Acupuncture should be considered a best practice treatment for many types of shoulder injury including, where damage is still relatively minor, what are commonly known as rotator cuff tears. What is commonly referred to as the “rotator cuff” actually consists of 4 tendons that come together to form a protective layer over the glenohumeral joint and to provide stability and the ability to lift and rotate the shoulder. The humerus is connected to the muscles subscapularis, teres minor, supraspinatus and infraspinatus by their respective tendons. Injuries to the “rotator cuff” involve one or more of these tendons or muscles. Inflammation of these tendons and muscles can occur with overuse, over-strain or in older adults, due to ischaemic changes- lack of blood, nutrients and oxygen to the soft tissue. Tendonitis and inflammation can in turn weaken the rotator cuff and lead to tears in the soft tissue. With a rotator cuff tear, the injury is typically accompanied by immediate and severe pain which continues to increase for 1-2 days before reaching its maximum level. The pain tends to remain very intense for a period of 5-7 days afterward and lingering pain can remain indefinitely until the rotator cuff is healed.
In my experience, untreated, a rotator cuff tear can take years to heal, or may not heal at all. Acupuncture can be an effective means of stimulating the body’s own immune system to heal tears in soft tissue more quickly and effectively by increasing blood flow and therefore oxygen uptake in areas with soft tissue damage. Improved circulation to the area of injury also facilitates removal of inflammatory products that are no longer needed.
The subscapularis muscle is the large muscle covering the shoulder blade and is in charge of medial rotation. Infraspinatus and teres minor muscles are responsible for lateral rotation. The supraspinatus muscle is in charge of abduction (raising your arm to the side) and is the muscle/ tendon most commonly affected by inflammation and tendonitis, and therefor most often torn of the rotator cuff tendons. A tear of the rotator cuff generally presents with both pain and weakness in the shoulder. There are many common assessments for rotator cuff tears such as “the empty can test” which assesses the supraspinatus. In the empty can test the patient turns his or her hand with thumb toward the ground and attempts to raise the arm against resistance. The “Drop Arm” test is another assessment of a possible tear of the supraspinatus and involves lifting the patient’s arm over head and allowing them to try and lower the arm to the side gradually. Generally with a tear in the supraspinatus, the arm will fall to the side with inability to lower it slowly. The infraspinatus and teres minor muscles are tested likewise against resistance to lateral rotation while the subscapularis is tested against medial rotation.
Once the location and nature of the rotator cuff injury has been accurately assessed, acupuncture can help speed healing of the soft tissue by helping to stimulate blood flow and oxygenation of the soft tissue as well as creating a histamine response that helps to simulate the body’s natural healing mechanisms, dilate blood vessels and reduce inflammation. Next time you or someone you know has a shoulder injury, find an experienced acupuncturist to help decrease your rehabilitation time and reduce the risk of more serious or permanent shoulder injury.
Terry M. Chen, Licensed Acupuncturist
Open Sky Acupuncture, Eugene Oregon