Thank you for joining me again this evening for our nightly podcasts. I perform these podcasts in the hopes that you will be able to education yourself on the topics discussed so you can make better informed medical decisions regarding your health in the future. I am doctor Harrison Campbell of Restoration Health a premier sugar land chiropractors office. Previously we discussed a treatment plan for a patient which recently came into my office seeking care several month post motor vehicle accident. It seems like everyone enjoyed it so we will do something similar tonight.
The case we will be covering tonight involves a shoulder injury after a job related incident placing this case in the realm of Worker’s Compensation. Now several weeks ago we covered worker’s compensation but let us review it briefly here. Worker’s Compensation is a system in place to help injured workers receive the care they need with the medical costs being covered by the insurance the employer has in place.
Now sugar land chiropractors who treat workers compensation patients understand that there are checks and balances in place which slow down the care provided to the patients. What is meant by this is a system called pre-authorization. Beyond X-rays and the first few treatments all steps of the treatment with the injured worker are authorized via an adjustor handling the injured employee’s case. This creates delays in treatment as there is a three to five day response time for requested therapies.
Now this is relevant due this particular patient whom we will name Joe. Joe was injured several months before he was able to come to my office. Now he did receive some care to other body areas which were injured like the neck and back, but the shoulder remained relatively untouched. The time delay creates as sugar land chiropractors know problems for the shoulder and can lead to frozen shoulder, where there is severe pain and decrease in mobility. This led to Mr. Joe coming to my office with the inability to raise the arm from his side more than approximately fifteen to twenty degrees. There was reduced strength in the arm as well in multiple muscle group leading to loss of function with the arm. To put it simply, the patient had trouble putting his deodorant on in the morning and thus reverted to physically lifting the injured arm with the healthy arm and resting it on the wall in order to do so. Now additionally, the patient had previous MRIs or magnetic resonance imaging of this shoulder. These particular MRIs were performed showed injuries to the rotator cuff, but the labrum appeared intact on the imaging.
As for the part of the rotator cuff which was injured sugar land chiropractors know that the most commonly injured muscle is the supraspinatus. In Mr. Joe’s case, the injured muscle was indeed the supraspinatus. In his particular case there was a complete tear of the supraspinatus tendon. Care began immediately following the most effective shoulder rehabilitation protocol.
This protocol as sugar land chiropractors know is called the Codman’s Shoulder protocol. This starts with exercises simply referred to as Codman’s exercises or stretches. The purpose of this exercise is to produce motion in the shoulder joint itself without placing strain on the muscles or tendons to do so. Essentially the arm hands and you use your body weight to move the arm in set motions to create motion at the shoulder. We would also perform wall exercises and using a pulley system to facilitate as much range of motion as possible. The goal with this treatment is to set a good foundation for surgical repair of the tendon.
After a complete treatment plan, we finally had Mr. Joe into the orthopedic surgeon where a date was provided for the rotator cuff repair. Following the surgery sugar land chiropractors know there is downtime for the healing process to start before the post-surgical rehabilitation begins. Once we can begin the rehabilitation the Codman’s protocol is used again starting with those Codman’s exercises.
Moving on from the Codman’s exercise we perform isometric exercises. This is a form of exercise where the muscle belly is put under strain, but there is no motion of the joint. This allows the tendons which were recently repaired to continue healing while getting the exercise needed through active care. Additionally, the pulley and wall exercises are again utilized to maximize range of motion. Remember the goal is to restore normal range of motion quickly so we can then move to strength reconditioning.
Aside from the active care manual therapy or instrument assisted soft tissue work is done to help the scar tissue fibers to align properly during the healing phase. Passive therapies such as electrical stimulation and ultrasound are done to decrease pain and stimulate the healing process as well.
Mr. Joe was diligent with his exercises. He pushed himself through the pain and performed every exercise or stretch placed before him. Because of this work, Mr. Joe was able to recover well not only from the injury but the surgery as well. I say that, because sugar land chiropractors know that shoulder surgeries are tricky business. The rehabilitation is uncomfortable to say the least. You have to push through the pain to make progress with recovery. Often times I find people struggle with this rehabilitation more than any other post-surgery I have in my office. I am constantly reminding patient that without the exercises, without the stretching you will not get better. I have even had the conversation with patients about if they feel not up to the task of shoulder rehabilitation they should think long and hard about whether they want to proceed with surgery.
Thank you for joining me again this evening for another great podcast. I hope you enjoyed the discussion on (blank). As always should you or someone you know require a sugar land chiropractors services or simply have more questions on what was discussed please call Restoration Health today. We would love to schedule you an appointment and get you on the path to better health today. Thank you once again for joining us. Have a good night.