Rotator Cuff Tears
Chiropractic treatment for rotator cuff tear. The rotator cuff is the name for the tendons that surround the shoulder joint. The rotator cuff is the most important group of muscles giving it support.
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Calcific Tendinitis and Chiropractic Treatment
Calcific tendinitis is a condition that causes the formation of a small calcium deposit within the tendons of the rotator cuff. These deposits are usually found in patients at least 30-40 years of age and have a higher incidence in diabetics. The most commonly involved muscles are the supraspinatus and infraspinatus, which are part of the rotator cuff musculature.
The calcium deposits are not always painful, and even when painful they will often spontaneously resolve after a period of 1-4 weeks, but not always. Sometimes calcific tendinitis is an incidental finding when the chiropractor takes an x-ray as part of the examination.
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What are the causes of calcific tendinitis?
The cause of calcium deposits within the rotator cuff tendon is not entirely understood. Different ideas have been suggested, including trauma, poor blood supply, or even autoimmune disease and ageing of the tendon, but the evidence to support these conclusions is not clear.
How does calcific tendinitis progress?
Calcific tendinitis usually progresses predictably, and almost always resolves eventually without surgery. The typical stages and progression are:
- Pre-calcification Stage: Patients usually do not have any symptoms in this stage. At this point in time the site where the calcifications tend to develop undergo cellular changes that predispose the tissues to developing calcium deposits.
- Calcific Stage: During this stage, the calcium is excreted from cells and then merge into calcium deposits. When seen, the calcium looks chalky and is not a solid piece of bone. Once the calcification has formed, a so-called resting phase begins. This is not a painful period and may last a varied length of time. After the resting phase, a resorptive phase begins – this is the most painful phase of calcific tendinitis. This may be brought about by trauma or overuse that result in an increase in blood supply to the area which changes the dry state calcium deposit to a more fluid state. This is why during the resorptive phase, the calcium deposit looks something like toothpaste.
- Post-calcific Stage: This is usually a painless stage as the calcium deposit disappears and is replaced by more normal appearing rotator cuff tendon.
Patients usually seek treatment during the painful resorptive phase of the calcific stage, but quite often patients have the deposits found incidentally as part of their chiropractic evaluation of shoulder pain.