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Types of Shoulder Pain

What most people call the shoulder is really several joints that combine with tendons and muscles to allow a wide range of motion in the arm — from scratching your back to throwing the perfect pitch. Mobility has its price, however. It may lead to increasing problems with instability or impingement of the soft tissue or bony structures in your shoulder, resulting in pain. You may feel pain only when you move your shoulder, or all of the time. The pain may be temporary or it may continue and require medical diagnosis and treatment. Most shoulder problems fall into four major categories: 

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Tendon inflammation (bursitis or tendinitis) or tendon tear

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Arthritis

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Instability

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Fracture (broken bone)

Other much less common causes of shoulder pain are tumors, infection, and nerve-related problems.

Bursitis

Bursae are small, fluid-filled sacs that are located in joints throughout the body, including the shoulder. They act as cushions between bones and the overlying soft tissues, and help reduce friction between the gliding muscles and the bone. 
Sometimes, excessive use of the shoulder leads to inflammation and swelling of the bursa between the rotator cuff and part of the shoulder blade known as the acromion. The result is a condition known as subacromial bursitis. Bursitis often occurs in association with rotator cuff tendinitis. The many tissues in the shoulder can become inflamed and painful. Many daily activities, such as combing your hair or getting dressed, may become difficult. 

Tendinitis

A tendon is a cord that connects muscle to bone. Most tendinitis is a result of a wearing down of the tendon that occurs slowly over time, much like the wearing process on the sole of a shoe that eventually splits from overuse.Generally, tendinitis is one of two types: Acute. Excessive ball throwing or other overhead activities during work or sport can lead to acute tendinitis. Chronic, degenerative diseases like arthritis or repetitive wear and tear due to age, can lead to chronic tendinitis. 


The most commonly affected tendons in the shoulder are the four rotator cuff tendons and one of the biceps tendons. The rotator cuff is made up of four small muscles and their tendons that cover the head of your upper arm bone and keep it in the shoulder socket. Your rotator cuff helps provide shoulder motion and stability. 

Tendon Tears

Splitting and tearing of tendons may result from acute injury or degenerative changes in the tendons due to advancing age, long-term overuse and wear and tear, or a sudden injury. These tears may be partial or may completely split the tendon into two pieces. In most cases of complete tears, the tendon is pulled away from its attachment to the bone. Rotator cuff and biceps tendon injuries are among the most common of these injuries. 

Impingement

Shoulder impingement occurs when the top of the shoulder blade (acromion) puts pressure on the underlying soft tissues when the arm is lifted away from the body. As the arm is lifted, the acromion rubs, or “impinges” on, the rotator cuff tendons and bursa. This can lead to bursitis and tendinitis, causing pain and limiting movement. Over time, severe impingement can even lead to a rotator cuff tear. 

Instability

Shoulder instability occurs when the head of the upper arm bone is forced out of the shoulder socket. This can happen as a result of a sudden injury or from overuse. Shoulder dislocations can be partial, with the ball of the upper arm coming just partially out of the socket. This is called a subluxation. A complete dislocation means the ball comes all the way out of the socket. Once the ligaments, tendons, and muscles around the shoulder become loose or torn, dislocations can occur repeatedly. Recurring dislocations, which may be partial or complete, cause pain and unsteadiness when you raise your arm or move it away from your body. Repeated episodes of subluxations or dislocations lead to an increased risk of developing arthritis in the joint. 

Arthritis

Shoulder pain can also result from arthritis. There are many types of arthritis. The most common type of arthritis in the shoulder is osteoarthritis, also known as “wear and tear” arthritis. Symptoms, such as swelling, pain, and stiffness, typically begin during middle age. Osteoarthritis develops slowly and the pain it causes worsens over time. Osteoarthritis, may be related to sports or work injuries and chronic wear and tear. Other types of arthritis can be related to rotator cuff tears, infection, or an inflammation of the joint lining. Often people will avoid shoulder movements in an attempt to lessen arthritis pain. This sometimes leads to a tightening or stiffening of the soft tissue parts of the joint, resulting in a painful restriction of motion. 

Fracture

Fractures are broken bones. Shoulder fractures commonly involve the clavicle (collarbone), humerus (upper arm bone), and scapula (shoulder blade). Shoulder fractures in older patients are often the result of a fall from standing height. In younger patients, shoulder fractures are often caused by a high energy injury, such as a motor vehicle accident or contact sports injury. Fractures often cause severe pain, swelling, and bruising about the shoulder. 

Even though your back pain may gradually improves with home treatment and self-care, usually within two weeks the symptoms maybe gone but the underlining cause of the pain may still be there. It is wise to see your doctor.

In rare cases, back pain can signal a serious medical problem. Seek immediate care if your back pain: 

  • Causes new bowel or bladder problems 
  • Is accompanied by fever 
  • Follows a fall, blow to your back or other injury 
  • Is severe and doesn’t improve with rest 
  • Spreads down one or both legs, especially if the pain extends below the knee 
  • Causes weakness, numbness or tingling in one or both legs 
  • Is accompanied by unexplained weight loss 


Also, see your doctor if you start having back pain for the first time after age 50, or if you have a history of cancer, osteoporosis, steroid use, or drug or alcohol abuse.

Call Today at (503) 589-0700 or Book Appointment!

Knee Pain

Most people have had a minor knee problem at one time or another. Most of the time our body movements do not cause problems, but it’s not surprising that symptoms develop from everyday wear and tear, overuse, or injury. Knee problems and injuries most often occur during sports or recreational activities, work-related tasks, or home projects. The knee is the largest joint in the body. The upper and lower bones of the knee are separated by two discs (menisci). The upper leg bone (femur) and the lower leg bones (tibia and fibula) are connected by ligaments, tendons, and muscles. The surface of the bones inside the knee joint is covered by articular cartilage, which absorbs shock and provides a smooth, gliding surface for joint movement. Although a knee problem is often caused by an injury to one or more of these structures, it may have another cause. Some people are more likely to develop knee problems than others. Many jobs, sports and recreation activities, getting older, or having a disease such as osteoporosis or arthritis increase your chances of having problems with your knees. 

Sudden (acute) injuries – Injuries are the most common cause of knee problems. Sudden (acute) injuries may be caused by a direct blow to the knee or from abnormal twisting, bending the knee, or falling on the knee. Pain, bruising, or swelling may be severe and develop within minutes of the injury. Nerves or blood vessels may be pinched or damaged during the injury. The knee or lower leg may feel numb, weak, or cold; tingle; or look pale or blue. Acute injuries include:

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Sprains, strains, or other injuries to the ligaments and tendons that connect and support the kneecap. 

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A tear in the rubbery cushions of the knee joint (meniscus). 

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Ligament tears, such as the anterior cruciate ligament (ACL). The medial collateral ligament (MCL) is the most commonly injured ligament of the knee. 

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Breaks (fracture) of the kneecap, lower portion of the femur, or upper part of the tibia or fibula. Knee fractures are most commonly caused by abnormal force, such as a falling on the knee, a severe twisting motion, severe force that bends the knee, or when the knee forcefully hits an object. 

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Kneecap dislocation. This type of dislocation occurs more frequently in 13- to 18-year-old girls. 

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Pieces of bone or tissue (loose bodies) from a fracture or dislocation that may get caught in the joint and interfere with movement. 

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Knee joint dislocation. This is a rare injury that requires great force. It is a serious injury and requires immediate medical care. 

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