Shoulder

Taking a swing at rotator cuff injuries

The shoulder is one of the most amazing parts of the human body. The combination of tendons and four major muscles in the shoulder make up the rotator cuff that can move and turn through a greater range of motion than any other joint in the body. Unfortunately, this flexibility comes at a price.
Rotator cuff injuries, whether from repetitive stress or trauma, are not uncommon. Injury may occur gradually, as in the case of tendonitis or bursitis. Tendonitis is an inflammation of the tendons due to overuse or overload. Bursitis is an inflammation of the bursa, a fluid-filled sac located between the shoulder joint and rotator cuff tendons. Not surprisingly, athletes and construction workers frequently experience rotator cuff injuriesdue to the repeated, significant strain put on rotator cuff muscles. A sudden strain or tear may also occur after an event such as falling on to an outstretched hand. Poor posture, weak shoulder muscles and age-related degeneration may increase a person’s risk of rotator cuff injury.

Typical symptoms

Symptoms of a rotator cuff injury include shoulder pain, especially during movement or when sleeping on the affected side, tenderness or weakness, and loss of shoulder mobility. A click or pop may also be heard or felt when the shoulder is moved. Movements that involve overhead motion, such as getting dressed or combing hair may become difficult and painful after this type of injury.

A trip to the doctor’s office to diagnose a rotator cuff injury may be necessary if shoulder pain lasts longer than two days or if pain prohibits normal activities, such as reaching overhead or engaging in sports. Identifying a rotator cuff injury is usually done following a physical examination and medical history review. Imaging tests such as X-rays, magnetic resonance imaging (MRI), ultrasound or arthrogram (when dye is injected into the shoulder and X-rays are then taken) may be used to help detect a full or partial tendon tears.

Treatment options

Treatment of a rotator cuff injury typically depends on the severity of the injury, as well as the patient’s age, overall health and duration of the condition. Minor shoulder problems can be treated with strengthening exercises and anti-inflammatory medications such as ibuprofen, aspirin or acetaminophen; occasionally a steroid injection into the affected area can help reduce inflammation, decrease pain and increase joint mobility.

An ice pack can be placed on the shoulder for 15 to 20 minutes every two to three hours during the first day or so after an injury can help reduce inflammation and pain. A heating pad can then be used for 20 minutes at a time to help relax tightened and sore muscles. Exercising the shoulder should begin slowly to prevent stiff joints.

Surgery may be necessary for younger patients with small tears that can be successfully repaired to reduce the probability of the tear getting progressively worse. Tears caused by acute, severe trauma should be surgically repaired immediately.

Preventing a rotator cuff injury is much less painful than treating one. Regular shoulder exercises can not only strengthen muscles and tendons, but also protect the shoulder’s range of motion. Other ways that may help prevent injury include maintaining good posture and taking breaks at work or play to rest the shoulder if the job or activity is physically demanding.