Friday, April 25, 2014

Common Injuries of the Rotator Cuff

The rotator cuff is a group of muscles and tendons in the shoulder. The rotator cuff allows for stability and movement of the shoulder. This piece of the anatomy is commonly injured as a result of overuse or acute injury.

There are five main conditions that involve the rotator cuff:

  1. Rotator cuff tear
  2. Rotator cuff tendonitis
  3. Rotator cuff impingement
  4. Frozen Shoulder
  5. Subacromial Bursitis

Rotator Cuff Tears

Rotator cuff tears cause pain and weakness in the shoulder, making everyday activities difficult. People most at risk for a rotator cuff tear are those over 40 and those athletes or workers who engage in repetitive overhead and lifting activities. Treatment varies depending on the size/severity of the tear and the age/activity level of the patient. 

Rotator Cuff Tendonitis

Rotator cuff tendonitis occurs when the rotator cuff tendons become aggravated or inflamed. This causes pain in the shoulder. The pain is typically located in the front of the shoulder and sometimes extends to the upper arm. Tendonitis often occurs in conjunction with bursitis. The pain may make sleeping uncomfortable and sometimes a ‘clicking’ sound is heard when raising the arm.

Rotator Cuff Impingement

Rotator cuff impingement occurs when the rotator cuff is being pinched by the bones of the shoulder causing pain. Symptoms of impingement may develop gradually, with the pain becoming worse over time. When diagnosed early, impingement can generally be treated conservatively with physical therapy, ice, activity modification and anti-inflammatories.

Subacromial Bursitis

Subacromial Bursitis occurs when the bursa (the fluid filled sac located between the acromion and rotator cuff) becomes inflamed. The bursa acts as a cushion between the bones and tendons. When inflamed, pain is felt. Bursitis can typically be treated conservatively. 

Frozen Shoulder

Frozen shoulder or adhesive capsulitis causes pain and stiffness in the shoulder that becomes worse over time. Individuals between 40 and 60 years of age are more prone to this condition. Frozen shoulder can be debilitating, but is treated non-surgically in 90% of cases. 

It is not uncommon for multiple conditions to be present at the same time. If you experience shoulder pain, it is important to see a physician as soon as possible. In many of these conditions, early treatment can prevent larger issues in the future. Left untreated, less serious conditions can develop into more complicated issues that require surgical intervention and longer recovery times.

Thursday, April 3, 2014

What is the Rotator Cuff?

The rotator cuff is a part of the shoulder that is necessary for stability and movement. The rotator cuff allows for lifting and rotation of the arm.  According to the American Academy of Orthopedic Surgeons, the rotator cuff sent approximately 2 million people to the doctor in 2008.[i]

The shoulder is a ball-and-socket joint made up of bones, muscles and tendons. The rotator cuff keeps the arm in the shoulder socket and is comprised of 4 muscles and tendons.
The three bones of the shoulder:
  1. Humerus (upper arm bone)
  2. Scapula (shoulder blade)
  3. Clavicle (collarbone). T
The 4 muscles of the rotator cuff are:
  1. Teres Minor
  2.        Infraspinatus
  3.        Supraspinatus
  4.        Subscapularis.
The muscles of the rotator cuff attach to the scapula. Each muscle also has a tendon that attaches to the humerus. The tendons form a cuff around the shoulder joint, which provides stability for the shoulder joint and allows movement. Another important part of the shoulder is the bursa. The bursa is a sac that lies between the acromion (the upper bone in the shoulder) and the rotator cuff. The bursa allows the tendons to move easily.
Common injuries of the rotator cuff are tendonitis, bursitis and tears. Causes of injury include age, overuse or acute injury (fall on outstretched hand). Many conditions/injuries of the shoulder can be treated non-surgically, but more serious tears are typically treated with arthroscopic surgery.
In upcoming posts, we will discuss these injuries and conditions in more detail. If you feel that you have injured your rotator cuff, it is important to consult a physician. Advocare Orthopedic and Sports Medicine, the office of John Vitolo, MD is available to treat any orthopedic issues.