Information about conditions is provided as a service to our patients for educational purposes only. "If you understand your condition, you will be able to do the things necessary to rehabilitate much faster." Please feel free to print the information so that you can refer to it often. Sharing of information is quite risky, however. Do not presume that information is meant for you if you have not seen the doctor and received a specific diagnosis. Some conditions share similar symptoms but require very different treatment. If you have friends or family who may have similar symptoms, please schedule an appointment to see the doctor.

Rotator Cuff Strain

The rotator cuff muscles control rotation of the shoulder. They consist of the infraspinatus, teres minor and supraspinatus which rotate the shoulder outwards and the subscapularis which is one of the muscles which rotate the shoulder inwards.

These muscles are put under a great deal of strain especially in throwing events and racket sports where your arm is above your head a lot. A sudden sharp pain in the shoulder would indicate a possible rupture of a tendon, while a gradual onset is more likely to be inflammation.

Symptoms also include:

  • Pain on overhead activity such as throwing or racket sports.
  • Pain when you bend the arm and rotate it outwards against resistance.
  • Pain on the outside of the shoulder possibly radiating down into the arm.
  • Pain in the shoulder which is worse at night.
  • Stiffness in the shoulder joint.

What is the outlook (prognosis) for rotator cuff disease? Without treatment, including exercise, the shoulder frequently permanently loses full function from rotator cuff disease. Sometimes, scarring around the shoulder (adhesive capsulitis) leads to a marked restriction of the range of shoulder motion. This condition is referred to as a frozen shoulder. Weeks of rehabilitation is the norm with significant rotator cuff disease. Some patients never recover full function of the shoulder joint.

Treatment and Rehabilitation

  1. Physical therapy of the shoulder joint, supporting muscles and tissues is critical for several days at first and then 3 times a week for a few weeks with the onset of exercises
  2. Sometimes, Manipulation of the spine and surrounding tissue relieves the stress on the muscle attachments.
  3. Proper exercises begun at the right time will reduce the strain on the muscles and improve function.
  4. Elimination of repetitive friction motions will relieve the symptoms.


  1. For acute situations, utilize ice packs on the affected area until numbness is reached. .
  2. Ultrasound therapy is effective in the healing process.
  3. At the appropriate time, stretches and strengthening exercises should be implemented in the treatment regimen.

We offer treatment of these conditions at various levels for all patients. We expect that you will follow this treatment plan through to its logical conclusion of restoration of complete function and rehabilitation. Our management system is designed to help you remember all of your appointments and to be fully compliant with all of our recommendations. At any time, should you decide to discontinue the process, please just let us know so that we don't become a bother.

LIFE STYLE CHANGES: Long periods of sitting should be interrupted by standing and stretching. Do not sleep or lie on your stomach and avoid activities that hyper extend the lower back.

SUPPLEMENTATION: Glucoseamine Sulphate and Trace Minerals: Have proven effective in long-term prevention of deterioration of joint tissues. This may help reduce the mechanical breakdown associated with posterior joint syndrome.

HOME REMEDIES AND RECOMMENDATIONS: Utilize moist heat packs on a daily basis during the first phase of treatment. This will help relax tight muscle fibers and bring blood to the region. Hot tubs and baths provide temporary relief. Exercises should be specific and in a particular order. They should be simple and aimed at stabilization at first. Seek advice from your chiropractic physician on when to do these exercises and how often. When performed correctly, rehabilitation exercises can be the key to avoiding multiple episodes of low back pain and maintaining the function of the low back muscles and joints.

MAINTENANCE: Regular spinal adjustments are important to reduce the symptoms of posterior joint syndrome. Patients who receive monthly spinal manipulation and therapy report fewer complications with posterior joint syndrome. It is important that you follow your physician's advice about the frequency of treatment for your particular condition.

Expectations We understand that you have come here for help. We have spent many years learning the best ways to solve the problems of mechanical back and neck pain. We expect you to comply with our recommendations and follow our treatment schedule completely regardless of the treatment plan you have. We expect you to set all of the recommended appointments at times convenient for you and we expect you to keep all of them. We expect you to respond favorably and know that your 100% compliance is the determining factor. We also expect you to attend our next class on Absolute Spinal Health. The staff can give you a schedule of the next class.

Other Information At our class on Absolute Spinal Health, we discuss mechanical conditions of the back, neck and spine and teach you ways to prevent mechanical conditions from occurring. We also offer a wide variety of health information at our web site. All patients are welcome to use our information to improve your life and maintenance your spinal health.

Follow our wellness recomendations for absolute health.

Holladay Physical Medicine - 4211 Holladay Blvd. Salt Lake City, UT - 801-272-8471 Please read the Disclaimer