Partial tear of the rotator cuff case study

Bryan, a sixty year old retired builder, slipped and fell landing heavily on the right elbow. He immediately felt sharp pain in the right shoulder and had limited movement. It was a few weeks before he came to visit me. The pain was still severe and disturbed his sleep.

On examination, he could barely lift his arm away from his body and he had difficulty getting a jacket on and off. My clinical impression was that he had a tear or a partial tear of the rotator cuff muscles. These muscles form a sleeve that helps keep the shoulder joint intact. In other circumstances I might have arranged for an ultrasound scan of the shoulder but he was waiting for a knee operation and hence didn’t want further medical intervention.

I used acupuncture initially to calm the symptoms for the first few visits and then osteopathic treatment to loosen and stretch the surrounding muscles. I gave Bryan exercises to do at home to strengthen the muscles around the shoulder blade and to move the joint in a pain-free range. By the time he went in for his knee operation he was much more comfortable at night and able to get a shirt or jacket on unaided.