Shoulder Injury And Chiropractic Rehabilitation – Ski Crash
This is the most recent Shoulder Injury case after skiing accident that I have finished rehabilitating in my San Leandro Chiropractic Clinic. Patient is a twenty five year old female. She is a full time student and loves to be involved in different sport activities. She was in a great deal of pain for two months prior coming to my office for rehabilitation of her shoulder.
About two months ago my patient was enjoying the white powdered slopes of Lake Tahoe. Unexpectedly she lost a control on one of the turns and fell really hard on her left shoulder. The left shoulder was in a dislocated position for about one hour. That how long it took for paramedics to reach her on a slope. She was taken to a near by Hospital E.R. and was diagnosed with minor shoulder dislocation without any fracture. She got very lucky that her bones were not broken. As usual patient was discharged and prescribed a ton of pain killers with advice to get some rest and applying ice on the injured area.
After getting back to Bay Area, this patient made an appointment with a local orthopedic doctor. This doctor was “nice enough” to see her in about two months. What if patient needs to be seen ASAP, why such a long delay? After all, evaluation and examination does not take hours, and any doctor can figure out what is going within given time frame.
During these two months period my patient had been taken pain medications which would become less and less effective because the intensity of the pain would go up every week. The pain level began affecting her sleep patterns and thus her ability to concentrate on her professional studies. Sleeping on a left side was out of question at all. She stopped working out completely and had to eliminate some of her activities of daily living.
Many would wonder why so much pain, if hospital has discharged her, and orthopedist thought she could wait for two months and he could cure her shoulder in one visit. The answer is simple enough. This patient had soft tissue injury which required immediate rehabilitation post skiing accident. The best result with soft tissue injury rehabilitation, are within first 72 hour post trauma. Read this post for more scientific explanation: “4 Stages of Soft Tissue Healing.” This particular patient had to wait eight weeks and be in a miserable pain.
During examination I have discovered that patient has lost about 70-80% of range of motion in her left shoulder with severe pain at the end range. This pain was present on active and passive range of motion (ROM) tests. Pain during active and passive ROM is a sign that her muscles, ligaments and tendons were injured – sprain and strain injury. All of the rotator cuff muscles were strained with severe pain during palpation.
I knew that I could help this patient. However, eight weeks of lack of motion in a left shoulder caused increased fibrotic tissue around injured soft tissues. That meant only one thing – longer rehabilitation process. This patient was very eager to fix her problem so the compliance was not an issue.
Each session consisted of full spine chiropractic adjustments, which helped to enhance the ability of her body to heal itself. If you want to know how this works please refer to this post: “Relationship of the nervous system and spine to organs.” Prior chiropractic adjustment she would get 15 minutes of electric stimulation with moist hot pack on her left shoulder followed by 20 minutes deep tissue massage from my CMT. After that I would performed post isometric relaxation of her shoulder in flexion, extension, internal and external rotation, adduction and abduction.
A noticeable response to a therapy was after session number three. Pain level has gone down and ROM has gone up. My original plan was two week of rehabilitation with frequency at three times a week – total six sessions. However, it took me additional 3 sessions to bring this injured shoulder to a full ROM and almost no pain level.
At the end of the session number nine patient informed me that she can have a good night sleep, she can lay down on her left shoulder and she is back to her activities of daily living. She began her exercise routine after last session. Patient was discharged with instructions on how to strengthen and stretch the injured body part.
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