The effect of chiropractic adjustment versus myofascial dry needling, of the shoulder and cervical region, to treat symptoms of shoulder impingement syndrome.
A research proposal presented to the
Faculty of Health Sciences, University of Johannesburg, as partial fulfilment for the Masters degree in Chiropractic by:
Devin Christopher Ramsden
(Student number: 201106502)
Supervisor: _________________ Date: _________
Co-Supervisor: ______________ Date: _________ EXECUTIVE SUMMARY.
Shoulder impingement syndrome is a progressively worsening condition in many individuals. The use of a chiropractic adjustment or myofascial dry needling as forms of treatment are both yet to be differentiated as to which is more beneficial (Fitness Pain Free. 2016).
The aim of this study is to research the effect of a chiropractic adjustment on the shoulder and the cervical spine, and compare to dry needling of the shoulder and cervical musculature.
The research study will include three separate groups that will receive chiropractic adjustments, dry needling or a combination of the two treatments. The results will then be evaluated and an outcome will be based on these results as to which treatment is more effective.
1. PROBLEM STATEMENT
The shoulder is made up of joints, bone, muscle and neurovascular tissue. These all allow for the large range of motion that the shoulder can produce in order to position the rest of the upper limb
Chiropractic is an invalid and harmful therapy, which is created on the basis of pseudoscientific ideas. Chiropractors use manual therapy, especially manipulation of the spine, other joints, and soft tissues to treat diseases and proclaim a cure-all and vaccination opposition. Only one of therapy (chiropractic) was used in the medicine and would not allow any vaccine inoculation to be made available to people, which is chiropractic theory. Chiropractic followers set up own theory, method and system and peddle this treatment. As modern humans we enjoy a wide range of medical treatment, and they provide a healthier life. However, advances in modern medicine as with the further research traditional medicines like chiropractic it met with incredulity. For decades the chiropractic has denied modern medicine to treat patients. Although chiropractic followers profess that it can cure all diseases by removal of the subluxation and replace vaccinations, more and more evidences support that chiropractic is an unscientific and dangerous therapy. What people must understand is that tradition and history are no excuse for therapeutic effect but should be more focused on scientific method that is widely proved to be effective and safe in the medicine.
‘Chiropractic (Greek kheir, hand, and praktikos, practitioner) is defined as the science of treating human ailments by adjustment of the spine’ Bradbury, P. (1957). It is grounded in the principle that the
Walch et al first described the internal impingement as an intraarticular impingement of the rotator cuff in the abducted and externally rotated shoulder. With 90 degrees of both abduction and external rotation, the articular surface of the posterior superior rotator cuff becomes pinched between the labrum and the greater tuberosity.5 The authors separated the labral lesions from SLAP lesions which extended anteriorly to the biceps anchor at the supraglenoid tubercle, concluding that internal impingement may be responsible for a subset of patients with isolated posterior SLAP tears.5
The philosophy of chiropractic possesses a holistic nature in order to promote optimal health. Instead of analyzing certain symptoms a person might be experiencing and treating the person accordingly, it looks at the source of the problem in order to encourage the entire body to heal properly. It integrates natural forms of healing to the body, such as adjusting subluxations. Adjusting subluxations provides a substantial flow of the nervous system which aids the body to progress to a healthier status and prevent diseases. This philosophy or idea stems from the concept that the human body is knowledgeable and is able to adjust in order to become stronger or reach an improved condition. The human body is extraordinary in that it is capable of healing itself in several situations with the proper assistance. It holds true that the body functions much more efficiently the closer it achieves a homeostatic state. Chiropractic adjustments enable the body to naturally repair itself in order to achieve an increased equilibrium. Allowing the nervous system to work properly, physical, mental and emotional health can be acquired from the nervous system which coordinates all the functions the body can perform. The nervous system is the critical component of how the different organs, glands and tissues of the body communicate with each other. This is why allowing the nervous system to function at the
Damage to any of these muscles and the ligaments that attach these muscles to the bone can occur because of multiple different reasons. These reasons could be an acute injury, chronic overuse, or gradual aging. The damage can cause a lot of pain and disability with decreased range of motion and use of the shoulder. The shoulder is made up of a ball and socket joint that allows the arm to move in many different directions. When the rotator cuff is hurt a lot of different things could occur things including; Pain and spasm limit the range of motion of the shoulder, Fluid build up within the joint due to inflammation limits movement, Arthritis and calcium deposits that form over time which could limit the range of motion. The main thing that causes rotator cuff injuries is injuries to muscle tendon units which are called strains, and these are classified by the amount of damage to the muscle or tendon fibers. There are a few grades of this injury which include grade 1 which involves stretching of the fibers without tearing. Grade 2 involves injuries of partial muscle or tendon tearing, while grade 3 which is the worse is a complete tear of a muscle or tendon. An acute rotator cuff tear can happen from a sudden raising of the arm against resistance or example like when your falling and you put your arm out to try and catch yourself, this type of injury requires a significant
Chiropractors, or doctor of chiropractic, are healthcare professionals who practice the holistic, drugless, healing art of chiropractic. They emphasize health maintenance and disease prevention through proper nutrition, exercise, posture, stress management, and care of the spine and the nervous system. Because of its emphasis on health maintenance, the whole person, and natural healing, it is considered an alternative health care approach (“Alternative Health Care” 45). Chiropractors use spinal adjustments, manipulation, and other techniques to manage back and neck pain. A career in chiropractic healthcare has many challenges such as: rigid career requirements, unique work environments, rewarding salaries with busy work days, and an increase in future needs.
Chiropractors hold that the body has immense ability to heal itself without using invasive medical techniques or drugs. This is why chiropractic health care focuses on the link between the spine and the functioning of the nervous system. According to chiropractors, the spine and functioning of the nervous system have a lot of influence on the recuperative capabilities of the body. At this juncture it is important to emphasize that chiropractic care does not work in isolation; practitioners in this field recognize that they must work in tandem with other health care professionals to assist patients access the best medical care.
Komblatt, the patient underwent extensive chiropractic treatment with 87 sessions from 10/07/11 through 07/11/12. It was opined that it does appear that the IW ha s undergone excessive passive-chiropractic treatment referable to both lumbar spine and right shoulder. It was further opined that the IW has reached MMI regarding the lumbosacral strain and contusion of the right shoulder within approximately 6-8 weeks post injury. Appropriate treatment would have consisted of aggressive right shoulder and low back rehabilitation to include aerobic conditioning, strengthening exercises involving the right upper extremity, lumbar spine and core, and resumption of normal recreational and work activities within 6-8
A first major argument is whether chiropractic care is effective. The word effective can be defined as, “Adequate to accomplish a purpose; producing the intended or expected result (“Effective”.)” Effective can be also defined in a working definition as, effective states you were successful in producing a desired result. Opponents of chiropractic care are making the claim it is not effective. The opponent makes the argument that at the beginning of your care a doctor might take x-rays to locate the so called problem in your body which can also be known as a subluxation. Though they believe it is not visible to the naked eye most times. Many
The shoulder is made up of two bones: the ball end called the humerus and the socket end called the scapula. It is held together by a semi complex series
There was a study done that involved people who suffered from chronic low back and neck pain. The subjects were asked to receive either traditional medical care or see a chiropractor. The study lasted for one year. At the end of the study, 56 percent of people who saw a chiropractor noticed significant relief in their back pain. Only 13 percent of the subjects who received traditional medical care
I previously mentioned that stress and anxiety can be alleviated through realignment of the spine due to the easing of spinal subluxations. Student athletes are the most vulnerable to subluxations due to their frequent exercise and activity. This is especially true in contact sports. Constantly participating in physical activity increases the chances of spinal misalignment. For this reason, student-athletes could end up being more stressed in general, as well as underperforming in their sport if they feel pain or general discomfort. Because of this, chiropractic care used in a rehabilitative nature would be largely beneficial to student
Therefore, numerous spectrums of instability types and associated lesions affecting capsuloabral, ligamentous, and osseous structures can be identified (Stayner et al., 2000). The pathophysiology of an anterior shoulder dislocation involves violent external rotation in abduction levers causing the humerus to be dislodged from the glenoid socket, tearing the shoulder capsule and detaching the labrum from the glenoid (the Bankart lesion) (Farber et al., 2006). Additionally, the posterior part of the humeral head exits the joint, colliding with the anterior rim of the glenoid, producing a bony depression at the back of the humeral head (the Hill Sachs lesion) (Farber et al., 2006). Furthermore, anterior dislocation can occur when people fall with a combination of abduction, extension, and a force directed posteriorly on the arm; this is a common mechanism in the elderly (Stayner et al. 2000). A fracture of the humeral head, neck or greater tuberosity can occur with a dislocation (Stayner et al., 2000). In contrast, a posteriorly dislocated shoulder is less common. It is commonly caused by external forces acting on the shoulder when the shoulder is held in internal rotation and adduction caused by direct trauma experienced during sporting activities (Hegedus et al., 2008). Additionally, it may be result from an epileptic fit,
Chiropractic is very important in the United States health care system; it is one of the largest forms of alternative medicine used (Kaptchuk, 2000). Chiropractic has been in the United States since the 1890s. It was founded by Daniel David Palmer and his son, Bartlett Joshua Palmer, helped to expand it. Chiropractic focuses on the treatment of the musculoskeletal system. It focuses on spinal manipulation to help with certain illnesses. The most common things it is used to help are back pain, headaches, and neck pain. Chiropractors usually go to approximately 8 years of school and are regulated and licensed in the United States in the same way as medical physicians. For much of its time, chiropractic has been looked down
I decided to share my findings to the group about chiropractic therapy and notified them that this may be a sound alternative to prescription narcotic medications to relieve neck, low back, and upper and lower joint pain. Majority of the data seems to support chiropractic therapy as a safe CAM treatment with multiple insurance company allowing their clients to pursue this type of treatment. However, some insurance providers require individuals to purchase a "rider" to receive chiropractic treatment coverage.