Rotator cuff tear: a case study
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Title – Rotator cuff tear: a case study
Rotator cuff tears are quite common and something we see quite frequently. The important thing to identify is the severity of the tear and the location. As the rotator cuff muscles are muscles of stabilisation these are most commonly the muscles affected in trauma cases. To learn more about the rotator cuff follow this link to my blog on the rotator cuff.
What is a rotator cuff tear and how does a tear happen?
A tear is literally a tear in one or more muscles of the rotator cuff. This can be in the muscle itself or in the tendon (this connects the muscle to the bone). A tear may also be referred to as a strain or pulled muscle. These tears are graded based on their severity and we have seen all of these in our chiropractic clinic in Eastbourne.
Grade 1: Mild damage to individual muscle fibres with limited loss of strength and movement
Grade 2: Greater damage to a larger proportion of muscle fibres with significant loss of strength and movement
Grade 3: Complete rupture of the muscle or tendon
Rotator cuff tears are often due to trauma or fast quick movements. I have seen many in my time in practice from falls directly on the shoulder or onto the elbow or hand; to throwing a ball or picking something heavy up quickly.
A case study
This case is of a seventy-year old woman who was an existing chiropractic guest of mine at Lushington Chiropractic clinic in Eastbourne. She had never had any issues with her shoulder but twisted her ankle causing her to fall forwards. She landed on her left hand as she put her arm out to stop her fall. This caused immediate severe pain in her left shoulder.
I saw her the next day and her range of movement in her shoulder was severely reduced with pain in all movements. Testing was performed to rule out fracture and advice on ice and basic exercises were given.
Treatment
Treatment then consisted of soft tissue work around the shoulder and work into the neck and upper back. Pain in the shoulder gradually decreased and range of movement began to improve. Testing was repeated regularly to check progress, and all seemed to be improving well apart from a couple of areas.
At this stage I decided to refer her on for an ultrasound of her shoulder to assess the cuff . I suspected that we had had a complete rupture of at least one of her tendons.
An ultrasound is best to assess the integrity of the tendons and check for the extent of injury. Following her ultrasound, we found that she had completely torn her Supraspinatus and Subscapularis tendons. In these cases, surgery for repair is an option but there is a significant chance of re-rupture (the tendon tearing again).
After speaking to a surgeon in Eastbourne he did not recommend treatment as he felt the risk of re-rupture was too high.
Her Results
With continued chiropractic treatment she has now got a near full range of movement, but the left arm is still weaker than the right. This is common following full thickness tendon tears in the rotator cuff, but she is continuing with exercises to improve this.
These results are the best we could have really hoped for in a seventy-year old woman with this level of injury.
This case shows that even with a rupture of two tendons within the rotator cuff the shoulder can recover and adapt, but her left shoulder will never be as strong as the right. This demonstrates just how important the rotator cuff is in how strong and stable the shoulder is.
Want to find out more about Shoulder pain and the RC?
If you’ve enjoyed this blog and want to find out more about shoulder pain and the rotator cuff, then please check out one of our other blogs on the shoulder joint below.
Three things you didn’t know about the Rotator Cuff
Louise’s Top Tips for Shoulder Pain
Common misconceptions regarding your Rotator Cuff
Shoulder Strengthening Exercises to Do at Home
Eastbourne Sports Massage Therapists’ Shoulder Injuries report
Yours in health,
Mykel Mason your Eastbourne Chiropractor
By Mykel Mason
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Gaby S
18:22 08 Nov 19
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Richard Bulman
09:05 10 Oct 19
Very professional and friendly people from the moment you walk in. Treatment has been very helpful.
Tania Snashall
19:04 07 Oct 19
I first visited Lushington Chiropractic 14 years ago and they are my first port of call when I'm suffering with my back. Dr Revell is my go to but I've seen all the others there and they are all very friendly and knowledgeable. If you have any condition that Chiropractic treatment might help with, I wouldn't hesitate to recommend Dr Revell and his colleagues. The receptionist staff are so kind and friendly too, it's an all round pleasant environment to go to.read more
twisted starz gaming
18:34 30 Sep 19
Absolutely great service very relaxing atmosphere!! The Dr i see is James revell u can tell he is so passionate for what he does and wants what's best for you would definitely recommend to anyoneread more
Danny Hatcher
10:45 16 Sep 19
To preface this review I will mention that I have been going to Lushington for a number of years, therefore I might be slightly bias but it does give me plenty of experience to review.
I want to start of by saying that I have been to Lushington for 2 major injuries, my shoulder and my back/neck but, I have been going to Lushington for maintenance care for the years in between those incidents.
I am an active person, competing in trampoline and engaging in many other physical activities which means my body is put under a lot of forces.
My experience with Lushington has always been positive. The staff are friendly and engaging, asking how my day/week has been and how my training is going. The facility is clean and well maintained, including the treatment rooms.
For my shoulder, I had a surgery that was for stabilising the shoulder. I was at the NHS physio for 6 months with very little progression in my range of motion. I decided to try another option, Lushington Chiropractic. This was my first experience at the clinic. I managed to regain the majority of my range of motion in my shoulder back within 2 months of regular treatments. I then carried on with Lushington leading to almost full recovery of my shoulder like the surgery hadn't happened. I say almost because there is still some restricted range of motion there, but that is down to surgery I think.
For my back, this was quite a recent injury. During a training session on trampoline I gave myself whiplash. This was not only painful, as I am sure you can imagine, but extremely frustrating as I couldn't drive. I have been going to Lushington, as I did with my shoulder, for regular treatments and now almost 2 weeks after my whiplash I have full range of motion back in my neck, driving again and am looking to get back to training trampoline next week.
I feel like this wouldn't be a fair review if I didn't mention some of the things that could be seen as negative.
Obviously within in any physical health care profession, the practitioners are different and some of the individuals at the clinic are better than others. What Lushington do to combat this is that if you aren't happy with your practitioner then just change them.
There are on occasion due to the busy nature of the clinic some sessions that do run late, this doesn't affect anything other than time for parking, depending on where you park.
Which brings me onto another point. The parking around the clinic can be challenging but I am clutching at straws here as they can't just move site.
And finally the price. As it is a private practice the price isn't the easiest thing to get your head around, and as a masters student it is not nice seeing the money go from my account. Having said that, I would much rather have a healthy body for training than money in my account.
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Ruth Kingsbury
06:13 23 Jul 19
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13:16 29 May 19
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Jean Whaley
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Richard Leech
12:56 30 Mar 19
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Bianca Stephens
06:46 27 Mar 19
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Caring approach and even given homework to aid recovery and beyond. It’s those little nudges you need sometimes, but very effective.
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Judy Russell
11:27 20 Mar 19
I have such confidence in the treatment I am being given.The team without exception have all tried helping me, and hopefully will be successful. I definitely have great faith in them and they appear to all be working for the good of the patients. I would have no hesitation in recommending this practice to anybody .read more
Katharine Drew
18:28 23 Feb 19
I had my first treatment yesterday at Lushington Chiropractic and will be wholeheartedly recommending them to everyone!
I’d never tried chiropractic treatment before and didn’t know what to expect, but from the moment I walked in the door the whole experience was caring, friendly and welcoming. My appointment was with Karen, and she put me at ease straight away. She explained everything in a clear, easy-to-understand way, answered all my questions and went through my treatment plan so that I was fully informed and happy with everything.
After just one treatment I’m already feeling better, and have been able to do so much more activity today with my children.
Thank you so much!read more
Philip Harris
21:25 16 Feb 19
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David Barr
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Luke Whelan
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Brenda Tompkins
10:14 31 Dec 18
My husband needed help with nerve pain relating to his back so we decided to try chiropractic treatment at this clinic.
Dr Revell asked many questions in order to get a clear picture of John's health, lifestyle and medical history.
He made us both feel at ease straightaway with his friendly yet professional manner.
We are confident that the treatment he is having is the best possible.
Finally, the premises has a parking area, which is convenient and the clinic staff all display the same level of friendly professionalism.
I am happy to recommend Lushington Chiropractic Clinic unreservedly.read more
Kali Filsell
17:14 28 Dec 18
Been going to Lushington chiropractic for a few years now and I recommend it highly.
It’s a very clean, homely and welcoming clinic.
My 11 year old daughter has been receiving treatment for the last few months and she feels really comfortable having her adjustments.
Chiropractic treatment by James and Gemma has definitely helped us with our problems.read more
Stuart Turner
16:24 28 Nov 18
I am writing this review on behalf of my mother Margaret Andrews who has been attending your clinic for a while. She always enjoys her visits to the clinic where the reception team are very friendly and caring. Her chiropractor Gemma is very caring too and is very conscientious and keen to alleviate her hip pain which has definitely improved together with her mobility under her care which is much appreciated.read more
Sylvia Markwick
19:13 07 Nov 18
I highly recommend Lushington Chiropractic. The whole team are so warm and friendly. The advice and treatment I have been receiving has greatly improved my fitness and well being.read more
Alison Hignett
15:17 06 Nov 18
Warm, friendly welcome every time. I'm very early in my course of treatment but, after years of neglect, I can already feel a huge improvement thanks to Vicky and the team. Would highly recommend (and already have) to friends and family.read more
Debbie Ridgway
11:14 06 Nov 18
Gemma makes me feel very relaxed during treatment and helps me to understand what and why she is doing things. Has helped me so much. The receptionists are helpful and friendly too.read more
Tabitha Russell
11:31 16 Oct 18
I've been going to lushington chiropractic for about 4 years now. I've seen the chiropractic team and the massage team. Both are great. I've already recommended family and friends who have had the same great results as I have.read more
Stephen Carroll
09:36 14 Oct 18
These guys are fantastic. I was offered 1st class treatment under the Hands4heroes charity and I’m so grateful for the help. James and the team made me welcome and took care of my additional needs.
I feel so much better and my sleep has improved lots. Please give these guys a shout and pass it on!!!!!!read more
Matt Kuchta
08:55 12 Oct 18
Would highly recommend Lushington Chiropractic and the whole team here. From the warm welcome and helpfulness of the reception team to the knowledge and skill of the chiropractors. They really know how to get the best results and tailor treatments so specifically to individual needs.read more
Tanya Hooper
12:39 09 Oct 18
I would highly recommend Lushington Chiropractic. They make you feel very cared for and safe with the thorough history and initial consultation.
Friendly staff, convenient appointment times and free talks to help your recovery.read more
Nic Williams
10:10 02 Oct 18
I am so impressed with the treatment I received for a slipped disc over the last few months following surgery. I arrived unable to touch my toes, sit comfortably or do any exercise and I am now back to 100%. I cannot thank Gemma and the practice enough and would not hesitate in recommending them.read more
Carl Titherly
08:29 29 Sep 18
The staff are very welcoming on arrival and Dr v white explains everything that she is doing and understands if things aren't working for me. Lizzy is very good at her massage and new exercises that help with my recovery. Recommend to everyone.read more
Shanon Attwood
15:26 25 Sep 18
I have been visiting James since March 2018 and the results have been incredible. Very professional service and friendly staff. Would recommend to anyone!read more
Clare Titherly
16:42 24 Sep 18
I have had a reduced motion in my shoulder for quite a few years. When I noticed I was missing out on joining in some activities with my young son I decided to something about it. I am so glad I did and annoyed at myself that I took so long. The combination of chiropractic and sports massage was just what I needed. Would highly recommend.read more
Bernard Barnaville
13:20 08 Sep 18
I can't rate Lushington Chiropractic highly enough. I have been suffering from Sciatica which had numbed my left leg and although the numbness hasn't gone completely my body is so much better shape and feels great thanks to Dr. Gemma. She really explains all the treatment that I'm having and gives great advice on how to maintain myself. Will be having a few more visits soon.read more
Martin Link
08:23 07 Sep 18
Fabulous people, fabulous results. They're easy to get to by car, bus or train. I cannot recommend them highly enough.
Linda Hunt
06:22 19 Jun 18
I highly recommend these lovely people. So friendly and helpful. Work wonders with my back. Thank you James and team
S J
18:24 05 Jun 18
After suffering from sciatica sporadically over 40 years l thought it was time to try a different solution. What a difference this has made to my life. The staff are friendly & very professional. If like me you suffer from back pain l cannot recommend Lushington Chriopractic highly enough.
After an incident involving a rather unfortunate manoeuvre stepping over my dog l managed to put my back out & trap a nerve. This made my entire right leg extremely painful. Team Lushington have been fantastic! It's been a bit of a haul but again l'm now pain free & able to lead a normal life. Many thanks to James, Stuart, & Dara for their care & treatment.read more
Robert Dewberry
19:14 12 May 18
Arrived for an appointment in pain and virtual unable to walk due to a severe arthritic knee. After intense treatment and massage I am mobile and virtually pain free, just waiting to see an Orthopaedic Surgeon.
I would highly recommend this practice not only for their professionalism, friendliness and knowledge. Every member of staff treats you with empathy and an interest in your specific case. Congratulations James on a very dedicated team.read more
Emily Coombes
12:07 25 Apr 18
I’ve always had a great experience at Lushington. I’ve had a few different chiropractors and they’re great giving lots of helpful advice as well as wonderful treatment. But the shining star is Theresa at reception, she always gives you such a warm welcome and is so helpful and caring. Definitely the place to go!read more
Tony Haines
08:55 05 Apr 18
In the New Year I was suffering from a slipped disc and deterioration of my lower back. As a result of this a friend of mine suggested I contacted James from Lushington Chiropractic, which I did.
I am still having treatment with James but I am feeling so much better. There is no more pain relating to my slipped disc and as a result of his treatments and exercises at home I’m able to move around pain free.
Following my, very thorough, first consultation James identified that I had problems from a neck injury from several years back. I’d been having headaches for years and had put it down to stress of life etc. Since James and Kim, who gives an excellent deep massage, have been giving me treatments for this my headaches have subsided.
Additionally to this review I’d like to say thank you to Claire, on reception who does an excellent job and makes you feel very welcome.
Thank you to all at Lushington Chiropractic.read more
Antony Hunt
18:30 27 Mar 18
Due to work activities I really struggled with pain in my lower back and had always been in fear of seeing a Chiropractor. However I was put at ease mentally and physically by Dr Victoria White. After an intense treatment program my back pain had gone and mobility had also improved. now I see Dr Victoria White once a month for maintenance and I am Pain free. I cannot rate Dr Victoria White high enough an excellent service.
All the team at Lushinton Chiropractic are really friendly especially front of house.read more
Michelle Gurr
20:43 07 Mar 18
I have been going to Lushington chiropractic since Nov 2017, Victoria has well and truly sorted me out. My back was a mess due to my line of work but within a few sessions a she had me walking easier and in a lot less pain. I have kept up my treatment to maintain my new found freedom. I have also started seeing Ryan for a massage. His hands are magic! He found my problem areas without me saying anything and was the best massage I have ever had. All in all these guys are magicians and I wouldn’t go anywhere else!read more
Trevor Young
15:14 07 Mar 18
I have been going to see James for some time now for neck and shoulder problems that I had endured for many years. I am so glad I found the clinic at Lushington. What an amazing team they all are. From the warm, friendly and welcoming reception staff especially Claire to the excellent treatment from the knowledgeable and professional Chiropractor and massage therapy team. I would highly recommend Lushington Chiropractic to anyone.read more
Susan Taylor
16:16 06 Mar 18
Lushington Chiropractic is a friendly, efficient and well run service. On-going treatment plans are agreed following thorough initial assessments and are reviewed regularly. I have benefitted greatly from both chiropractic treatment and sports massage and have no hesitation in recommending them highly.read more
Joy Knight
13:27 05 Mar 18
I have been in pain with my neck and lower back for years. After three weeks I am feeling so much better. Thank you James and the other staff who are always friendly and welcomingread more
Lois Pelecanos
02:18 20 Feb 18
I thought I'd try Lushington as I have a chronic muscular stenosis as well as lumbar arthritis. I had a series of sessions with Joshua French who helped to ease my aches and pains and lower back problems. I've followed that up with a monthly massage from Ryan Keats who takes great care in analysing my specific weaknesses to achieve the best outcome. I am very pleased with the treatment received and know that I can increase or decrease the sessions as it suits me. I particularly like the fact that all treatment is explained carefully and patient notes are kept to assess progress.read more
Francesca Wood
12:50 17 Feb 18
I was recommended Lushngton by my GP as I had been suffering from a bad back and pain in my leg. I can't thank them enough for their help. Regular chiropractic with massage has helped me immensely. I am no longer on painkillers and can enjoy walking again. The chiropractor, massage therapist and reception staff were wonderful. Made me feel very at ease and enjoyed my visits to them. Thankyou and have recommended to freinds.read more
Samuel Finnis
11:50 16 Feb 18
I came to Lushington Chiropractic following issues with my back, neck and knee which I had been enduring for a number of years. I have recently been receiving treatment from James and have seen continued progress with my adjustments with no (prior to treatment common strains/pains) recurring. The staff are always very welcoming and professional and I have felt very comfortable there. I have no hesitation in recommending Lushington Chiropractor to my friends and family or to anyone needing treatment.read more
Daphne Rodemark
16:50 15 Feb 18
I have been having treatments with Gemma for several weeks and can not thank her enough for her help. Today I took my five year old for a health check and Gemma was fantastic with him too. Communication is always fantastic, always greeted with a smile and always made to feel comfortable - Highly recommendedread more
Eddie Pitwell
13:48 21 Jan 18
After 18 years of back issues due to an injury while at work i decided to get it sorted.
The staff here are very knowledgeable and have explained everything during treatment.
I have been having treatment for 2 months now and have seen vast inprovement in my back to the point where i can say it doenst give me any pain during my day.
Treatment is expensive but very much worth it.read more
Chris Watling
21:55 15 Jan 18
I’m a plasterer I have had an on going back pain didn’t think much of it till just before Christmas when it became unbearable but since coming to Lushington chiropractic it has got so much better and they have helped me where I have been going wrong with looking after my back. Thank you.read more
Rebecca Jade
14:55 10 Jan 18
I went to Lushington Chiropractic following an ongoing issue with my back that became completely unbearable very suddenly. I have been seeing Dr Victoria for 6 weeks now and have seen incredible progress. The entire staff are very welcoming and professional and I feel very comfortable there. I would highly recommend to anyone needing chiropractic care!read more
Katy Wise
11:55 04 Jan 18
Highly recommend to anyone needing treatment. Friendly and welcoming reception staff, with very comfortable waiting room. Professional care provided with very successful and effective results. The free evening classes are also super interesting and helpful. I wouldn't go anywhere else to see a Chiropractor and I was quick to notice improvement in my QOL. I also appreciated the time taken to help me understand the cause of my problems and what treatment would help and how. Top class service, 5 stars!read more
Beverley Midgley
10:30 10 Dec 17
I started to see Gemma a couple of months ago with a very debilitating sciatic pain down my left leg, thigh and buttock.The pain increased when I was sitting, and was worse when I was driving or sitting for long periods of time.
I had been in pain for nearly a year. I felt very desperate as no one seemed to be able to help me. The pain was affecting my life in a negative way.
Gemma was very understanding and when she said that she could help me, I was so happy I had come to the right place at last.
Over a numbers of weeks I saw a steady improvement in my pain levels.Gemma was so helpful and showed a huge amount of empathy.At last I had hope that things might actually start to improve.
Gemma made adjustments to my spine and manipulated muscles that weren’t working properly. Slowly I made improvements, driving and sitting watching TV didn’t cause as much pain as before.
Thank you Gemma, I can’t thank you enough and I would have no hesitation in recommending Lushington Chiropractor to my friends and family.read more
Wade Matthews
10:22 09 Dec 17
Brilliant service by Dr Joshua French at lushington chiropractic, was in excruciating pain and barely able to walk, josh was very professional and incredibly knowledgeable in his field of expertise. After a couple of sessions I was already walking better and standing up straight was much easier. I had a total of 8 treatments and felt like a new man. All the staff were very supportive and I’ve had regular phone calls to make sure I’m ok, couldn’t recommend these guys enough, they all go above and beyond to get you back on the straight and narrow. Thanksread more
mag cf
09:12 29 Nov 17
I have visited the practice following an excruciating nerve pain down my left arm. The environment is relaxed and I felt at ease with everyone immediately, from the receptionists to the practitioners. Mykel examined me, spotted the problem and within a few sessions with him I had my sleep back. I am now recovering with Gemma and getting better and better. Thanks to Victoria as well for her help. I wouldn't hesitate to recommend Lushington Chiropractic thanks to the knowledgeable people and the friendly atmosphere.
Claudioread more
John Steele
10:31 09 Sep 17
I have been receiving treatment from Josh since he started a couple of months or so ago. He has helped me tremendously in reducing the amount of pain in my knee by making adjustments to my ankle (never had that before), working on my hip and working on areas surrounding the knee. Within the first 2-3 sessions with him the severe pain I had for a year and a half prior was reduced by around 80% and I can now load my knee a lot better and continue to progress. He has also really helped my shoulder by making adjustments to my neck and spine which has allowed me to exercise more and recover better from my workout's after having 4 shoulder surgeries. I would highly recommend him for both sports people and also to people just looking to get their bodies moving in the correct way and reducing unnecessary stress on the joints. He's a great guy aswell so you will really get on with him, he will really look after you and has great knowledge too. I have also seen other chiropractors at the clinic and masseuse's and they have also been great. Thank you Josh and to all the staff at lushington including the reception staff who are great. Johnread more
Michelle Clayton
22:07 02 Sep 17
I've been attending for various treatments for sciatica mainly and muscle tension. Always welcoming and kind. Ive been seeing Dr Mykel Mason, Olly, and Louise. I can highly recommend all practitioners in their expertises. Genuine concerns for their clients and practical exercise handouts in between treatments. Good free informative talks about general maintenance and care of body Good central location.read more
Ken Ellis
08:18 25 Aug 17
Dr Mykel Mason has been looking after me at this clinic for a year and a half and he is working wonders on a knee problem that has troubled me for some time. He is an absolute professional in his approach to patient care and treatment and I would thoroughly recommend him. The whole team at Lushington Chiropractic are welcoming and a pleasure to see, thank you so much guys!read more
Stephen Cranmer
13:19 11 Aug 17
Well worth my visits but I should have gone a year earlier! I am having both chiropractic and massage treatments from practitioners who are very thorough and knowledgeable and have helped me understand my problems as well as treating them. All the staff are friendly and the atmosphere is relaxed.read more
Merran Waters
20:44 15 Jun 17
The reception staff are very welcoming. I've been treated by Dr Mykel Mason he is very knowledgeable and so far he's had an answer for all my ailments. He has explained everything step by step which makes you feel relaxed about the treatment to follow. I highly recommend Lushington Chiropractors and Dr Mason - a top class service!read more
Neil Brooks
03:26 15 Mar 17
I have been going to Lushington Chiropractic for a number of years now and I am very impressed with the whole experience.
The first thing you notice is just how pleasant the place is, it is always spotlessly clean, well looked after and a rather calming environment.
The clinic staff are wonderful, they always have a smile and a cheer for you, and everyone I have met at the clinic makes you feel welcomed from the moment you walk in the door, which I really do like and value.
Dr Revell, as are all the staff, is very attentive to your concerns and makes you feel at ease and takes the time to explain to you any proposed treatments, and I never feel like talking to him is too much trouble or a problem.
I always feel better after visiting and would thoroughly recommend the clinic to anyone looking for a high-quality service and practice with a patient focused approach.read more
tom ryan
14:06 14 Feb 17
I have the highest of praise for Lushington Chiropractic. I first attended last Autumn in some discomfort, minimal flexibility and with ever growing pain in my neck, shoulder, arms and fingers. I was assigned to Vicky who I cannot express just how much she has helped me and I am now without pain, standing straighter then I have in years and now I feel I am able to take on more.
I was deeply impressed by how thorough Vicky was in going through my medical history and she was able to say that she would be able to help me. She was certainly true to her word. I now look forward to the treatments as Vicky's professional attitude and very warm personality ensures I am always relaxed. I cannot recommend Vicky enough and I can say the same for the other chiropractors who have seen me when Vicky was fully booked. At these times it was very clear that my treatment plan had been shared and I so appreciated this consistency in approach.
If you are struggling in some way with back pain or something similar, book yourself a consultation and see what it can do for you.read more