How will my shoulder heal?

The Shoulder and Rotator Cuff Injury

This article is about restoring shoulder ease and function and explains what I do when people come to see me in my office. Holistic and integrative care are words people have overused to the point of cliche, but that is truly how I work.

But now, let’s talk about the shoulder.

People often ask me how long it will take for a rotator cuff injury or injury repair to heal.

The answer depends on who you are and how and why you got an injury in the first place.

1. Alignment. If your posture is good, your odds go up.
2. Work and Play. If you don’t have a repetitive activity in your life that strains your shoulder (for example, hair styling, ping pong, or plumbing), the chances of regaining a pain-free, full range of motion are better.
3. Amount of Damage. If your only injury was to one of the four rotator cuff muscles, and there wasn’t damage to other muscles/tendons, cartilage, the joint capsule, or the labrum, your chances are improved. The more fibrous the tissue (ligaments, labrums, and joint capsules are the most fibrous), the longer your recovery will be. Interestingly, bones heal fast because they have a huge blood supply. Muscles heal somewhat slower, often because you can still use them, so you usually do.
4. Diet. If you eat a good diet, low in sugar and processed food, with plenty of green leafy vegetables, protein (in the case of muscles), and water, your chances go up.
5. Mindful Rehab. If you engage in a targeted and thoughtful physical regimen, one where you pay attention to how you feel and develop subtlety to balance strength, flexibility, and coordination in your shoulder and throughout your body, and stay physically active, you will perform better.

(Body-based meditation is helpful for the same reason.)

1. Passive Care and Coaching. If you get your muscles and joints balanced through bodywork or chiropractic, and you have someone looking very carefully at your rehab movements to make sure they’re optimal, you’ll get a huge boost in healing. Don’t go it completely alone, or you’ll be rehearsing your compensation patterns.
2. Balance Flexibility and Mobility. This is where a lot of people go wrong, leading to a 20% reinjury rate in people who have surgery for a rotator cuff tear. This is where bodywork, chiropractic, and a careful rehab strategy are crucial. I spend far more time on bodywork and rehab than I do on chiropractic adjustments.

 

Many individuals who experience rotator cuff tears were overly flexible in their shoulders prior to the injury. If you fall into that category and undergo surgical repair, or if you take months off without thoughtful passive care and movement work, you may find that your range of motion is reduced compared to before, causing side-to-side imbalance, or that it is diminished in some directions more than others, in which case a tangled web of compensations and counter-compensations will endanger the joint and the adjacent ones, especially your neck.

If you start to observe that, it’s particularly important to get manual therapy and to establish a consistent movement practice that emphasizes the balance between stretch and flexibility in the joint.

The body must always balance stability with mobility; if you are too stable in specific directions—equivalent to being rigid—while too mobile in others—akin to being collapsed—you will merely exchange one set of challenges for another, leading to dissatisfaction. In all things, balance – the golden mean.

Nearly all shoulder problems originate with issues in the joint, which are caused by poor overall posture and movement patterns. The problem is that the ball at the top of your upper arm bone is too far forward or up in the socket it fits into (the socket is part of the shoulder blade). Thoughtful postural analysis can show what patterns elsewhere in the body are leading to chronic shoulder stress. And a trained bodyworker or chiropractor can help move the bone into its proper place in the joint to reduce stress/inflammation and improve function/ease.

Take home: Awareness, activity, an outside eye, and passive care will improve the way your shoulder works, and that is the number one determinant of how both your shoulders feel and perform for the rest of your life. I provide support in all those areas. Please come to see me and send your suffering friends if those issues arise.

“Confidence is going after Moby Dick in a rowboat and taking tartar sauce with you.” -Zig Ziglear