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Shoulder pains

✔ Comprehensive and holistic diagnosis
✔ Conventional and alternative medicine
✔ Individual therapy program

«I would be happy to introduce you to my diagnostic and therapeutic concepts to relieve your pain in the shoulder and help you to improve your quality of life.» – Specialist Dr. med. Martin Ihle

Shoulder pains can affect any meeting

The symptoms of the shoulder joint are just as complex as its structure. Younger and older people can be equally affected. The pain can be acute or chronic. More frequent than acute injuries of bones, muscles and joint parts are complaints resulting from permanent overloading or incorrect loading of the shoulder joint.

The high susceptibility of the shoulder joint to chronic overload complaints is due to its special anatomical structure. Although this results in a high range of motion, it also leads to an increased susceptibility of the joint to functional complaints, since damage to the surrounding muscle cuff or the stabilizing ligament structures can quickly lead to incorrect loading in the joint.

Painful movement restrictions

The resulting complaints manifest themselves in a painful restriction of shoulder mobility. This can occur both under stress and at rest, so that in the lateral position it can also disturb the night’s sleep.

In the foreground of chronic shoulder complaints are generally a muscular imbalance and an overloading of myofascial connective tissue structures with correspondingly active trigger points. These can occur both at the back of the shoulder blade and at the side of the deltoid muscle.

Diagnosis and therapy of shoulder pain

In the context of a holistic and integrative diagnosis of shoulder problems, it is important to also consider the cervical spine, because there is an interaction here: The nerves supply the shoulder and the entire arm via the spinal cord. Influences from the vertebral segment can provoke these nerves to a pain reaction. At the same time, the cervical spine offers a good approach for therapeutic measures.

Sometimes the mere treatment of the trigger points is enough to quickly relieve the shoulder pain. Inflammatory changes of bursa or muscle attachments often occur, so that the internal gliding in the shoulder joint is disturbed. This is accompanied by a painful restriction of mobility when lifting the arm, also known as impingement syndrome.

Natural treatment of shoulder pain

Non-surgical therapy is particularly suitable for chronic pain in the shoulder area, whether through the treatment of the disturbed structures or the superior segments.

In principle, a subtle manual diagnosis is always the first step in determining the individual symptoms. The particular strength of the manual medical examination lies in the fact that in the case of functional syndromes a therapy can be started without transition.

The diagnosis of the shoulder always includes an inventory of the cervical spine with the upper cervical joints, the temporomandibular joints and the thoracic spine. The motion sequence of the shoulder joints in a lateral comparison also provides important information on the cause of the complaint. It often happens that the complaints radiate from the neck over the shoulder and the arm to the hand. Here the influence of the nerve supply must be considered and, if necessary, treated. This can be a constriction of the nerves in the course, a constriction at the outlet of the nerves at the cervical spine or through the interconnection in the segment also an influence on the nerve roots in the spinal cord.

Ultrasound, X-rays and MRT as a supplement to manual diagnostics

In the next step, ultrasound diagnostics provide valuable information on calcium deposits or structural damage to muscles and tendons. The results are incorporated into further therapy and treatment approaches. Under certain circumstances, an X-ray examination, computer tomography (CT) or magnetic resonance imaging (MRI) can also be performed. If the symptoms are appropriate, a neurological finding with measurement of the nerve conduction velocity and muscle activity may also be necessary.

If the symptoms are functional, the strength of manual medicine can be seen here. It leads seamlessly into the therapy. Already during the examination manual intervention can contribute to the mobilization of the joint, to the stretching of the musculature, to the treatment of the social trigger points and to the release of blockades of joint structures.

Combination of chiropractic and myofascial stretching techniques

In the treatment of my patients, the application of myofascial stretching techniques with chiropractic techniques has proven to be particularly effective. For joint mobilisation in shoulder and vertebral joints, I rely on a combination with regulative neural therapy.

In addition to manual techniques, dry needling and infiltration techniques are suitable for the treatment of trigger points. In addition, the application of physical methods such as shock wave therapy is possible. This method is particularly suitable in cases of irritation caused by calcium deposits in the connective tissue. Subsequently, a kinesiotape can have a lasting positive effect in the sense of a micromassage and stabilization.

Long-term exercise programme for lasting treatment success

After all therapy procedures, I recommend that you learn certain stretching and mobilization techniques, which you should perform yourself on a daily basis in order to consolidate the result of the treatment.

In the case of receding complaints, an exercise program should always follow in which stretching, strengthening and mobility are practiced. In the first step I strongly recommend a physiotherapeutic treatment in which an individual exercise program is developed. In the further course I recommend after arrangement and anticpate the need for a qualified movement program as for example Gyrotonic training.

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Private practice for orthopedics

Dr. med. Martin Ihle

Jägerstr. 70
10117 Berlin

3. OG - Aufzug im Innenhof

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Dr. med. Martin Ihle

Jägerstr. 70,
10117 Berlin

030 747 807 36

praxis@orthopaedie-ihle.de

Visit by appointment