Upper Extremity Disorders

When it comes to the upper limb, there are very few orthopedic surgeons, physcial therapists and chiropractors that understand the shoulder joint complex as well as Dr. Zumpano. He has successfully rehabilitated scores of patients with shoulder, arm and carpal tunnel pain produced by impingement syndrome, pinched nerves, rotator cuff tears and bicep brachii avulsions. He also knows when a shoulder needs surgical repair and will refer you to a surgeon. Dr. Zumpano has even published a textbook in 2006 entitled: Clinical Dissections of the Extremities and Pelvis.

Rotator Cuff and Shoulder Pain

The shoulder is attached to the body by mostly muscles. These muscles take the brunt of every day activities. Think about how many times your use your arms or hands to reach for something. The slightest muscular imbalance at the rotator cuff can cause alterations in your posture that can cause pain. Over time, these imbalances can have grave consequences such as rotator cuff tears or ligament injury.

Before considering surgery or repeated corticosteriod injections, please consider a 3-5 visit treatment plan at Victor Chiropractic. Often, patients notice relief after 1 or 2 treatments. If surgery is needed, Dr. Zumpano can correctly rehabilitate your joint.

Peripheral Nerve Entrapments - "The Pinched Nerve"

There are five major nerves that exit the armpit and run through the upper limb. These nerves run through muscles in the arm, forearm and hand and around the joints in the arm, forearm and wrist. Every nerve has the potential to become "entrapped" by muscles, tendons or ligaments as they move along their path to innervate muscles or skin. In fact, each nerve has several entrapment sites.

Here is an example that most people are familiar with: Carpal tunnel - in which the median nerve is compressed at the wrist. Some people know people who have had carpal tunnel surgery. Many had great post-surgical results, only to slowly redeveloped carpal tunnel symptoms. This happens when the median nerve is not compressed at the wrist. The most common site of median nerve entrapment is in the proximal forearm as it runs through a muscle called pronator teres! In fact, there are 5 sites in the upper limb where the median nerve can be entrapped and they all cause carpal tunnel like pain. These sites include: subscapularis, medial intermuscular septum, protator teres, between flexor digitorum superficialis and profundus, carpal tunnel, and a branch can be compressed in the hand as it passes between flexor pollicis brevis and abductor pollicis brevis.

Each of the 5 nerves have several entrapment sites that can cause a myriad amount of arm, forearm and hand pain. Since Dr. Zumpano has actually dissected these nerves in over 1000 cadavers at NYCC, he knows where they run and how they can be entrapped, but more importantly, he knows how to treat these peripheral entrapments.

Treatment Plans:

Dr. Zumpano uses active soft tissue methods to free the nerve and restore neural glide (a term used to describe how a nerve moves through a muscle like dental floss moves through teeth. For rehabilitation, he prescribes home care exercises so that you can be part of your healing process. Just like his approach to the TMJ, he will rarely adjust a shoulder or elbow. Adjustments are performed at the wrist, fingers and thumbs to help circulate synovial fluid and help restore