Dooley Noted: 2/13/2015
Last week, I helped dissect many rotator cuffs.
Our approach is typically a posterior one, since three of the four muscles are located in the back of the shoulder.
As these muscles cuff themselves around the head of the humerus (aka: arm bone), they prevent anterior and inferior dislocation.
If they become damaged, scar tissue may infiltrate the joint capsule, as well as the muscles themselves.
I observed a glorious cadaver with massive global musculature. The four rotator cuff muscles were equally as glorious.
The dissection team reflected the musculature to expose the joint capsule of the glenohumeral (shoulder) joint.
What we saw shocked all of us.
His joint capsule was so thick and scarred that it could not be separated from the bone.
A joint capsule provides cushion between bones, as well as lubrication.
If the capsule is scarred, the joint can’t move properly.
The scars we don’t see affect the way we move.
While these are hard to see, they can be treated with movement therapy.
The work of Drs. Lewit and Janda, as well as David Weinstock, opened my eyes to the importance of scars and myofascial dysfunction and pain. (See links below.)
The scars you can see from the outside are also affecting motor control.
If you have limited range or faulty movement affected by scars, this relationship can change.
Techniques like acupuncture, cold laser, and movement therapy can help to mobilize scar tissue and even create fibroblastic changes to the scar tissue.
Scar tissue may act like caulking, filling in gaps where integrity was lost.
It doesn’t mean you are stuck like caulking.
Tissue integrity can change.
Motor control can change.
If you’re not working on your scars, seriously consider it.
Acupuncturists and manual therapists can help you gain back some mobility you’ve lost from the scars.
Continue to work on them yourself, too.
Scars only set movement in stone if you let them.
As always, it’s your call.
– Dr. Kathy Dooley
* For more information;
1. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2050813/
2.
3.
Click to access clinicaimprtance.pdf
4.
https://books.google.com/books?id=TkMyMb_z6HkC&pg=PA130&lpg=PA130&dq=scars+motor&source=bl&ots=HTxmTJiyXJ&sig=esj3a66lajzTeJiSGBlDUJAjayc&hl=en&sa=X&ei=5zzeVOmqCoymNsqRgdgJ&ved=0CB8Q6AEwAjgK
5.
http://www.liberatedbody.com/david-weinstock-lbp-013/