Chiropractic care focuses on the diagnosis and treatment of mechanical disorders within the musculoskeletal system. While often associated with the spine, this approach also addresses joints throughout the rest of the body, recognizing the structure’s interconnectedness. Chiropractors use non-invasive, manual therapy to influence joint alignment and movement. The goal is to restore proper function, alleviate pain, and support the body’s natural healing capabilities.
Scope of Chiropractic Practice for the Shoulder
Doctors of Chiropractic (DCs) are authorized to perform adjustments on joints outside the spine. The shoulder complex falls within this scope, including the glenohumeral, acromioclavicular (AC), and sternoclavicular (SC) joints. State licensing boards grant this authorization, permitting the treatment of the neuro-musculoskeletal system.
Many DCs seek advanced post-graduate training to specialize in extremity care, often achieving certifications such as the Certified Chiropractic Extremity Practitioner (CCEP). This focused education ensures expertise in diagnosing and applying manual techniques to joints like the shoulder. Addressing these peripheral joints is often necessary, as shoulder dysfunction can influence spinal mechanics and posture.
Identifying Mechanical Dysfunction
A chiropractor’s initial assessment determines if a shoulder problem stems from joint restriction, soft tissue injury, or both. This diagnostic process begins with a detailed history and a physical examination, including an analysis of posture and shoulder rhythm. The evaluation tests the shoulder’s active and passive ranges of motion to pinpoint movement limitations and the specific direction of restriction.
The chiropractor employs specific orthopedic tests to differentiate conditions like rotator cuff strain or shoulder impingement syndrome. Tests such as Neer’s or Hawkins-Kennedy help assess for space-narrowing issues that can pinch tendons. Palpation is then used to locate areas of joint fixation, which are segments where movement is restricted, often indicating the need for manipulation.
Postural analysis is a significant component, particularly observing the positioning of the scapula, or shoulder blade. Scapular dyskinesis, or abnormal movement of the shoulder blade, is a common finding that alters the mechanics of the shoulder complex. Identifying these specific mechanical dysfunctions allows the chiropractor to develop a treatment plan that targets the precise area of joint restriction.
Specific Adjustment and Mobilization Techniques
Chiropractic intervention for the shoulder involves two main types of manual methods: joint mobilization and specific adjustments. Joint mobilization uses slower, rhythmic movement within the joint’s normal range of motion to improve flexibility and decrease stiffness. These techniques are often preferred for the highly mobile glenohumeral joint due to its relative instability compared to the spine.
Specific adjustments are the high-velocity, low-amplitude (HVLA) thrusts commonly associated with chiropractic care. For a restricted glenohumeral joint, a chiropractor applies a controlled, quick force to restore normal joint play. A common mobilization technique involves applying an inferior-directed passive glide to the head of the humerus while the patient’s arm is in a semi-relaxed, open-packed position.
This mobilization helps create space within the joint capsule to prevent superior migration of the humeral head during arm elevation. Treatment integrates soft tissue work alongside joint correction, recognizing that muscle tension and scar tissue frequently accompany joint issues. Techniques such as Active Release Technique (ART) or Graston Technique may be used to address fascial restrictions and muscle adhesions. This combination of joint adjustment and soft tissue therapy restores the proper biomechanics of the shoulder.