Updated: Sep 22, 2020
Rotator cuff healing can be tricky.
It can take a long time, and it can be frustrating.
This is not the news my patients want to hear when they present to me with pain.
Typically they’ve been battling this annoying, yet not overly debilitating pain for months before they finally bite the bullet and have someone look at it.
“Should I get an MRI?”
Let’s look at this practically.
Doctors and insurance companies and medical systems want to make money. It’s a business like anything else. Would they REALLY pass up an opportunity to get more money?
Only if it’s unethical and proven to to be unnecessary. More on this in a moment
From your standpoint, what will you do with the information from an MRI?
Will you “at least know what’s going on”? Maybe, not necessarily, but again, what does that do for you?
Are you going to have surgery before trying conservative treatment?
People forget that MRIs are expensive AND increase your radiation exposure.
Maybe you don’t think that’s a big deal, but we are exposed to a lot of radiation in the atmosphere every day, and with the prevalence of cancer as high as it is, I don’t think willingly exposing ourselves to more than is necessary is something we should take lightly.
Aside from that, if an MRI is only a picture of a moment in time, and studies prove time and time again that the picture does not necessarily correlate to clinical exam findings and the pattern of pain.
These findings are well documented. The papers I looked at showed a range of 54%-65% of diagnosed complete or partial rotator cuff tears revealed on MRI were actually asymptomatic.
These were mostly in the “aged” population (over 40), but in an article reported in The New York Times, Dr. James Andrews conducted MRI scans of 31 healthy professional baseball pitchers with absolutely no shoulder pain or injury. He found that over 85% of them had tears in their shoulders.
It’s pretty conclusive that little to no statistical relationships exist between the level of pain and disability and the size or location of rotator cuff tears.
If you need to rule out a tumor, bone fracture, or any other life-threatening foreign object, push for an MRI.
If you’re just having grumpy shoulder pain that won’t go away, let’s move on with fixing it, shall we
The shoulder is a complex joint with a lot of mobility, not a lot of stability, and a bunch of small, relatively thin muscle groups that need to work in a perfectly synchronized fashion for you to have full freedom of use.
It’s fairly easy for things to go wrong here, but the good news is the research also indicates that conservative treatment (ie Physical Therapy!) is just as good, if not better than surgery.
I’ve also got some evidence that points to…wait for it…YOGA being an effective tool to relieve shoulder pain!
Now what if you’ve got someone who can help you with both Physical Therapy AND Yoga?!
Hey that’s me!!!
Step one in rehab is to assess and restore full joint mobility. Here's a quick video to take you through some yoga-inspired movements to restore full range of motion:
See the full post in my Instagram here.
Here’s what I’ve found in my over 15 years working with patients.
Your shoulder is NOT just your shoulder.
We are one continuous, cohesive network of muscles and fascia and what is going on in one area of the body directly effects the other.
Your tight hips might be altering your posture and creating strain on your shoulder.
Your big toe might be giving you headaches.
You just don’t know, so you have to open yourself to exploring the whole body.
PT’s are experts at evaluating your body from head to toe, and we can zero in on your pain drivers to get you relief quickly.
Unlike pain meds and injections from your doctor, our treatments are long lasting because we find and address the cause of the pain.
After restoring range of motion we move on to strength and functional integration. Seemingly simple, but many hiccups can come up along the way.
That's why it's helpful to have a trained, knowledgeable guide to help you understand what's normal and what's not.
If you’re ready to take the next step and work together, please contact us so can get started asap!
**DISCLAIMER** This series is intended for individuals in good health and is NOT meant to serve as a diagnosis or personal treatment plan of any kind. If you are having pain in your shoulders that is not going away with rest and is hindering your ability to function normally, please go get evaluated by your physical therapist!