and I applied it. Several years back I had a chiropractor tell me that I had short leg syndrome and that I had fallen arches in my right foot and leg. He ordered me an orthotic and a lift to make up the difference. My foot hurt all the time and my right hip hurt all the time and so I stoppd wearing them. A few years later I discovered that I had a bad right ovary. Once I had a doctor that agreed that it was bad and removed it and all that pain went away I was left with my right foot hurting. I found arch supports that made that better but then I had the bursitus and snapping hip syndrome symptoms. No Doctor knew what to do for me and basically tried to give me pain medication to cover it up. I don't want to cover anything up. I want to find the root of the problem and treat it. So, I got to thinking about your statement. (I know it seems like I am going around this same tree, but I will get there) My thought was that because of the pain I was suffering from my ovary, maybe with that all gone I should try the lifts again and see what happens. I am tellinig you...that one little statement you made took care of my bursitus and my snapping hip syndrome. I am no longer suffering from any of that. I have not had to use the ultra sound device at all. I am sleeping well at night. Thank you for your statement. You just don't know how much that has meant to me. You don't know me, you have never met me but you literally saved the quality of my life. It took me a few days after I read your e-mail to put two and two together so to speak but it was worth trying again. Thank you so much.

Rating: Five Star Rating

Vickie Wilkins

Rotator Cuff Anatomy

The rotator cuff has an incredible range of motion. To allow this incredible range it is made up of many complex parts which means that it is also injured easily. The shoulder joint can easily slip out of alignment by a few millimeters, become weak due to regular wear and tear, or become completely dislocated during a fall. The joint where the upper bone (humerus) of the arm meets the shoulder (scapula and acromion process) is called the rotator cuff. The rotator cuff is the most vulnerable part of the shoulder and is where most shoulder injuries occur. To better understand what is happening inside your rotator cuff it is helpful to understand the different parts of the shoulder.

What is the Rotator Cuff?

The rotator cuff is a group of 4 tendons and related muscles that form a cuff at the shoulder joint where the humerus meets the scapula.

The Rotator Cuff muscles are connected individually to a group of flat tendons, which fuse together and surround the front, the back, and the top of the shoulder joint like a cuff on a shirt. The tendons attach the muscles to the bone and allow movement in the shoulder, as well as providing strength to hold the ball in its socket. They are involved in all shoulder motions: when the muscles contract, they pull on the rotator cuff tendon, causing the shoulder to rotate upward, inward, or outward, hence the name Rotator Cuff.

The Rotator Cuff ligaments attach bone to bone and provide stability to the shoulder joint bones. Between the bones, muscle and other soft tissue there are several bursae (fluid filled sacs) and synovial fluid (lubricates your joint), which permit smooth gliding between the joint. They also protect the rotator cuff from the bony parts of the shoulder blade.

Shoulder Joints

Inside the shoulder there are three joints; the glenohumeral joint, the acromioclavicular joint (A/C joint) and the sternoclavicular joint.

The glenohumeral joint is a joint where the greater tubercle (humeral head at the top of the arm bone) meets the shoulder socket of the scapula, called the glenoid cavity or glenoid fossa. Inside the joint, the labrum (a form of cartilage) cushions the humeral head against the glenoid.

The glenohumeral joint in the shoulder is surrounded by the tendons of the rotator cuff. This shoulder joint provides stability while allowing a large range of rotation and movement.

This joint is considered a ball and socket joint however the 'socket' is not as deep as similar joints in your body. Instead, the humerus sits against the glenoid cavity similar to how a golf ball sits on a tee. Since the ball does not fit directly inside socket of the glenohumeral joint, it is the labrum, muscles, and tendons that hold the ball of the humerus against the glenoid fossa providing stability between your scapula and your humerus.

Due to this shallow socket and the scapula 'floating' above the rib cage (connected to the clavicle by ligaments, muscles and tendons) your shoulder is able to move around freely in several directions. This makes the shoulder the most mobile joint in the body. However, this also makes it the least stable joint and the one most prone to injury.

The acromioclavicular joint (A/C joint) is a gliding joint between the clavicle and the acromion. The acromion is a bony projection that comes off the scapula and forms the point at the outside edge of your shoulder. The acromioclavicular joint allows you to rise your arm over your head. If this joint dislocates it is commonly known as a separated shoulder.

The sternoclavicular joint, where the collar bone meets the sternum (breast bone) is not considered as important for shoulder movement.

Rotator Cuff Tendons and Muscles

The 4 muscles and tendons of the rotator cuff are called the supraspinatus, subscapularis, teres major, and infraspinatus. These tendons and muscles work together to stabilize the glenohumeral joint and move the humerus in the shoulder socket.

Although many people refer to the rotator cuff as a general area in the shoulder, your rotator cuff itself is a group of 4 tendons located at the top of your humerus. These tendons are called the subscapularis tendon, the supraspinatus tendon, the infraspinatus tendon, and the teres minor tendon.

These tendons come together to surround the front, back, and the top of the shoulder socket acting as a 'cuff' to connect your humerus to the rotator cuff muscles. When you contract the attached muscles (subscapularis muscle, the supraspinatus muscle, the infraspinatus muscle, and the teres minor muscle), they pull on the tendons causing the shoulder to rotate up or down, back or front, in or out; hence the name 'rotator' cuff.

These muscles, along with the teres major and the deltoid, keep the shoulder's ball and socket joint firmly in place and are responsible for stabilizing the shoulder. These muscles work together as a unit rather than individually.

As a result, rotator cuff injuries usually involve more than one of these muscles or tendons. If any of the 4 main rotator cuff tendons or muscles become injured it will greatly affect the stability of shoulder.

The supraspinatus muscle and tendon assists with raising you arm out to the side.

The supraspinatus is the most frequently torn of all the rotator cuff tendons. It is the uppermost muscle of the rotator cuff and is located at the back of your shoulder blade. It passes beneath the acromion and runs towards the greater tubercle at the top of your humerus joining at the top of the cuff by the supraspinatus tendon. Your supraspinatus muscle primarily helps you to bring your arm directly out to the side(known as abduction) although it assists you with other shoulder motions as well.

The subscapularis muscle and tendon assist with rotating the arm and shoulder toward the body.

The subscapularis is the largest and the strongest of all your rotator cuff muscles. It completely covers the front of the shoulder blade. This muscle is attached to the front of the humerus which allows you to move your upper arm inward toward the center of your body (known as internal rotation).

The infraspinatus muscle is located at the back running from the bottom of the shoulder blade across to the top of the humerus. This muscle works with the teres minor muscle to move your arm outward, away from the center of your body (known as external rotation).

The infraspinatus and teres minor muscles and tendon allow you to rotator your arm away from the body.

The teres minor muscle sits below the infraspinatus and runs at the same angle attaching just below the greater tubercle of your humerus bone. The teres minor also assists with the outward rotation of your arm from the center of your body (know as external rotation).

Other main muscles in the shoulder area include:

the deltoids
the subclavius
the trapezius
the teres major
serratus anterior
pectoralis minor
sternocleidomastoid
levator scapulae
rhomboids

Shoulder Bones and Ligaments

The bone structures inside the shoulder that are significant to the rotator cuff include the humerus, the scapula, the acromion process, the clavicle, the greater tubercle, and the glenoid cavity.

The bones and ligaments of the shoulder and rotator cuff are designed to allow an incredible range of motion in the shoulder joint.

The humerus (upper arm bone) runs from your elbow to your shoulder and meets at the rotator cuff with a ball-like end known as the greater tubercle. This is the 'ball' part of the ball and socket joint in your shoulder.

The scapula (shoulder blade) is a triangular shaped bone with 2 bony projections at the top, right at your shoulder cuff. One of these projections is referred to as the acromion and it sits above the humerus. The other is called the coracoid process and it sits in front of the acromion and below the clavicle. Where your humerus meets your scapula there is a very shallow concave 'socket' known as the glenoid cavity (also called the glenoid fossa).

Ligaments are soft tissue bands that connect one bone to another. The joints of the shoulder that are primarily responsible for movement are held together by several strong ligaments. They include the coracoclavicular ligaments, the coracoacromial ligaments, the superior transverse scapular ligament, the coracohumeral ligament, the acromioclavicular ligament, and the glenohumeral ligaments.

Bursae in the Shoulder

In your shoulder joint there are 4 main bursae; the subacromial bursa, the subcoracoid bursa, the subscapular bursa, and the subdeltoid bursa.

Bursae (plural for bursa) are fluid filled sacs that act as cushions to help the bones and soft tissue move smoothly within the joint. Your bursae also act as padding to protect your soft tissue from the bony points on the scapula, coracoid, and acromion.

The subacromial bursa is the most susceptible to bursitis in the shoulder. It's located in the subacromial space, between the acromion and the humeral head (greater tubercle), and is used frequently during shoulder movement to reduce friction. The risk of impingement of this bursa in the subacromial space is high because the area is small.

What Causes a Rotator Cuff Injury?

Rotator cuff injuries are very common, especially in people over 40 years of age. Most problems involve damage and irritation to the rotator cuff soft tissues (muscles, ligaments, tendons and bursa) rather than the bones, as they move frequently within a tight space.

A rotator cuff injury usually begins as inflammation caused by some form of small but continuous source of irritation, such as repetitive overhead motions from sporting activities, work tasks or daily chores, which can lead to tendonitis, tendinosis, frozen shoulder, impingement, or bursitis.

If you do not address the cause of the inflammation, a partial or complete tear (rupture) can develop in your rotator cuff due to chronic wear and tear of the tendon. A tear may also result at any age from an acute or single traumatic event, such as a fall onto an outstretched arm.

Rotator Cuff Treatments

Your initial treatment should involve decreasing any swelling, relieving any pain and stress on the rotator cuff, correcting any biomechanical dysfunction, and then restoring strength and mobility to your injured shoulder. It's also very important to follow any instructions you receive from your physician.

Allowing your shoulder to rest is recommended following injury, however, some careful shoulder movement is required to prevent the joint from freezing and losing range of motion. See your doctor or physical therapist for stretches that will not cause further injury to your rotator cuff. Avoid activities that may have caused the injury or irritation and begin cold compression treatments as soon as possible.

Scar tissue develops as damaged rotator cuff tissue heals. This can lead to re-injury or other painful conditions if left untreated.

The trick to healing your rotator cuff injury and getting your shoulder back in the best possible condition you can is getting it to heal with minimal scar tissue - something ultrasound therapy is great at! Even with optimum healing, there is always less elasticity in previously injured rotator cuff tendons, muscles and ligaments. However, if you heal your tissue properly and treat scar tissue build up, your chance of re-injury or chronic shoulder conditions later on is much lower than average.

There are healing tools that can help treat your rotator cuff tendon, bursa, or other soft tissue and speed up the healing process so you can get back to a life without pain and risk of further injury. Therapeutic Ultrasound and Blood Flow Stimulation Therapy^™ (BFST^®) will treat scar tissue and promote blood flow to heal your tendon faster and more completely than any other methods available.

Although steroid injections may provide temporary relief from the pain of rotator cuff tendinitis, bursitis, and other injury they should generally be avoided as they weaken the tendon and may lead to a rupture. If you do opt for an injection, doctors usually recommend that you do not participate in strenuous activities for several weeks to reduce the risk of a rupture.

Freezie Wrap^® Cold Compression Therapy

To decrease inflammation and relieve pain for a chronic or diagnosed rotator cuff injury doctor's recommend cold compression therapy. For an acute trauma, cold compression therapy within the first 48 - 72 hours and after any strain or re-injury is important to limit the amount of damage done to your tissue. For chronic pain, cold compression therapy will relieve pain and swelling as needed and will reduce, or even eliminate, the need for NSAIDs.

The Shoulder Freezie Wrap treats pain, swelling and inflammation caused by rotator cuff tendon injuries while reducing tissue damage.

The Shoulder Freezie Wrap^® is the cold compression tool you need treat your supraspinatus tendon, subacromial bursa, and other shoulder tissue in an effective and convenient way.

Cold Compression Therapy works by interrupting and slowing nerve and cell function in the injured area and reducing swelling that can block blood vessels. This is important because once blood vessels are blocked or damaged, they can no longer carry oxygenated blood through your tendon and tissue cells begin to break-down. Without cold compression therapy cellular break-down and tissue damage continues as the cells do not get the oxygen they need to survive. By limiting the amount of damage done to your tissue, you also limit the amount of healing that needs to occur. This is a very important step to healyour injured tendon, bursa, muscle, labrum, or ligaments faster and with less pain!

The deep cooling effect provided by the Shoulder Freezie Wrap slows cell metabolism thereby reducing cellular break-down and tissue damage. Furthermore, because the cold wraps gently numb the nerves, the wraps also reduce pain! The Shoulder Freezie Wrap^® uses a supercharged cooling gel pack, that chills in the fridge, not in the freezer like ice or other freezer packs, giving you deep cold therapy without the risk of 'cold burns' or cryoburn. The medical-grade wrap keeps the cold directly off your skin preventing cryoburn while delivering cold right where you need it.

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Ultrasound Therapy

Ultrasound therapy is a great therapeutic option to decrease inflammation, pain and soft tissue damage experienced with a rotator cuff injury. Therapeutic ultrasonic waves increase tissue elasticity while increasing blood flow to your injured rotator cuff. This cleans the injured area by getting rid of damaged tissue and reducing the inflammation in the tendon and/or bursa while opening up the blood vessels to begin healing.

MendMeShop Therapeutic Ultrasound treats rotator cuff tendon injuries and reduces inflammation and scar tissue

Not only does ultrasound aid in the duration of healing, but it helps to prevent long term complications. Pain, lack of mobility, tendinosis, or a complete tendon rupture are some of the more common long term complications that can occur when rotator cuff tendinitis, tendon tears, and other injuries go untreated. By treating your rotator cuff with ultrasound, scar tissue becomes softer and the tendon and other tissue becomes stronger reducing the risk of chronic problems in the future.

During the healing process, scar tissue builds on the rotator cuff tissue. This scar tissue can cause the tendon and bursa to thicken, decreasing the area in the subacromial space and increasing the chance of impingement.

In addition, scar tissue can also bind the tendons and ligaments together within the joint capsule and surrounding the rotator cuff. The inflexible scar tissue limits the movement of these tendons and ligaments that were once elastic and allowed the shoulder its large range of motion. As a result, movement of the entire joint is limited making it difficult to lift your arm or to reach for objects. If left untreated, the shoulder may 'freeze' (a condition called frozen shoulder or adhesive capsulitis) altogether making movement impossible. At the very least, scar tissue leaves your tendon weaker than a healthy tendon, leaving your rotator cuff at greater risk of further deterioration and possible tearing.

Fortunately, you can treat your supraspinatus tendon, subacromial bursa, labrum and surrounding ligaments with MendMeShop Ultrasound to soften scar tissue and improve the motion and flexibility of your shoulder.

Ultrasound can also be used to administer therapeutic medicines into the body. This is a process known as phonophoresis. Ultrasound with phonophoresis is rapidly becoming more popular than ultrasound therapy alone.

MendMeShop^® Ultrasound System with phonophoresis is safe, convenient, and easy and generally requires between 10-15 minutes per treatment. It is based on a form of deep tissue therapy, which is generated through high frequency sound waves (that we can not hear). These waves send micro vibrations into your body and carry medicated molecules within the ultrasound gel deep into your soft tissue to enhance the ultrasound therapy, resulting in even healthier tissue. Ultrasound waves penetrate deep to relax your muscles, decrease inflammation and accelerate your recovery rate, so you can return to your daily activities as soon as possible.

Lavender Infusion Ultrasound Gel contains the healing power of natural Bulgarian lavender, eucalyptus, menthol, and peppermint.

Use MendMeShop Lavender Infusion Ultrasound Gel for ultrasound therapy and you get 2 therapies in 1. You get the benefit of the regenerating sound waves from the ultrasound device itself AND the added bonus of the therapeutic ingredients inside the gel being delivered into the tissue where it is most effective. 1 FREE bottle of MendMeShop^® Lavender Infusion Ultrasound Gel comes with every MendMeShop^® Ultrasound System and it contains the therapeutic essential oils of natural Bulgarian lavender, peppermint, eucalyptus, and menthol.

Click here to learn more about Ultrasound Therapy

Once the inflammation of your rotator cuff injury has been reduced, nourishing and strengthening the tendon tissue and surrounding area is recommended. Using Blood Flow Stimulation Therapy^™ will speed your recovery and heal your rotator cuff more completely preparing it for strengthening exercises. Talk to your doctor or physical therapist to find out which exercises are appropriate for your situation.

Inferno Wrap^® Blood Flow Stimulation Therapy^™

After severe inflammation and swelling is reduced you can begin to treat your rotator cuff tendon, bursa, labrum and other soft tissue with Blood Flow Stimulation Therapy^™ (BFST^®). BFST^® increases the amount of blood that flows naturally to your shoulder to nourish your tendons, ligaments and muscles to speed healing.

Shoulder Inferno Wraps speed the healing of rotator cuff tendon injuries and tears.

The rotator cuff naturally receives a limited blood supply and when you stop moving your shoulder because it hurts the blood flow is reduced even further, limiting your body's natural ability to heal itself.

By treating your rotator cuff with BFST^® you can increase your body's blood supply to the shoulder and increase your body's natural healing power.

An Inferno Wrap^® is the tool you need to treat your sore shoulder because it speeds healing and relaxes the surrounding muscles. With BFST^®, tissues are safely and gently stimulated. Your body responds with a rapid increase in blood flow to the area, increasing the supply of oxygen and nutrients to injured cells to promote healing. Our Shoulder Inferno Wrap^® provides effective, non-invasive, non-addictive pain relief and healing with no side effects.

In addition, the improved blood flow whisks away dead cells and toxins that have built up from the injury. When you stop moving your arm and shoulder due to shoulder pain, your muscles and other tissue can become weaker and dead cells and toxins in the area can cause further tissue deterioration - this can lead to atrophy. By clearing the area of toxins and increasing the amount of oxygen and nutrients to your muscle and other tissue, the risk of atrophy (muscle weakness and/or deterioration) is greatly reduced. Keeping your upper arm, shoulder and rotator cuff tissue as healthy as possible throughout the healing process will allow you to improve shoulder strength again once your pain has gone and your injury has healed.

Click here to learn more about how BFST^® and Inferno Wraps^® work.

With these 3 easy therapies, cold compression, ultrasound and BFST^®, you will notice significantly reduced pain and an incredible improvement in your rotator cuff range of motion.

During your recovery, you may have to modify and/or eliminate any activities that cause pain or discomfort in your rotator cuff area until your pain and inflammation settle, and you gain more mobility and strength in your shoulder. The more diligent you are with your treatment and rehabilitation, the faster you will see successful results!

Remember: We recommend that you consult your doctor and/or physiotherapist before using any of our outstanding products, to make sure they're right for you and your condition.

Physical Therapy

Physical therapy is a beneficial way to help decrease pain in the soft tissues, restore atrophied muscles and improve shoulder strength and mobility. The type of physical therapy and the duration will be dependent on your injury.

Once your pain starts to diminish, a physiotherapist can set up an individualized rotator cuff strengthening and stretching exercise program for you to perform at home or in the gym. This will be based on your needs and abilities, and will help you return to performing your normal routines.

Individuals will often lift weights on their own, to try and build up their shoulder strength. However, in doing so, they can do more damage to their shoulder. It is extremely important to strengthen your muscles properly, as they may have weakened during the period of non-use. A trained therapist will help to ensure your rehabilitation process is effective. For fast and effective results, use ultrasound in conjunction with physical therapy and an exercise program.

Anti-Inflammatory Medication

The use of NSAIDs can be greatly reduced with the use of a Shoulder Freezie Wrap.

NSAIDs (Non-steroidal anti-inflammatory drugs) can be used if required to help manage your pain and inflammation. However, these aren't recommended for long term use, as they can cause gastrointestinal difficulties. Some health professionals have also recommended natural supplements such as glucosamine, MSM or hyaluronic acid to help strengthen the injured tissue.

The use of a Shoulder Freezie Wrap^® can greatly reduce, if not eliminate, the need for NSAIDs. Cold compression therapy is a natural, less harmful way to reduce your pain and inflammation.

Once the initial swelling has decreased, you can provide pain relief and improve your arm function by using an Inferno Wrap^® to increase the blood flow to the area. Gentle massage around the injured area or small shoulder movements (if not painful) will also help increase blood flow, oxygen and nutrients and will prevent stiffness. To increase your comfort and prevent further damage, you may want to stabilize your arm by using a shoulder sling or brace to avoid unpredictable movements.

If pain and inflammation persist, you can see your physician to investigate cortisone/steroid injections or topical medications, which may help reduce swelling and inflammation. However, cortisone/steroid injections can deteriorate tissue if used frequently and should not be used at the same time as ultrasound therapy.

Please be aware that this information is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider before starting any new treatment or with any questions you may have regarding a medical condition.