| |
 |
Shoulder Injuries - Rotator Cuff Tendonitis
and Tears |
|
Rotator cuff injuries are extremely common. They may occur due to a single
traumatic event or from repetitive overuse. Classically, the patient complains
of difficulty sleeping on the affected side, pain with overhead activities,
a catching or popping sensation in the shoulder and weakness.
 |
Overuse Tendinitis
Shoulder motions used during activities like golfing, pitching or
carrying luggage may cause repetitive stress within the rotator
cuff, leading to irritation, bruising, or fraying. This can cause
shoulder pain and weakness in the joint.
|
 |
Impingement Tendenitis
When the space is narrowed between the rotator cuff and the bony
acromion above it, the bone pinches and irritates the cuff. This
can happen when the cuff is weak, the bursa is swollen, or the acromion
angles down too far. Tendinitis caused by impingement can occur
with repetitive shoulder activities, such as sports or jobs involving
overhead reaching.
|
 |
Calcification Tendenitis
Inflammation can sometimes result in a buildup of calcium deposits
within the rotator cuff, leading to pain and loss of shoulder strength
and movement.
|
 |
Tears
Severe tendinitis from impingement, degeneration, or sudden injuries
like falling can cause partial or complete tearing of the rotator
cuff. This can result in shoulder pain, weakness, and loss of normal
movement.
|
Treatment of these injuries is individualized but usually consist of
physical therapy, anti-inflammatory medication, cortisone injections and
occasionally surgery. The non-surgical treatment is designed to strengthen
the rotator cuff muscles, decrease inflammation and restore function.
If this fails, then surgery becomes an option. Before surgery is considered
an MRI is often undertaken to better define the problem.
|
Restore your Flexibility with Strengthening |
|
|
|
Back Scratcher
1. Stand straight, with the back of the hand on your injured side
held flat across your back.
2. With your "good" hand, throw one end of a towel over
your good shoulder and grab it with the hand behind your back.
3. Pull gently on the towel with your good arm, raising your injured
arm as high as you can comfortably. Hold for 5 seconds, then release
slowly . Repeat 5-10 times.
|
 |
Build up to holding the stretch for 10-60 seconds and/or
pulling your hand higher behind your back.
|
 |
|
Wall Walk
1. Stand with your injured shoulder about 2 feet from a wall.
2. Keeping your shoulders level, gently walk your fingers up the
wall as high as you can.
3. Hold for a few seconds, then walk them back down. Repeat 5 times.
4. Step closer to the wall and, keeping your arm straight, repeat
the exercise 5 times.
|
 |
Build up to holding for 10-60 seconds and/or moving closer
to the wall and putting your arm straight up against the wall.
|
|
|
Pretzel Twist
1. Reach your injured arm over your good shoulder. With your good
hand, gently pull your injured elbow toward your good side. Hold
for 10 seconds. Repeat 3-5 times.
2. Reaching behind your head with your injured arm, repeat the
exercise 3-5 times.
3. Reaching your injured arm behind your back, clasp your hands
together and repeat the exercise 3-5 times.
|
 |
Build up to holding each stretch for 10-60 seconds and reaching
your arm as far as you can.
|
|
Regain Your Power with Strengthening |
|
|
|
Taffy Pull
1. Attach rubber tubing to a pole or doorjamb. Grasp the tubing
with the hand on your injured side and stand away from the door
so the tubing is tight.
2. Standing sideways to the pole or door, with your arm against
your side and your elbow at 90 degrees (L-shaped), rotate your forearm
across your chest.
3. Slowly return to the starting position and repeat 5-15 times
(1 set). try to do 2-3 sets.
|
 |
Build up to using more resistance by doubling or tripling
the tubing (by folding it once or twice), or by using stronger tubing.
|
|
|
Wings
1. Stand with your arms at your sides, holding a hand weight or
a can of soup in each hand. With your elbow straight, turn your
arms in so your thumbs point toward the floor.
2. Keeping your thumbs pointed toward your little toes, lift your
arms to waist level and slightly forward.
3. Slowly lower your arms and repeat 5-15 times (1 set). Try to
do 2-3 sets.
|
 |
Build up to using heavier weights.
|
|
|
Drawbridge
1. Lie on your good side, with your head supported by your arm or
a pillow.
2. Grasp a hand weight or a can of soup in front of you. Bend your
elbow to 90 degrees (L-shaped), keeping your arm and elbow against
your side.
3. Slowly lift the weight until your forearm is parallel to the
floor, then slowly lower the weight.
4. Repeat 5-15 times (1 set). Try to do 2-3 sets.
|
 |
Build up to using a heavier weight.
|
The physicians at Sports Medicine North utilize newer arthoscopic techniques
in their approach to rotator cuff disease. Tendonitis (inflammation of
the tendon) or partial-tears of the then can be treated by simple debridement
(removal of scar tissue) through the scope. This requires only small,
barely noticeable incisions about the shoulder. When more extensive tearing
is encountered the arthroscope is used to remove the scar tissue and prepare
the tendon for direct repair which is performed through a mini-incision.
The rehabilitation after a rotor cuff repair is long but is successful
in over 85% of cases.
|
Arthroscopic Surgery
Your orthopaedist can get a detailed look at your rotator cuff by
using an arthroscope, a pencil-shaped lighting and lens system.
Corrective procedures, such as making more space for tendon movement
or repairing minor tears, are performed with specially designed
instruments inserted through tiny incisions smaller than a buttonhole.
|
The acromion is shaved to create space between it and the
rotator cuff, which helps prevent irritation during shoulder movement
|
Damaged tissue and small flaps are removed from around the injured
tendon, and small tears are repaired.
|
|
Open Surgery
To repair complete tears in your rotator cuff, open surgery is usually
necessary. The incision is larger than in arthroscopic surgery,
and healing and rehabilitation may take longer.
|
Space is increased between the acromion and the damaged tendon
of the rotator cuff.
|
The damaged tendon is trimmed and a small area is cut in
the humerus.
|
The tendon is secured to the humerus with sutures or tacks.
|
Top
|
 |
