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Happy Holidays from Village Family Clinic

Joseph Coupal - Thursday, December 20, 2018
Happy Holidays from Village Family Clinic

Our warmest Holiday wishes from the entire team here at Village Family Clinic. Calendar year 2018 was, and continues to be, a truly remarkable year and we take this moment to recognize the joy that each and every one of you has brought to our personal and professional lives. We exist because of your faith and trust in us.

As calendar year 2019 approaches, we reflect upon the foundational recognition that your success is our success. Our New Year’s wish for 2019 is to nurture our positive and ever strengthening partnership and to deliver ever increasing value to you and your business through the entirety of 2019.

Throughout this Holiday season may you be blessed with health and surrounded by friends and family. All the best! Cheers!

Rotator Cuff Tears

Joseph Coupal - Thursday, December 06, 2018
Village Family Clinic- Chiropractic in Hackettstown, NJ

What is the rotator cuff?

    It is the tendinous attachment of 4 muscles that start from the Shoulder blade (Scapula) to attach to the top of the Shoulder (Humeral head).
  • Tendons attach muscle to bone and allow the muscle to move/control the joint.
  • Tendons can sustain tears as a result of trauma (fall, accident etc.) or because of wear and tear (aging, sport or work demands).

Signs & Symptoms of Rotator Cuff Problems:

Pain and stiffness around the top of the shoulder, pain on the outside of the upper arm, pain at night that interferes with your sleep, pain, and difficulty or inability to lift your arm overhead and weakness of the arm.

How are Rotator cuff tears diagnosed?

Subjective History, Fall onto an outstretched arm or directly onto the shoulder, Decreased ability to raise the arm overhead, Pain with lowering the arm from above head level, Age > 55, Night pain

Imaging: X-rays and MRI

With a history of trauma X-ray and MRI are warranted to rule in or out other serious pathology, (fracture, dislocation, labral lesions) as well as checking the integrity of the Rotator Cuff

In the case of a Non-Traumatic onset X-rays and MRI have limited predictive value and should be held until a course of conservative care has been undertaken. (exceptions are patients with a history of cancer or a know metabolic disease

Do Tears Progress?

Several studies indicate that larger full-thickness tears (> 1.5 cm) will progress about 50% of the time over a 5 year period and become more symptomatic

About 35% of partial tears will increase in size over 5 years follow up but most remain less symptomatic then full-thickness tears.

Tears that are more anterior and involve tears into the ‘Cable” region are usually more symptomatic and typically require surgical repair vs conservative care.

Conservative Care?

May include a short period of rest in the case of traumatic injury

Management of pain with either prescription or over the counter NSAIDs or Tylenol (Opioid medication is not indicated)

Management of pain/inflammation via Cortisone Steroid Injection(CSI) tends to be short-term relief of 4-8 weeks but may allow the patient to tolerate other interventions.

Physical Therapy to address, shoulder mobility, control, strength and load tolerance ( recommended timeframe is 8-12 weeks) Exercise for rotator cuff tendinopathy – A systematic review of contextual factors and prescription parameters Littlewood et al (2015. International Journal of Rehabilitation Research)

Significant outcomes can be achieved when programs are prescribed by physical therapists, Patients of varying age, duration of symptoms and severity of pain and disability can achieve significant outcomes, Pain production or pain avoidance during exercise does not appear to matter.

Village Family Clinic offers proven conservative care such as Physical Therapy, Chiropractic care, Nutritional counseling, and Acupuncture. If you are having shoulder area pain and problems we offer care to help you get back to the activities and life you want to have!.

Should you have any questions regarding this information please feel free to contact us.


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Hi I'm Laurel, I'm a patient at the Village Family Clinic. I just want to thank Dr. Fedich and the whole staff for everything they have done for me. My back feels so much better. This machine that I have been using has really helped my back and I just want to thank everybody. Thank you!


Hi! My name Maria and I'm here at the Village Family Clinic. I came for compression for my neck and chiropractic for my back and I'm feeling better. The atmosphere in this clinic is so friendly. They know what they're doing and I would love for people come to this place. They're very friendly, especially my friend Jessica. Fully nice work, everybody fully nice. I wish everybody would come here. Very friendly people in this clinic.


Hi I'm Peggy. The entire team is friendly and helpful, from the moment you walk in the door! To be greeted by your first name makes you feel welcome, this team really cares about YOU! I have 3 pinched nerves in my lower back which is the reason I first came here. Bob taught me stretches to do, Pat & Michelle put me on the stretchingboard & electric shock. ( even providing me with a comfy blanketšŸ˜). Dr. Miller keeps me aligned. And there is a crazy woman running around who especially makes me laugh! Abbby!? (Sorry, I forget your name. ) I actually love going here!