Truckee’s Dr. Triestman offers shoulder pain relief tips |

Truckee’s Dr. Triestman offers shoulder pain relief tips

Barry Triestman D.C.
Special to the Sun
Getty Images |

TAHOE/TRUCKEE, Calif. and#8212; In general shoulder injuries are separated into two categories: Overuse and trauma, overuse being the most common.

Overuse injuries are also known as a repetitive micro-trauma injuries. What happens is we repeat small abnormal movements over and over again, day in and day out. This creates small tears in our ligaments, tendons, muscles or bones that we do not feel until the tear has gotten bigger. This may take months or years to occur. Trauma injuries usually happen from a single fall or accident. The two most common trauma injuries are shoulder dislocation, when the shoulder joint proper comes totally out of place and the acromio-clavicular joint separation, which is when the joint distance between the collar bone and shoulder, increases in width. Shoulder pain is a common ailment that affects 10 percent of the population at some time.

Of the two, more than 90 percent of those seen in sports injuries practices are overuse injuries. The most common of these are partial rotator cuff tears, bursitis and impingement. Common symptoms are pain at the shoulder, decreased range of motion and loss of strength. These problems are caused by poor biomechanics, improper control, abnormal flexibility, poor posture, and lack of muscle strength, coordination and conditioning. They happen more with overhead activities like throwing a ball, tennis and overhead construction work.

First, rest, ice and alter your sleeping position. If that is not enough, try anti-inflammatory medication after checking with your doctor. Try to limit the anti-inflammatory medication due to their many side effects. The most critical one in tendon, ligament and muscle injuries is their interfering with healing. You should then see your sports medicine specialist to put together a program to include manual manipulation of the muscles, ligaments, tendons and joint capsules.

At my practice we find the Active Release Techniques system addresses these problems successfully. To complement that, a specialized rehabilitation program to correct the bio-mechanic, control and muscle problems should be taught. These programs generally start with simple movements that emphasize control of the arm, shoulder and spine. The Pilates reformer with a trained instructor is an awesome tool to help people get connected to their body and gain control. As the patient improves, the exercises get progressively more challenging. For those who lack flexibility, a stretching regime should be initiated. I have found that these measures prevent future problems and help heal injuries faster.

As you progress with the program you will get stronger and have more range of motion and less pain. This should start to happen after three visits. The longer the injury has been present the longer it will take to reach maximum improvement.

and#8212; Dr. Barry Triestman practices Chiropractic, Sports Medicine, Active Release Techniques and Pilates based rehabilitation in Truckee. Send questions to

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