Return to Play Standards for Shoulder Injury
The shoulder joint, or glenohumeral joint, is one if the most regularly injured joints in athletes I handle many shoulder injuries in my practiceMost shoulder injuries can be treated with chiropractic care and the client can anticipate recovery Some of the most typical injuries to the joint are:
- Instability
- Rotator Cuff Injury
- Superior Labrum Sore
There is enhancing evidence that the pathophysiology of rotator cuff injuries are more complicated than formerly believed. The way the tendon heals has a fantastic effect on treatment and recuperation
Tendons are usually injured in 2 ways:
- Direct trauma– usually in contact sports
- Senescence– gradual ‘wear and tear’ though aging and overuse
Apoptosis of fibroblasts (laser therapy can stimulate fibroblasts to produce more collagen to speed healing).
Decrease in cell activity (laser therapy can stimulate the cells associated with healing to enhance activity).
- Rotator cuff pathology usually increases with age.
- Since there are many different etiologies to rotator cuff injury, treatment, rehab, and return to play need to be customized for each person.
- Factors considered are:.
- Age– the older you are, the longer it will take to recover.
- Expected chance of recovery– severity of injury and other factors.
- Dominant extremity involved– dominant extremity is used much more and may take longer to recover.
- Extent of the pathology (i.e. tendonitis vs a tear).
- Co-existing pathology– involvement of other structures, or conditions (for instance, diabetes can impair tissue healing).
RETURN TO PLAY:
- There are a number of GENERAL rules for go back to play when dealing with rotator cuff injury.
- Full ROM.
- Full strength.
- Pain-free, or mostly pain-free.
