For chronic rotator cuff tendonitis, Dr Demi’s big tip is to get the central system AKA spine, aligned and moving. In a textbook normal spine we should have three main curves in our spine. Our ears, shoulders, hips, knees and ankles should all line up as well. If you think about where your shoulder is attached into your spine, it is attached right onto your ribs and thoracic spine. Culturally we spend a lot of time at desks or on phones than we have ever done. Due to this, our posture has changed, moving our head in front of our shoulders and our shoulders rounding forward. This position changes the stress and tension on the muscles as they are stretched forward. This change in position alters how much mobility you have overhead and out to the side and it is with this that chronic inflammation occurs in that stressed joints. To correct this sort of tendonitis you must first improve mobility through the thoracic spine which is why Chiropractic can be beneficial in your healing process. The next thing is strengthening your extensor and postural muscles and stretch the muscles through the front of the chest. If you are just looking at the shoulder without addressing the surrounding joints and tissue, you aren’t going to get to the root cause of the problem. Remember that for every 1cm that your ear sits in front of your shoulder it puts an extra 4kg of stress along the top of your shoulders.
The Levator scapula is another muscle that tends to get put under a lot of tension because it is what helps stabilise your shoulder blade when you lift your arms and shoulders. We are not designed to spend too much time with our arms out in front of us like we do driving, on computers and carrying kids. The other thing that goes along with levator scap tension is the serratus anterior which is a small feathered muscle that can sometimes be seen under the arm. This small muscle counteracts the levator scap to keep the base of your shoulder blades flat against your ribcage. When this weakens, your shoulder blade may flare out and your shoulders sit high and round forward further perpetuating levator scapula tightness. Because these muscles work hand in hand, it is beneficial to work on both the levator scapula AND the serratus anterior for best results.
Research shows that 75% of tennis elbow aka lateral epicondylitis is actually a combination of a subluxation in the neck and altered elbow biomechanics. Remember it is important to have a healthcare practitioner who looks at the WHOLE picture so that you can get back to 100% function as soon as possible.
What can you do at home?
Stretch for levator scap: sit up nice and straight, tilt head forward point your nose toward your armpit and you shoulder feel a nice stretch from your ear down to your shoulder holding for 15-30 seconds
Trigger ball release: with a trigger ball or tennis ball place it behind your shoulder and roll up against a wall to release some tension in the muscle and ribs which will help with thoracic mobility
Posture pole: long foam roller or large towel at the end of the day have your head supported and knees bent. Place the towel/foam roller lengthwise down the spine with your arms out to your side opening up. This is also great to calm your fight or flight response and focus on your wonderful belly breathing.
As always if you have any topics you would like us to cover please be vocal on social media or via email.
Dr Em and Dr Dem x