Shoulder or rotator cuff injury? Dry needling could help

One of the most common areas of treatment in our outpatient physical therapy offices is the shoulder. It is not terribly surprising, since it is one of the most mobile joints in the body, and also one that is under constant demand.  This is especially true in athletes, especially those who perform a repetitive motion of the arm, this includes those playing baseball, softball, tennis, and golf. Patients presenting with shoulder pain, but more specifically, rotator cuff issues are a daily occurrence.   The rotator cuff is term given to a group of four muscles and their tendons that help to stabilize the shoulder joint when you move your arm. Our shoulder joint is a ball and socket joint and one of the main jobs of the rotator cuff is to compress or stabilize the ball within the socket when you are moving your arm. When the rotator cuff is not functioning properly, there is an inability to fully elevate the arm.

Clinically, rotator cuff dysfunction is one of the most common conditions affecting the shoulder joint and not all dysfunctions are equal.  Issues may range from a strain to a complete tear. One of the most frequent causes of rotator cuff dysfunction is repetitive use.  This, coupled with the fact that the rotator cuff tendon does not get a very good blood supply, place it at increased susceptibility for degeneration.

Symptoms may include pain or ache over the front and outer aspect of the shoulder.   Discomfort may be increased by activities that cause irritation to the rotator cuff tendon such as reaching behind your back, across your chest, and overhead, as well as pain with repetitive overhead motions such as throwing a baseball or serving in tennis.

Patients who suffer from pain, but still have maintained a good amount of shoulder function are generally good candidates for non-operative treatment.  Some of the more conventional treatment options include rest, ice/heat, stretching, corrective exercise, ultrasound, and manual therapy. One of the newest and most effective treatments that we are using at our clinics is the implementation of dry needling. Since introducing dry needling into our practice, we continue to be amazed at the results patients are experiencing.  Conditions that are chronic in nature and may have plateaued towards improvement in the past with conventional therapies, are now completely resolving, and doing so in a quicker fashion.

When an injury is sustained, our tissues go through a healing process that starts with inflammation/swelling and ends with reconstruction of the injured tissue.  It is during this healing process, where inflammation, contracture of tissues, formation of adhesions between neighboring tissues, and scar formation become the causes of chronic soft tissue dysfunction.  These changes result in blockage of fluid into and out of an area, as well as a decrease in blood circulation (this is especially apparent in rotator cuff dysfunction).  Injured tissues eventually become weakened and deformed due to a lack of nutrition, resulting in increased pain, disuse, and altered movement patterns.

The rotator cuff tendon, like many other tendons in the body, does not receive a great blood supply, which is part of the reasoning as to why it does not heal well on its’ own. Dry needling is a process by which fine gauge solid filament needles are inserted into the symptomatic dysfunctional area to create tiny lesions (micro trauma) in the underlying soft tissue. These lesions stimulate the body’s natural response of healing by way of secretion of proteins and the blood factors responsible for tissue remodeling.  In other words, the micro trauma that is caused in the tissue creates an environment that allows the tissue to remodel and repair itself. Because the needles are of an extremely fine gauge, the procedure has minimal to no pain associated with it.

A thorough history and physical examination by a board certified orthopedic physical therapist can determine if you would be a candidate for dry needling for shoulder pain.  So if you or someone you know is having shoulder pain or another musculoskeletal problem and would like to know more about dry needling or other physical therapy options, seek the consultation of a physical therapist at one of our three locations or see your physician for a referral to one of our facilities.

Dr. Richard DeFalco is a physical therapist with Professional Rehabilitation Services in Myrtle Beach. He is a Board Certified Orthopedic Specialist as well as a Certified Strength and Conditioning Specialist.  He treats patients of all ages and activity levels that suffer with neuromusculoskeletal disorders.  For more information on this topic please visit our website at www.prsrehabservices.com or call 843-839-1300.

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