If you have rotator cuff pain or dysfunction and are in Edmonton area, look no further than Unpain Clinic for shoulder pain relief.  Shoulder pain physiotherapy can be very frustrating, particularly in cases like a torn rotator cuff, which can sometimes take years to resolve.  

There are several reasons to consider shoulder pain treatment at Unpain Clinic:

• over 31,000 medical shockwave treatments performed in the last decade
• certified with the International Society of Medical Shockwave Treatment (ISMST)
• well-informed on the latest techniques and treatment recommendations 
• a broad range of treatment approaches available across a large multidisciplinary team
• knowledgeable therapists with a proven track record with stubborn shoulder pain
• 9 true extracorporeal shockwave therapy devices between 2 clinic locations in South Edmonton
• professional educators in the medical shockwave field, as well as clinicians
• friendly team members always happy to help, including answering tough questions and direct billing to most insurance plans
• this is not a pain management clinic, the focus is rapid pain resolution, wherever possible. *

*”We aim to treat your condition in 3-5 treatment sessions. 
There are obviously some conditions that cannot be ‘cured’; but in many cases, their associated symptoms can be successfully managed.  A few of these would be: Multiple Sclerosis (spasticity and pain), Diabetes (circulation and healing), Fibromyalgia (trigger points and pain), and Arthritis (pain and inflammation).  Learn more about our unique approach to arthritis physiotherapy in Edmonton.” 

What is the rotator cuff?

Although the rotator cuff is comprised of 4 relatively small muscles in the shoulder (the teres major, the teres minor, the supraspinatus and the infraspinatus), it is responsible for a large range of fine shoulder movements.  It has attachments across the scapula (shoulder blade) and the humerus (the bone in your upper arm that inserts into your shoulder socket).  As small as they may be, these muscles can cause BIG problems and even BIGGER pain for many a patient.  Fortunately, most Unpain Clinic clients have found significant or total relief with shockwave therapy.

What is a rotator cuff injury?

A rotator cuff injury occurs when one (or more) of the four rotator cuff muscles becomes strained or torn, causing pain, weakness, and dysfunction in the shoulder, and occasionally the neck and arm.

What are common rotator cuff injuries?

Although rotator cuff tears are common, the most common rotator cuff problem we encounter is tendinitis, which is pain and inflammation in the tissue that connects the muscle to the bone.  

When it comes to the specific muscles of the rotator cuff, the supraspinatus is typically the most commonly aggravated rotator cuff muscle.  It often causes a pinching pain and weakness right on the top of the shoulder joint on certain movements.  It is possible to injure any of the other four muscles in the rotator cuff – and their pain can present in surprising ways.

Painful arcs occur over the top of the shoulder and can often feel like a problem directly in the insertion of the bicep tendon.  It is, however, often caused by a problem in the infraspinatus muscle, which is in a completely different, often painless, part of the shoulder.

Rotator Cuff Tear Symptoms

The first symptom of a rotator cuff injury is almost always pain.  It would be unusual to not feel any pain for an injury like this.  You may also have range of motion problems or shoulder weakness.  The only exception would be an injury in which the tendon is completely ruptured.  These usually occur quite violently and suddenly, such as a sudden heavy lift or an overzealous baseball throw.   Surprisingly, these are usually not as painful because the muscle’s connection has been completely severed and the nerve is no longer firing a warning to the brain in the same way.  In this situation, even with less pain, there would be obvious and immediate dysfunction.

Examples:

As a primary injury, a sudden event, such as a muscle torn explosively or a blunt force to the shoulder, will cause instant pain and dysfunction.  The patient will usually seek medical attention quite quickly (within hours to a few weeks) and they know exactly how they hurt themselves, right down to the minute it happened.  

As a secondary injury, a rotator cuff tear may present as insidious shoulder pain, where it crept in and won’t leave – but you can’t really say how you did it or when it started (often months to years ago).  You may feel fine on certain movements, but others cause crippling pinching pain and weakness.

Common Causes of Rotator Cuff Injuries

Overuse, sports, and car accidents.  This is where we see the largest number of rotator cuff problems.  The rotator cuff can become compromised for several other reasons, including but not limited to injuries from blunt force or sudden overexertion causing tears or ruptures.  It is also possible to cause damage to your rotator cuff by using it for unintended purposes, such as regularly making up for movements expected of a large trapezius or deltoid muscle that may not be firing properly.  

Common sports, occupations, or activities where rotator cuff injuries occur:

• bad posture – this can set the shoulder in a way that predisposes it to injury on certain movements
• baseball, tennis, volleyball, badminton, soccer (throw-ins), throwing sports in track & field – (commonly overuse injuries)
• basketball, football, rugby, hockey, soccer (goalie), lacrosse (commonly excertional or blunt force injuries)
• cleaning & maintenance (overuse – particularly scrubbing and overhead work)
• construction & trades (overuse, blunt force and sudden strain –  due to higher risk nature of work – especially common in overhead work, such as mechanics)
• police, fire, nurse and paramedic (overuse, blunt force and sudden strain – due to higher risk nature of work and frequent lifting/restraining/moving patients, etc)

We see torn rotator cuffs from the simple act of making a bed, to insidious onset after 20 years of intensive overhead mechanic work, to rotator cuff injuries from serious car accidents – and just about everything in between.

Treatment:

• Exercises
  • Our bodies can do amazing things with the right guidance.  Check out these 12 simple exercises that can help alleviate shoulder pain right from the comfort of your home or office.
    
    
• Physiotherapy
  Whether you have a partial tear, a complete rupture healing from surgery* or pain/weakness you can’t quite seem to figure out, physiotherapy and shockwave therapy are exceedingly popular treatment options for rotator cuff pain and injury in Edmonton and area.  Rotator cuff injuries are treated at Unpain Clinic using all approaches available to maximize your care.  While we will offer intensive manual therapy and exercise for those in need, we find most patients respond best to shockwave therapy.  Some studies have shown that different types of shockwave have varying levels of positive effects on calcifications in different layers of the rotator cuff – fortunately, we have both technologies and a broad range of treatment devices available. 
  
  Additionally, if you have imbalances that contributed to the injury to begin with, those will also be addressed, along with the injury itself.  For example, many clients come to Unpain Clinic with a chief complaint of neck pain, only to learn it may be a rotator cuff problem referring pain to their neck.  It is usually the other way around to be honest (i.e. neck referring to shoulder) – but it is always something we look for and treat, if needed. 
  
  Shockwave works by speeding up the natural healing process or, in some cases, re-activating it after years of dormancy.   Your own stem cells are activated, old scar tissue is removed and replaced with healthy new collagen, and blood vessels grow rapidly to improve tissue health.  Your body does the healing work, we just know where to treat to get the best possible result.  

See what a few of Unpain Clinic’s shoulder pain clients have to say about their experience with shockwave therapy:

Meet Warren – shoulder dysfunction due to a motor vehicle accident plagued him for 3 years

Meet Patrick – months of frozen shoulder left him unable to work, play or hold his children

• Medication
  Typical medications for a rotator cuff tear could range from Non-Steroidal Anti-Inflammatory Drugs (NSAIDs), such as ibuprofen, all the way to potent pain-relievers in the narcotic family of drugs, such as Tylenol 3, Percocet, Morphine, etc.  In some cases, powerful steroid injections are recommended to help control inflammation.
  
• Injections
  • PRP – platelet-rich plasma injections are becoming increasingly popular in medicine today.  The procedure is basically performed by removing a small amount of the patient’s blood, spinning it in a centrifuge to separate the plasma from other components, and re-injecting it into the problem tissue.  This stimulates a healing response in the body in that area of tissue using the patients own growth factors.
    
  • Cortisone – powerful steroid meant to reduce inflammation and pain.  It does not stimulate a healing response in the body.
    
  • Stem Cell – injecting exogenous stem cells to help stimulate/re-program a healing response in the problem tissue.
    
• Surgery
  • Often performed when there is too much damage to heal itself, such as a complete rupture. 

*A complete tendon rupture initially requires surgery to be repaired properly but will respond very well to shockwave therapy within a few weeks of surgical intervention.

When to see a doctor?

It is not a bad idea to see a doctor as soon as you notice the shoulder pain.  It could be a quick way of catching something early, such as a heart or gall bladder problem – seriously!  We have even had cases where clients have come in for shoulder problems due to unmanaged diabetes symptoms – not even a problem in the rotator cuff.  So, get it checked early, always.  If it is a benign issue or a muscle strain, at least you’ve started the process early and have removed any potential doubts.  Plus, if it does become an issue that requires surgery down the road, you’ve gotten the ball rolling.  

FAQs

How do you know if you have damaged your rotator cuff?

• Generally, your shoulder is going to hurt, especially on specific movements.
• There are several tests a therapist can perform quickly and easily to assess which muscle is impacted and to what severity.  
• Sometimes, referral for MRI or ultrasound is required to determine any need for surgery.

How long does it take for a strained rotator cuff to heal?

• Typically, 4-6 weeks; however, if the tear is the result of an underlying dysfunction or if it is not properly rehabilitated, it can take much longer.

Can a rotator cuff heal on its own?

• In its own way, absolutely.  Almost everything in our body can heal on its own given enough time and the proper resources.  Unfortunately, many rotator cuff injuries do not heal well due to the inability to rest the small muscles of the shoulder.  This is where you will often see fast buildup of scar tissue to prevent further injury and pain.  It may ‘heal’, but is it like it was pre-injury?  Likely not.  Some patients will have range of motion impairment and lingering pain well after it has healed while others will make a full recovery on their own.
  

What rotator cuff injury feels like?
– Pinchy, weakening pain around the shoulder that can radiate into the neck and down the arm.

Can a chiropractor fix a rotator cuff injury?

• It depends on what is causing the issue but, generally, yes.  With the right tools and skillset, a chiropractor is more than capable of getting you moving again.
  

What methods does Unpain Clinic Uses to treat rotator cuff injury? (mention shockwave)

We offer manual therapy and hot/cold therapy as needed.  We regularly prescribe a few simple exercises to keep up the recovery between treatments.  Our most used approach for rotator cuff pain and injury, however, is shockwave therapy.  This is because it stimulates deep, cellular healing in a shorter period of time than our traditional options.  It is one of the most well-researched technologies in regenerative medicine today, with an extensive amount of study performed on conditions of the shoulder, specifically.  In fact, it was the highly successful treatment of calcifications in the rotator cuff using extracorporeal shockwave therapy that broke the ground for the study of the treatment of other musculoskeletal conditions using extracorporeal shockwave therapy (ESWT).

Is a Physiotherapist covered by Alberta Health Care?

Yes and no.  Confusing, right?  Alberta Health Care holds contracts with specific clinics – so you could have a perfectly good physiotherapist in a private practice who is not covered under Alberta Health Care since they do not negotiate contracts with them.  It usually comes down to cost.  If a clinic is offering a more specialized service that is more expensive to offer, it is not typically covered by Alberta Health.  There are, however, many reputable clinics out there that provide excellent traditional care for clients under Alberta Health Care contracts.  Unpain Clinic does NOT bill to Alberta Health Care at this time.

How much does physiotherapy cost in Edmonton, Alberta?

Physiotherapy in Edmonton can range anywhere from $50-$400+ per visit.  This depends on the therapist, the clinic, and the technology or treatment being offered.

Do you need a referral to see a physiotherapist in Edmonton, Alberta?

Absolutely not.  Your extended health benefits plan may require a doctor’s prescription in order to claim your visit; however, Unpain Clinic does not require a referral for you to access our services.