The Patient’s Complaints

• Right sided shoulder pain and weakness with mild neck pain of unknown cause that began 3 weeks ago and has gradually worsened
• Limited movement and increased pain with reaching overhead and behind back to fasten her bra

Snapshot of My Examination Findings

• Restricted ranges of motion of the right shoulder as compared to the left, especially bad on lifting the arm up, to the side, and reaching behind her back
• Tight and painful muscles surrounding the shoulder joint, especially the supraspinatus and teres minor muscles (both are muscles of the rotator cuff)
• Weakness of the shoulder muscles (especially the supraspinatus)
• Multiple areas of spinal subluxations (jammed spinal bones that irritate the nervous system)
• X-ray evaluation of the right shoulder and cervical spine (neck) showed no problems with the bones

My Diagnosis

• Rotator Cuff Sprain/Strain – moderate
• Spinal subluxations

My Recommendations

• A course of 12 visits of integrative care to include the following:
• Chirporactic adjustments of the spine and extremities
• Myofascial release performed by massage therapist
• Progressive therapeutic exercises targeting the rotator cuff and surrounding musculature
• Ice at home as needed for 15 minutes per hour.

The Prognosis

• Fair

Discussion

Shoulder pain is a common complaint that is often associated with neck pain and upper back pain.  The only complaint we see more frequently in our office is low back pain.

According to the Centers for Disease Control and Prevention, about 13.7 million people in the United States sought medical care in 2003 for shoulder problems.

When you think of shoulder injuries, you probably think of sports-related injuries seen in baseball or tennis.  However, shoulder injuries can be easily caused by many normal everyday activities (even those of a 67-year old). The shoulder is so  susceptible to injury because it has the greatest range of motion of all the joints of the body.

The shoulder consists of three major bones and over twenty different muscles.  Two major tendons of the shoulder are the biceps tendon, which attaches the biceps muscle to the shoulder and helps stabilize the joint, and the supraspinatus tendon, which helps form the rotator cuff.  Four short muscles originate on the scapula and pass around the shoulder where their tendons fuse together to form the rotator cuff.

Rotator cuff strain/sprain is an injury to the muscle and tendon that covers, rotates, and raises the shoulder.  Symptoms usually include shoulder pain and difficulty raising the shoulder.

Our Approach To Shoulder Problems

If you were a new patient visiting our office, we always start with a thorough case history, consultation, and examination.  I may recommend diagnostic studies (x-ray or MRI) if I need more information. At this point, if I determine that care is appropriate and you decide to begin care, I will design a treatment plan for you.  If at any time I discover something beyond the scope of my practice, I won’t hesitate to contact your primary care provider to discuss a possible referral to another healthcare provider.

We follow a very effective  treatment strategy based on the letters ASR.  They stand for:

• A – Adjust (whole-body adjustment techniques)
• S – Support (spinal pelvic stabilizers and other joint supports)
• R – Rehabilitate (targeted exercise therapy/physical rehab)

My approach that works so well with the spine can be applied to other joints of the body. Virtually every articulation of your skeletal system is susceptible to fixations that can impair function and range of motion.  We have a variety of other treatment options to help you recover quickly and completely.  Some of our other treatment options could include:

• Massage therapy
• Laser therapy
• Electrostimulation treatment
• Home TENS unit
• Therapeutic taping
• Targeted rehabilitative exercises for the shoulder
• Exercise modification
• Home exercise program
• Nutritional supplementation and dietary modification

We don’t want you to have to resort to dangerous medicines, injections, or surgery.  Our approach is to use chiropractic care and other natural therapies (such as massage or rehab exercises) to correct your shoulder problem quickly and  naturally.

Have you ever wondered why some physical problems never seem to get better? Perhaps you have an injury that has become “chronic”.    Maybe it’s a “bad” back… or a stiff neck… or a sore shoulder.  Whatever it is, you know that something’s wrong.  You should be feeling better by now.  You would love to get out and enjoy the Spring weather.  Or start going to the gym.  Or begin that new exercise class.But you hurt too much.  So why isn’t your body healing normally?  Some days you feel like there’s an improvement, but then the pain is back again.  Why?

I put together the simple diagram at the top of this post to help you understand why. The diagram describes a concept called “The Vicious Cycle of Injury or Trauma”.  This diagram explains the process of an injury and the reasons why you may not be healing properly.

The top of the diagram is where things begin.  Your injury may be mild, severe, or somewhere in between.  But whatever your injury, cellular death occurs at the tissue level.  Muscle fibers tear, ligaments stretch, discs bulge, etc.

Going clockwise, the next circle shows that your injury results in pain, inflammation, and spasm:

• Pain is your body’s “alarm system” letting you know that your body has passed it’s limit.
• Inflammation is your body’s response to the damaged tissue.  Inflammation is the beginning of the healing process.
• Spasm (uncontrolled muscle tightening) is your body’s way of putting a “natural splint” on the area to prevent further injury.

Next you suffer a loss of range of motion.  Examples of how this could manifest include:

• Low back stiffness in the morning.
• A tight neck while in the car.
• An inability to reach behind yourself and scratch your back.

Any of your joints can suffer a loss of motion if there’s local swelling, pain, or muscle spasm. When you have a loss of normal motion for some time, two things happen:

• Your muscles will shrink and weaken (atrophy).
• Adhesions (tough patch-up tissue) will develop in and around the injured area.

Unfortunately, chronic pain results in fatty infiltration into the supporting muscles.  You can get a sense of this by inspecting a cheap cut of meat.  The marbling of fat is the “fatty infiltration” into the muscle.  The tough gristle areas are the adhesions that can develop in and around your muscles.

When you suffer a loss of motion, adhesions and spasm, your normal blood flow will be restricted.  Limited blood flow means that your injured site is receiving less oxygen and less nutrition than normal.  This leads to more tissue death, and the cycle starts all over again.

So how can you get out of this cycle if you feel you’re trapped?

It all starts with coming in to our center for a visit.  After a thorough exam, I will develop a reasonable wellness strategy to help you break the cycle.  Always remember that physical problems can be best fixed with physical solutions.  It can include:

• Chiropractic care
• Massage therapy techniques
• Trigger point therapy
• Laser therapy
• Weight loss techniqes
• Rehabilitative exercises

Please understand that we can’t make you heal, but we can ensure that as you heal, you’ll heal more perfectly.

In your care, we’ll use natural techniques to “attack” each area of the Vicious Cycle.  We have found that the combination of natural therapies works the best to break the vicious cycle because we target multiple points of the cycle at once.

With the help of natural therapies we can:

• Reduce your pain, inflammation and spasm
• Improve your range of motion
• Restore muscle strength and endurance
• Reduce adhesions and trigger points
• Improve blood flow to your tissues

If you’re in pain due to a big or little injury, don’t ignore the problem.  It is critical that healing start as soon as possible.  By getting treatment early, you can prevent abnormal chronic pain patterns from taking root.

With natural therapies you can finally be free of your pain and be the best you can be.

Mostly all of us have been taught to view symptoms as bad.  And when you have spinal pain, headaches, or just feel rotten, you’re told to get rid of the symptoms as fast as possible. But usually this is done without regard for your own health and without understanding the role of symptoms in your health.

When we are suffering we are told to take aspirin, or Tylenol, or to TAKE MORE AND MORE CHEMICALS!  Listen.  First of all, health can’t be found in any bottle!  Second, symptoms and pain are NOT always bad!  Your body was designed with a special warning system to let you know if something is harming you.  Pain is a way that your body talks to you.  Back pain may be your body’s way of telling you that you’re injured and need rest.  In many ways, pain helps you prevent injury and harm to your body. 

Covering up the pain can be DANGEROUS and can even invite the possibility of further injury.  It’s like having a really expensive fire alarm system in your home…and then disconnecting it before you go to bed so that it doesn’t wake you up in the middle of the night!  BUT THAT IS ITS JOB!

If you injured your back, can imagine the damage you could do if you used a simple pain-killing drug that allowed you to forget the pain.  You might begin lifting again, which could very easily cause severe muscle and joint damage worse than the first injury!

There’s another aspect of symptoms that we need to look at.  Sometimes your symptoms are an indication that your body is doing its job perfectly.  Vomiting and diarrhea are natural body functions that could save your life!   If you’ve eaten bad food, you want your body to do its best to flush out the toxins you just ate!  These types of symptoms are your body’s own defenses working to keep you as healthy as possible!  Trying to remove these types of symptoms would be just plain harmful to your health!

Now let’s look at this from a different angle.  Most of us believe that if you feel good then you are healthy.  Let me explain why this is a very dangerous way to measure your health.  First, we already saw that symptoms aren’t always bad.  Sometimes they’re present when your body is working fine… as warning signs of damage, or as natural defense mechanisms.  Secondly, many times symptoms are the LAST stage of a disease. 

Did you know that the FIRST symptom of high blood pressure is often a DEADLY STROKE?  The first symptom of heart disease could be a FATAL HEART ATTACK!

You see, heart disease is a process – it takes time before your heart gives way.  By the time you feel it, it may be too late.  To put it simply, symptoms are a terribly inaccurate measurement of your state of health.

This is why I take a different approach to health care.  I won’t put my focus on your symptoms… I’ll put 110% of my focus on your health!  I understand that if your health is good then you are less likely to get sick. And my techniques are guaranteed to help you be healthier!  Let’s face it, what you really need to do is this:

TAKE CARE OF YOUR HEALTH NOW BECAUSE BY THE TIME YOUR SYMPTOMS WARN YOU OF A PROBLEM, IT MAY BE TOO LATE! 

You’ll be much less likely to be sick and suffer from symptoms if your body is really healthy!  

Since TRUE HEALTH IS NOT DETERMINED BY HOW YOU FEEL, then how do you really know if you’re healthy?  You’re probably thinking, “What determines health, if it isn’t determined by the absence of things like symptoms and pain?”  The answer is…

SUPERIOR HEALTH IS DETERMINED BY THE PRESENCE OF THINGS – NOT BY THE ABSENCE OF THINGS SUCH AS SYMPTOMS OR PAIN!

Health is determined by the presence of all of your body parts functioning at their optimum levels.  In other words, when all of your body parts are working at 100% – you are 100% healthy.  It’s that simple!  If there were one thing I would want you to remember from this article, it’s this:

HEALTH IS THE NORMAL STATE OF YOUR BODY!

You need to view your health as something that can be created, enhanced, destroyed, and lost. You can picture your health like the contents of a bucket.  Doing the right things adds to the contents of the bucket and increases your health.  Doing bad things lessens the contents and may bring about disease.  Unfortunately, there’s an inherent problem with the bucket… it has holes at the bottom through which the contents continually leak.  Some of the holes are due to things you can’t change such as: aging, unavoidable stress and previous injuries.  But remember, there are many things that are in your control that cause holes.  So what are you to do when the contents leaks out all over the floor?   Should you spend time mopping up the floor?  NO!  This is just taking away the symptoms of a possible deeper health problem.  And we already discussed that this is taking a dangerous risk with your own health.  To really make a positive change in your health, you need to continually add to the contents of the bucket and to avoid things that cause more holes in your bucket.  You can’t do much about the past.  But remember:

IT IS NEVER TOO LATE TO BEGIN TO DO WHAT’S RIGHT AND BEGIN DOING WHAT IT TAKES TO EXPERIENCE SUPERIOR HEALTH!

And remember that I’m here to help!  I’ll work with you one-on-one and help you with your individual needs.  I promise to do my best to guide and encourage you to get on and stay on the road to good health!

Your focus then moves from treating symptoms, to actively doing the things necessary to EXPERIENCE SUPERIOR HEALTH!  If you make the effort to stop chasing your symptoms and start moving towards optimum health then you’ll be truly practicing preventative health care.

Why be content to be merely free from symptoms when you can ensure better health & vitality for yourself and your whole family for your entire lives?

Earlier this week, I was talking with Christine and Linda about our vision and our passion. After an insightful discussion we summed it up: Our passion is to help our clients get well and stay well – using natural therapeutic techniques that are safe and effective. We love the idea of promoting superior health in our community through natural therapies. We discussed just how different our approach to wellness is than the typical “Western” medical approach. To clarify our thoughts, I’d like to share the following story of a patient who visited us this month. Her story isn’t that unusual…

(I have changed the patient name to protect her privacy)

Debbie was referred in to our office by a caring family member. After she was warmly greeted by Christine and Linda, she was introduced to me. She was pleasant enough and seemed to carry herself well, but I could tell something was bothering her. After Debbie completed some health history forms I brought her into my exam room and began the interview. I looked over her forms with her and when I got to the pain/body diagram, my heart broke for her.

She literally had nearly every symptom checked and every body part circled – indicating she had pains everywhere. She indicated that her pain was a 9 out of 10 and was fairly constant. I discovered that she had been suffering from debilitating pains for over 14 years and had not been getting any better despite the numerous medications and injections she was given. She was at her wit’s end.

I began asking some hard questions. Did any of her doctors recommend chiropractic, massage or any other natural healing art?… “No.” Did any of her prior doctors advise her to a try healthier way of eating?… “No.” How was her diet? “Poor.”

Then I started the exam. Debbie was able to move fairly well during the exam and nothing really struck me as that extraordinary until I had her lie down on my exam table. I performed a detailed exam of her spine and the muscles of her back, thighs, legs, shoulders and arms. I discovered multiple areas of spinal subluxation (“stuck” spinal joints that cause nerve interference). I also found that she had multiple areas of extreme muscular tension and active trigger points (muscular “knots”) throughout her body. Some of her trigger points that were so “fired up” that when pressed they shot pain to across to other areas of her body.

I then asked her if any of her prior doctors examined her like this?… “No.” She told me she her doctors interviewed her and then she had x-rays, MRIs, and lab work. All tests revealed nothing wrong. It didn’t surprise me.  I see this type of case frequently.  I knew that all those expensive diagnostic tests don’t reveal the types of problems I found in her joints and muscles. And I found her problems (and the cause of her pains) by just using my hands. (Side note: chiropractic means “With Hands” or “Hand Practice”)

So what does traditional medicine do when they can’t find any causes?  She was prescribed medication to ease her pain. Over the years that changed to injections, and then more and more drugs. And she just didn’t think anything else could be done.

After finishing the exam, I clearly explained to Debbie what was wrong, and that I could definitely help. I provided hope. Her face lit up.

I let her know that I would accept her as a patient, and there was good hope that she would recover, but she would have to make a commitment to better health. She would have to start a program consisting of regular visits for chiropractic and massage therapy. It was also vital that she change her way of eating. She joyfully agreed. Her journey to superior health was just beginning.

This true story helped me clarify my passion as a chiropractic doctor and a natural healer. And in regards to wellness, it also revealed a very distinct difference between our approach and the typical “Western” medical approach…

We know that true health comes from within… not in a bottle.

And we don’t just cover up the symptoms with drugs… we uncover the true cause of the problem and provide natural and corrective care. How refreshing!

And in Debbie’s case… life-changing.