| kground-color: #ffffff;" /> | | | | This is called referred pain. |
| The term “rotor” cuff, actually- the | | | | Rotator cuff problems are diagnosed by taking a |
| rotator cuff- refers to a group of muscles and | | | | careful history and doing a thorough physical |
| associated tendons that connect the scapula (shoulder | | | | examination. |
| blade) to the humerus (upper arm bone). The rotator | | | | Plain x-rays are of limited usefulness unless the patient |
| cuff tendons sit on top of the humerus and permit | | | | also has concomitant arthritis. An MRI is probably the |
| movement in all directions. In fact, the shoulder is the | | | | most accurate method for imaging the entire shoulder |
| most mobile joint in the body. Because of the wide | | | | including the soft tissues, tendons, and bone. Diagnostic |
| range of motion that the shoulder joint has… | | | | ultrasound is another less expensive technology which |
| plus the amount of work that the shoulder has to do | | | | is probably as effective for visualizing the rotator cuff. |
| doing activities of daily living, the rotator cuff becomes | | | | Partial tears can be treated with anti-inflammatory |
| prone to overuse and injury. Excessive stress on the | | | | medication and physical therapy. In patients with more |
| rotator cuff leads to shoulder pain. | | | | severe pain or who do not respond to conservative |
| Rotator cuff injury is fairly common and can be due to | | | | measures, injection of glucocorticoid (cortisone) can be |
| repetitive stress, trauma, and aging. | | | | effective. Injections should be done using ultrasound |
| Repetitive stress can be occupational- people who do | | | | needle guidance. Otherwise, the injection may not be |
| work with the arms raised above the level of the | | | | done in the proper location. |
| shoulder- can develop shoulder problems easily. | | | | Larger rotator cuff tears generally don’t heal |
| Examples would be auto mechanics, dry wall installers, | | | | without intervention. Depending on the age of the |
| house painters, and electricians. | | | | patient, length of duration of the tear, size of the tear, |
| Sports activities such as golf, tennis, softball, and other | | | | and the patient’s other medical problems, |
| athletic endeavors that require repeated shoulder | | | | surgery may be a solution. In cases where more |
| movement can also be a problem. | | | | conservative measures fail to provide relief from pain |
| Trauma, particularly falls are a common cause of | | | | and improved function, surgery is also an option. |
| rotator cuff injury. | | | | Most rotator cuff surgery is performed arthroscopically |
| As people get older, the tendons that comprise the | | | | using small incisions for the insertion of a tiny camera |
| rotator cuff become more prone to injury and | | | | and surgical cutting instruments. Despite, the relatively |
| degeneration. The tendons of the rotator cuff are | | | | small instruments, this is still a surgical procedure with all |
| made of tough fibrous connective tissue similar to | | | | its attendant risks. |
| connective tissue located elsewhere in the body. | | | | As mentioned earlier, multiple factors go into deciding |
| Examples of connective tissue include ligaments, | | | | whether a patient is a good surgical candidate. Other |
| tendons, and cartilage. Connective tissue tends to | | | | factors determine prognosis. Factors that can influence |
| degrade with age. Combining repetitive use with the | | | | healing include the size of the tear, the number of |
| aging process is a recipe for significant rotator cuff | | | | tendons that are torn, smoking and patient age. |
| injury. | | | | Physical therapy following surgery is essential to |
| Injuries to the rotator cuff usually are due to | | | | restore full mobility and to protect the surgical repair. |
| inflammation. This is called tendonitis or tendonopathy. | | | | This may be arduous, taking several weeks before |
| More serious injuries result in partial tearing of the | | | | function is restored adequately. |
| tendons. Even more serious is a "full-thickness" or | | | | Recently, a new treatment approach called |
| complete tear. While there are many causes of rotator | | | | "percutaneous needle tenotomy" has shown a great |
| cuff injury, the most common is when the rotator cuff | | | | deal of promise. With this procedure, the physician |
| tendons are squeezed between the humerus and the | | | | uses a small needle to irritate the rotator cuff tendons |
| scapula. This squeezing occurs when the arm is raised | | | | using direct ultrasound guidance. Then, platelet rich |
| above the level of the shoulder. | | | | plasma, obtained from the whole blood of the patient |
| Symptoms of rotator cuff related malfunction usually | | | | prior to the procedure is injected into the irritated site. |
| are pain related. Pain at night is very common and is | | | | Platelet rich plasma contains multiple growth and |
| caused by inflammation in the both the tendons as well | | | | healing factors which help to build new healthy tendon |
| as the adjacent bursa. This bursa- called the | | | | tissue. This procedure often prevents the need for |
| subacromial bursa- is a sack that contains a small | | | | surgery! |
| amount of fluid and cushions the shoulder. When it | | | | For prevention of rotator cuff tears, it is good practice |
| becomes inflamed, the condition is called bursitis. | | | | to consult a knowledgeable physical therapist who can |
| Muscle spasm may also contribute to the pain. Pain is | | | | teach specific exercises. |
| most intense at night. | | | | Warming up and stretching before activities is |
| The pain may radiate down the side of the upper arm. | | | | recommended. |