The Shoulder

Shoulder pain has many causes:

• Inflamed tendons (tendinitis) from injury or overuse

• Calcifying tendinitis

• Rotator cuff injury (often from throwing/pulling/lifting motions)

Overuse injuries result in over-recruitment of major muscles (e.g latissimus doris, pectoralis minor mm) at shoulder (infraspinatus, suprapinatus, deltoid, and the

ever-important and often neglected subscapularis mm) - this results in altered biomechanics of the complex shoulder joint, causing ligament and tendon inflammation, restricted motion, and pain.

‘However, high-energy ESWT has been found to be an effective means of improving overall shoulder function and pain scores.’

Suzuki, Kentaro MD, et al Calcific Tendinitis of the Rotator Cuff: Management Options Journal of the American Academy of Orthopaedic Surgeons 2014; 22(11):p 707-717 [read article]

The corrective treatment protocol for the shoulder:

• Chiropractic adjustments to the mid-thoracic and cervical spine to release nerve irritation and attendant muscle guarding

• ART (Active Release Technique) on the involved muscles

• Isometric muscle engagement therapy

• SoftWave Tissue Regeneration Therapy

• This comprehensive mult-faceted approach will get the shoulder back to pain-free, functional action most efficiently

This protocol has been developed by Dr. Paul from his post-graduate training in extremity adjusting and 35+ years of clinical experience treating thousands of patients; plus dealing with his own shoulder injuries from years-and-years of beach volleyball, surfing and ironically, adjusting patients.

‘The ESWT results were goof to excellent in 87.9% of shoulders and fair in 12.1%, and the control results were fair in 69.2% and poor in 30.1%. Among ESWT patients, calcium deposits were completely eliminated in 21.2%, partially eliminated in 36.3%, and unchanged in 45.4%. In contrast, elimination was partial in 15.3% and unchanged in 84.7% of control group.’

Chin-jung Hsu MD, et al. Extracorporeal shock wave therapy for calcifiying tendinitis of the shoulder Journal of Shoulder and Elbow Surgery 2008 17(1): p 55-59 [read article]

SoftWave Treatment:

• The in-office treatment is about 10 minutes

• The results are long-lastings

• The treatment area is determined through history, examination, and diagnosis

• Ultrasound gel is used to conduct the SoftWave pulses

• The quantity and intensity can vary depending on the indication

• Treatment usually consists of four to six sessions over 4 weeks

• No adverse effects

Importantly, SoftWave has the unique feature of ‘diagnostic mapping’ - using the shock wave pulses to identify the area of injury/inflammation that requires treatment.