Luther – Shoulder Tear
Luther, a 34 y/o self-employed natural health shop owner came in after suffering from spending a long time in A&E a few days prior, following an acute shoulder injury. He sustained his injury while swinging on scaffolding where his whole body weight was suspended through his arms. Although he had a history of shoulder pain in the past, he had not experienced any significant problems for a number of years. This injury occurred just as he had started to regain momentum by taking positive steps with his health and getting back into training. After spending a whole day waiting to be seen in A&E, Luther was advised that he had torn the tissues deep in his shoulder and that he would not be able to fully use his arm for the next 3 months. He was put in a sling and advised to rest.
On initial assessment, it was clear that Luther was in a lot of pain. He was unable to bear any weight and even taking the weight of his own arm was too painful for him to do. He had to constantly support his right arm either with the sling he was provided or with his opposite arm. There was a fullness to the contours of the shoulder as well as redness on the skin coupled with a palpable difference in temperature with the affected side being much hotter to touch. Active range of motion was non-existent while the passive assessment was extremely limited due to the level of pain Luther was in. Gentle palpation of the tissues established that there were heightened areas of soft tissue tenderness, particularly in the posterior shoulder.
Luther’s assessment findings and case history were consistent with a rotator cuff injury and soft tissue tear. There was clearly a significant amount of inflammation in the area and an increased tissue pressure within the local tissues. This along with any internal bleeding that may have occurred as a result of the tissue damage sustained had the potential to inhibit the body’s ability to clear the injured tissue and begin the tissue repair process. The lack of movement during the pain cycle of the injury may also contribute to this hindrance and facilitate both muscle wasting and the development of adhesions within the soft tissue, giving rise to future complications such as further instability and the potential of a sequential progression to a capsular adhesive pattern, such as frozen shoulder (adhesive capsulitis). It was imperative to help manage pain, reduce inflammation and begin the rehabilitative process as soon as possible to enhance the recovery process and prevent longer-lasting complications of the injury. There were clear indications that this injury had wider implications for Luther’s livelihood, mental health and social life and hence giving him confidence in a positive outcome was also an imperative part of his healing journey, especially when considering the not so promising prognosis given to him by the hospital.
Bearing in mind the extent of Luther’s injury and the wider goal of correcting the inherent instability in his shoulder, we prescribed him a 10-week program to focus on reducing pain and inflammation initially followed by a rehabilitation phase in which we would guide him with strength building, mobilisation and exercise. It was established that the wider goal of care was to help increase the functional capacity of his shoulder to match the challenges of his regular activities which were planned to include regular attendance at the gym.
The initial phase of care focused on wet cupping techniques as the main intervention. This was followed by IASTM (Instrument Assisted Soft Tissue Mobilisation) techniques all to patient tolerance. Within the first 3 visits, there was a marked improvement in pain, range of motion and overall functionality. Reassessment highlighted specific areas of weakness and restriction that were further focused on. Dry cupping, fascial stretch and rehabilitative exercise were all incorporated over the remaining weeks. Luther is now on a maintenance program to help create accountability and supplement further progression away from dysfunction and towards optimisation.
Full recovery from the episode was attained over the course of the initial treatment program and the strength gained through Luther’s recovery helped him realise that his other shoulder also needed improvements. Patient education and self-empowerment on self-release methods, strengthening and mobilisation were all achieved during the program. This has helped Luther implement positive change and active management of his health in the area of biomechanics.
The limited approaches of drugs and surgery in such cases provide very few options for people in similar scenarios to Luther, who is led to believe that they have to accept the false reality of a hands-off prognosis. Having wide artillery of treatment interventions such as those within ICAHT protocols of integrative management, allow us to provide more avenues of recovery for patients. These alternative pathways significantly alter the road to recovery. From one that is long, passive and open to the risk of further complications, to one that is shorter, active and empowering in safeguarding against the cause of such issues in the future. The implications of such are making these protocols the go-to choice of many high-level athletes and individuals who value the ability to enhance recovery and limit risk.
- Luther severely damaged his right shoulder
- His first course of treatment was Hijama (wet cupping)
- He has significantly improved his range of motion
- He was already on a treatment plan prior to severely damaging his shoulder
- IASTM and Manual palpation used
Luther came to us in a bad way. He injured his shoulder when some acrobatic activity went sour resulting in him twisting his arm whilst being fully loaded with his body weight. He was in a lot of pain and completely unable to use his arm.
After spending a lot of time in A&E and being told that he would need at least 2 months to regain his arm function, he booked in to see us. He was in absolute agony and needed help taking his clothes on/off and doing regular day to day activities.
We assessed the situation and selected a specific protocol to target the deep inflammation within his shoulder, followed by a rehabilitative program to help restore mechanical function to the area.
Within 48 hrs, Luther was lifting his arm & went back to the specialists to show them the magic of what a specifically targeted protocol of wet cupping can do. Their amazement at Luther’s progress made them admit that they had no idea how the therapy was working but he should keep doing it!