How can you identify a rotator cuff injury. What are the common symptoms of rotator cuff problems. When should you seek medical attention for shoulder pain. What treatment options are available for rotator cuff injuries.

Understanding Rotator Cuff Anatomy and Function

The rotator cuff is a crucial component of shoulder anatomy, playing a vital role in arm movement and stability. This complex structure consists of four muscles and their associated tendons that work together to enable shoulder rotation and arm elevation.

The four muscles that make up the rotator cuff are:

• Supraspinatus
• Infraspinatus
• Subscapularis
• Teres minor

These muscles attach to the shoulder blade and wrap around the upper arm bone (humerus), forming a “cuff” that stabilizes the shoulder joint. The tendons of these muscles connect the muscles to the bone, allowing for smooth and controlled arm movements.

Primary Functions of the Rotator Cuff

The rotator cuff serves several essential functions:

1. Stabilizing the shoulder joint during arm movements
2. Enabling rotation of the arm
3. Facilitating arm elevation and overhead activities
4. Maintaining proper alignment of the shoulder joint

Given its importance in shoulder function, any injury or damage to the rotator cuff can significantly impact a person’s ability to perform everyday tasks and activities.

Recognizing Symptoms of Rotator Cuff Injuries

Identifying a rotator cuff injury early can be crucial for proper treatment and recovery. While symptoms may vary depending on the type and severity of the injury, there are several common signs to watch for:

Shoulder Weakness

Is shoulder weakness a significant indicator of rotator cuff problems? According to Dr. Christopher Kim, an orthopaedic surgeon specializing in sports medicine, shoulder weakness is indeed the primary sign of a rotator cuff injury. If you find it challenging to lift your arm above your head or notice a decrease in strength when performing routine tasks, it could be a sign of rotator cuff damage.

Pain and Discomfort

Many individuals with rotator cuff injuries experience pain, particularly when performing certain arm movements or sleeping on the affected shoulder. This pain may be accompanied by a popping or clicking sensation during arm rotation or elevation.

Limited Range of Motion

Do rotator cuff injuries affect arm mobility? In many cases, yes. Individuals with rotator cuff problems often experience difficulty reaching behind their back, combing their hair, or performing other activities that require a full range of shoulder motion.

Nighttime Pain

Is it common for rotator cuff injuries to cause pain at night? Many people with rotator cuff problems report increased pain when lying down, particularly when sleeping on the affected shoulder. This can lead to sleep disturbances and overall discomfort.

Types of Rotator Cuff Injuries

Rotator cuff injuries can range from mild inflammation to complete tendon tears. Understanding the different types of injuries can help in identifying the problem and seeking appropriate treatment.

Rotator Cuff Tendonitis

Tendonitis occurs when the rotator cuff tendons become irritated and inflamed. This condition often develops over time due to repetitive overhead motions or prolonged pressure on the shoulder, such as consistently sleeping on the same side.

Dr. Kim explains that tendonitis is sometimes referred to as impingement or bursitis. The bursa, a fluid-filled sac that allows smooth movement in the shoulder, can become inflamed and swollen, leading to pain and restricted motion.

Partial Rotator Cuff Tears

In partial tears, the tendon is damaged but not completely severed. These tears can vary in severity, from minor fraying to significant partial detachment from the bone.

Full-Thickness Rotator Cuff Tears

A full-thickness tear occurs when the tendon is completely detached from the bone. This type of injury often results in significant weakness and may require surgical intervention for proper healing.

Causes and Risk Factors for Rotator Cuff Injuries

Understanding the causes and risk factors associated with rotator cuff injuries can help in prevention and early detection. These injuries typically fall into two categories: acute traumatic injuries and degenerative tears.

Acute Traumatic Injuries

Traumatic rotator cuff tears often result from sudden, forceful movements or impacts. Common causes include:

• Falls, particularly on an outstretched arm
• Sports-related injuries, especially in contact sports
• Lifting heavy objects improperly
• Sudden, forceful arm movements

These types of injuries are more common in younger adults and athletes engaged in high-impact activities.

Degenerative Tears

Degenerative tears occur gradually over time due to wear and tear on the rotator cuff tendons. Factors contributing to degenerative tears include:

• Age-related changes in tendon strength and elasticity
• Repetitive overhead motions, common in certain occupations or sports
• Poor posture and shoulder mechanics
• Reduced blood supply to the rotator cuff tendons

Dr. Kim notes that degenerative tears are more prevalent in individuals over 40, with the risk increasing significantly in people aged 60 and above. In fact, many older adults may have rotator cuff tears without experiencing noticeable symptoms.

Additional Risk Factors

Several other factors can increase the likelihood of developing rotator cuff problems:

1. Occupations requiring repetitive overhead motions (e.g., painters, carpenters)
2. Participation in sports with frequent overhead arm movements (e.g., tennis, swimming)
3. Family history of rotator cuff injuries
4. Smoking, which can impair blood flow and slow healing
5. Certain medical conditions, such as diabetes or thyroid disorders

Diagnostic Procedures for Rotator Cuff Injuries

Accurate diagnosis of rotator cuff injuries is crucial for determining the appropriate treatment plan. Sports medicine physicians like Dr. Kim employ a variety of diagnostic techniques to assess the extent and nature of the injury.

Physical Examination

The initial step in diagnosing a rotator cuff injury typically involves a thorough physical examination. During this assessment, the physician will:

• Evaluate range of motion in the affected shoulder
• Test muscle strength through various arm positions
• Perform specific maneuvers to isolate rotator cuff function
• Check for tenderness or swelling in the shoulder area

These tests help differentiate rotator cuff injuries from other shoulder problems, such as cervical spine issues or biceps tendon injuries.

Imaging Studies

To confirm the diagnosis and assess the extent of the injury, imaging studies may be recommended. Common imaging techniques include:

1. X-rays: While not directly showing soft tissue damage, X-rays can reveal bone spurs or other structural abnormalities that may contribute to rotator cuff problems.
2. Magnetic Resonance Imaging (MRI): This non-invasive technique provides detailed images of soft tissues, allowing for accurate assessment of tendon damage and tear size.
3. Ultrasound: This method uses sound waves to create real-time images of the rotator cuff, offering a cost-effective and radiation-free alternative to other imaging techniques.

The choice of imaging study often depends on the suspected severity of the injury and the patient’s individual circumstances.

Treatment Options for Rotator Cuff Injuries

The treatment approach for rotator cuff injuries varies depending on the type and severity of the injury, as well as the patient’s age, activity level, and overall health. Treatment options generally fall into two categories: conservative management and surgical intervention.

Conservative Treatment

For many rotator cuff injuries, especially mild to moderate cases, conservative treatment is the initial approach. This may include:

• Rest and activity modification to allow the injury to heal
• Ice or heat therapy to manage pain and inflammation
• Non-steroidal anti-inflammatory drugs (NSAIDs) for pain relief
• Physical therapy to improve strength, flexibility, and range of motion
• Corticosteroid injections for temporary pain relief and inflammation reduction

Conservative treatment often proves effective, particularly for partial tears and tendonitis. However, it may take several weeks or months to see significant improvement.

Surgical Intervention

In cases where conservative treatment fails to provide adequate relief or for large, full-thickness tears, surgery may be recommended. Surgical options include:

1. Arthroscopic repair: A minimally invasive procedure using small incisions and a camera to guide the repair
2. Open repair: Traditional surgery involving a larger incision, typically used for complex or extensive tears
3. Tendon transfer: In cases where the torn tendon cannot be reattached, a nearby tendon may be used as a replacement
4. Shoulder replacement: In severe cases with significant arthritis, a partial or total shoulder replacement may be necessary

The choice of surgical technique depends on factors such as tear size, tissue quality, and the surgeon’s expertise.

Rehabilitation and Recovery After Rotator Cuff Treatment

Regardless of whether treatment involves conservative management or surgery, rehabilitation plays a crucial role in recovery from rotator cuff injuries. The rehabilitation process aims to restore strength, flexibility, and function to the affected shoulder.

Physical Therapy

Physical therapy is a cornerstone of rotator cuff rehabilitation. A typical physical therapy program may include:

• Range of motion exercises to improve shoulder mobility
• Strengthening exercises for the rotator cuff and surrounding muscles
• Stretching routines to maintain flexibility
• Postural training to improve shoulder mechanics
• Manual therapy techniques to address soft tissue restrictions

The specific exercises and their progression will be tailored to the individual’s needs and the nature of their injury.

Timeline for Recovery

How long does it take to recover from a rotator cuff injury? The recovery timeline can vary significantly depending on the severity of the injury and the treatment approach:

1. Conservative treatment: Mild injuries treated non-surgically may show improvement within 4-6 weeks, with full recovery potentially taking 3-6 months.
2. Surgical repair: Recovery after surgery typically takes longer, with most patients requiring 4-6 months of rehabilitation. Full recovery and return to high-level activities may take up to a year.

It’s important to note that every individual’s recovery is unique, and adherence to the rehabilitation program is crucial for optimal outcomes.

Preventing Rotator Cuff Injuries

While not all rotator cuff injuries can be prevented, there are several strategies that can help reduce the risk of developing these problems:

Proper Technique and Posture

Maintaining good posture and using proper form during activities that involve the shoulders can significantly reduce strain on the rotator cuff. This includes:

• Avoiding prolonged overhead activities when possible
• Using correct lifting techniques, keeping heavy objects close to the body
• Maintaining good posture during daily activities and while working at a desk

Strengthening and Flexibility Exercises

Regular exercise to maintain shoulder strength and flexibility can help prevent rotator cuff injuries. Key areas to focus on include:

1. Rotator cuff strengthening exercises
2. Scapular stabilization exercises
3. Shoulder and upper back stretches
4. Core strengthening to improve overall posture

It’s advisable to consult with a physical therapist or trained fitness professional to develop an appropriate exercise program.

Gradual Progression in Activities

When starting new activities or returning to sports after a period of inactivity, it’s important to progress gradually. This allows the rotator cuff muscles and tendons to adapt to increased demands, reducing the risk of overuse injuries.

By implementing these preventive measures and maintaining overall shoulder health, individuals can reduce their risk of experiencing rotator cuff injuries and maintain optimal shoulder function throughout their lives.

How to Tell When You’ve Torn or Injured Your Rotator Cuff

There’s a fine line between normal wear and tear and an actual tear of your rotator cuff.

Posted
by Featured Provider Christopher Kim on Friday, March 26, 2021

Raise your hand if you’ve experienced shoulder pain.

If your hand isn’t stretched high above your head, there’s a decent chance you have a damaged rotator cuff.

Shoulder weakness is the No. 1 sign of a rotator cuff injury, says Christopher Kim, MD, an orthopaedic surgeon who specializes in sports medicine. So if you struggle to lift your arm above your head, it’s likely that there’s something wrong in this part of the shoulder.

Shoulder weakness is the common symptom across a range of rotator cuff injuries.

Like the shoulder itself, the rotator cuff is a complex set of working parts that allow you to lift and rotate your arms (hence the name). The rotator cuff is made up of four different muscles (the supraspinatus, infraspinatus, subscapularis and teres minor) and the tendons that attach them to the bone to help stabilize your shoulder joint. So you can have a problem with one or many of the muscles and suffer from the same weakness.

“People come in with similar kinds of pain and often complain of the same thing,” Dr. Kim says. “We sort out where the weakness is really coming from to figure out which part of the rotator cuff it is, and how bad it is.”

You may not easily notice the weakness yourself if, say, you can still raise up your arm. But you might feel a pain, pop or click when you move your arm a certain way or sleep on it in bed. Other times, you don’t notice it until one shoulder gives out or is noticeably weaker when you try to lift something you normally have no problems with.

Uniquely Trained to Identify Your Shoulder Issues 

Only a sports medicine physician can pinpoint your shoulder problem. Meet with Dr. Kim to improve your strength and overcome your injury. 

Make an Appointment 

Sports medicine physicians like Dr. Kim run you through a battery of tests to first identify that it’s a rotator cuff injury and not something wrong with cervical vertebra, neck, biceps or AC joint. Then they sort out the severity of the damage.

“There’s a very broad spectrum. On one end, you have impingement, bursitis and rotator cuff tendonitis. On the other end of the spectrum, there’s a full thickness rotator cuff tear. And then you have a whole bunch in between and partial tears that range from low-grade or high-grade.”

Rotator Cuff Tendonitis

The tendons of your rotator cuff can become irritated and inflamed, leading to tendonitis. It’s something that usually occurs over time, whether from sleeping on the same side of your body every night or performing repetitive motions that require you to raise your arm above your head.

“This is what some refer to as impingement or bursitis,” Dr. Kim says. “We have a bursa, which is a little fluid-filled sac around the rotator cuff that allows things to glide over each other. Inflammation can cause it to swell with more fluid, which leads to pain.”

And as you move, the space around your rotator cuff narrows. The tendons rub against other parts of the shoulder, causing more irritation and pain.

Rotator Cuff Tears

The tendons that attach the rotator cuff can also start to fray or lose their connection to the bone.

“We characterize rotator cuff tears in lots of different ways. We can define it as more the wear-and-tear, degenerative tear that happens as we get older, which is common. There are also the traumatic tears, where you have a fall or an injury. Either of these can be partial or full,” Dr. Kim says.

Partial rotator cuff tears are when there is damage, but some of the tendon is still connected. Full-thickness, or complete rotator cuff tears, are completely disconnected and look like there is a hole where the muscle should attach to the bone.

Age and repetition both wear on your rotator cuff muscles and tendons.

Traumatic tears are more common in young adults, as the result of a fall. But the majority of rotator cuff tears are of the degenerative type — the normal wear and tear your body faces over time. You’re more likely to suffer a rotator cuff tear after the age of 40. People in their 60s, 70s and 80s have a good chance of tearing a rotator cuff without even knowing it, Dr. Kim says.

With age, comes the repetition that causes these degenerative tears. By the time you’re 40, you’ve simply moved your shoulder a lot more times than through age 20. But there are other risk factors for developing a degenerative tear or even rotator cuff tendonitis.

“The non-traumatic type of tear typically happens in people who had a lot of repetitive motions with their shoulders. And that repetitive motion could be lifting heavy objects or performing manual labor where you’re constantly lifting and pulling,” Dr. Kim says. “It can actually even be repetitive desk work, like using a mouse or keyboard all day. People complain about shoulder pain with that, too.”

There are also biological, internal risk factors, he says. A history of shoulder trauma or surgery puts you at risk of a tear. So does smoking. Smokers tend to have more rotator cuff problems and more pain.

Rotator cuff pain is easy to overcome with stretches and exercises.

There’s no specific shoulder stretch, exercise or routine for you to prevent a rotator cuff injury. But that’s typically the prescription for rotator cuff problems, even up to partial tears.

“Rotator cuff treatment is so variable. Not all rotator cuff injuries are treated the same. One full-thickness tear is different from another. Partial tears are different from full tears,” Dr. Kim says. “There are a lot of factors involved, but almost always our recommendations are non-surgical. You undergo therapy with a physical therapist or do your own home exercises. And then we discuss whether a steroid injection is beneficial or not in managing your pain.”

When these more conservative treatments aren’t effective, or you suffered a complete tear, rotator cuff repair surgery is needed.

“The majority of rotator cuff surgeries are all arthroscopic. It’s a less invasive surgery but recovery from a rotator cuff repair is actually quite long. It takes much longer for soft tissue to heal back onto bone,” Dr. Kim says.

“You’re typically in a sling for about six weeks. During that time, you come out of the sling two or three times a week for physical therapy. It’s usually three months before you start any strengthening exercises — light bands and things like that. And you typically go to therapy for five to six months before continuing to improve on your own at home. It’s usually about nine to 12 months total before it’s the best you’re rotator cuff is going to get.”

Nobody wants to hear that their shoulder weakness is going to take a year of treatment and effort to heal. That’s why it’s so important to get evaluated early, Dr. Kim says.

“The longer you have symptoms, the harder it often is to treat. And the injury has progressed,” he says, “Treating a rotator cuff problem when it’s at the early stages of bursitis or tendonitis is best. People respond pretty well with non-surgical, conservative measures like injections and physical therapy.”

So as soon as you feel a twinge of shoulder pain or weakness, schedule a shoulder evaluation or visit the Bone & Joint Center to start a much shorter road to recovery.

Are You Suffering With These Symptoms of a Rotator Cuff Tear?: Dr. Matthew Pifer: Orthopedic Shoulder Surgeon

Rotator cuff tears are painful shoulder injuries that occur when there’s damage to the rotator cuff — a collection of muscles and tendons that contribute to shoulder mobility and stability. While there are numerous techniques to treat a small rotator cuff tear, a significant tear usually requires surgery for a full recovery.

Board-certified orthopedic surgeon Matthew Pifer, MD specializes in minimally invasive shoulder surgery and has extensive experience performing rotator cuff repairs. 

Most rotator cuff tears are the result of a single incident, like a sports injury. Occasionally, a bone spur in the shoulder might cause a tear. Hobbies or sports that involve repeat shoulder movements, such as baseball, tennis, and construction work, raise the risk of rotator cuff injuries.

Telltale signs of a rotator cuff tear

Shoulder pain is one of the main signs of a rotator cuff tear, but there are other signs that make it more likely. Where in the shoulder the pain occurs and how your shoulder moves provide helpful clues to the source of your shoulder issues.

In rotator cuff injuries, the pain is felt at the front of the shoulder. Because the rotator cuff enables shoulder mobility and provides stability, problems in these areas suggest a rotator cuff tear. Patients with rotator cuff tears have trouble raising their arms and reaching behind them. When you try to make these movements, your pain may worsen.

Because the shoulder is unstable, patients often notice a popping or clicking sound in the shoulder when moving the arm. This happens when the rotator cuff is unable to keep the upper arm bone in the shoulder socket. 

Some individuals report pain all the way to their elbow because nerves from the rotator cuff flow down the arm. Here are the main signs that suggest you have a rotator cuff tear. 

Movement restriction

It will be difficult to move your arm and shoulder normally if the rotator cuff is torn. Simple tasks like brushing your hair, dressing, and cooking will be excruciatingly painful. You may find it challenging to carry even small objects due to the lack of range of motion. Reaching overhead is particularly problematic when the rotator cuff is torn. 

Shoulder stiffness

If your rotator cuff is injured, your shoulder will become painful and stiff. Your arm will become much more rigid if you stop moving it. You may feel like your shoulder is frozen at times. 

Shoulder weakness

Your shoulder can’t hold as much weight as it usually can when your rotator cuff is damaged. Even something as small as a book may feel too heavy and your arm may become fatigued quickly. 

Repairing a rotator cuff

Dr. Pifer has experience repairing partial and full rotator cuff tears. The following are common approaches. 

Partial rotator cuff tear repair

When the rotator cuff tendon is ripped but hasn’t completely separated from the underlying bone, a partial repair can restore mobility and relieve pain. Surgery typically involves removing a portion of the acromion bone, which is situated on the shoulder blade. 

The ragged ends of the torn tendon are smoothed, and the inflamed bursa sac is removed. Damaged ligaments are removed in the process. 

Full rotator cuff tear repair

If the tendon has entirely torn or is completely separated from the upper arm bone, a comprehensive rotator cuff repair procedure is required. Depending on the degree of the damage, there are a few different procedures to complete a full rotator cuff repair.

Dr. Pifer specializes in minimally invasive arthroscopic shoulder surgery. With arthroscopic surgery, small incisions are created in the shoulder’s side and back, and Dr. Pifer removes any damage, such as bone spurs. He then reconnects the tendon to the humerus using suture anchors.

Only in cases of severe joint deterioration or serious injury is open surgery performed. Bone, cartilage, and tendons that have been injured are replaced using bone and tissue grafts from other parts of the body. The humerus bone’s head is then used to reconnect the tendon.

Dr. Pifer may use mini open surgery, which involves making a wider incision than is necessary for arthroscopic surgery but doesn’t involve opening the entire shoulder joint or using grafts.

Rotator cuff tears are serious business. Not only is a rotator cuff tear unlikely to get better on its own, but left untreated, it can progress into a chronic issue that causes more problems down the line.  

Trust an experienced shoulder surgeon to provide exceptional shoulder care when you need it most. Give us a call to schedule a visit with Dr. Pifer at our Santa Barbara, California office. A team member can assist you in scheduling an in-person or telemedicine appointment with Dr. Pifer.

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Shoulder pain can be a warning sign of a common but potentially serious injury: a rotator cuff tear. Don’t let this condition go unnoticed; learn the telltale signs and take action to protect your shoulder health.

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Your age and other factors play a role in whether arthroscopy is the right treatment option for your joint injury. It’s wise to meet with a specialist for a thorough evaluation and to discuss your options.

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For anyone looking to speed up their recovery, platelet-rich plasma (PRP) therapy is a game-changing option. Find out how this cutting-edge treatment can help you get back to your daily activities pain-free.

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Sports medicine offers a range of benefits, and you don’t have to be an athlete to reap them. Patients with a range of issues can take advantage of sports medicine programs for preventing and treating injuries.

Shoulder rotator cuff repair

Shoulder rotator cuff repair.

A ruptured rotator cuff is a serious injury with limited upper limb function. Usually complicated by subluxation of the head of the humerus.

Types of tendon rupture:
Depending on which ligaments are damaged, there are:
– Torn rotator cuff – it consists of tendons of the subscapularis, teres minor, supraspinatus and infraspinatus muscles. All of them are interconnected and with the joint capsule, provide its mobility and integrity.
– Rupture of the tendon of the biceps muscle of the shoulder
• long head
• short head
Depending on the degree of damage, they distinguish:
– Complete rupture of the ligament – in this case, all fibers of the ligament are damaged and it is torn in two.
– Partial rupture of the ligament – not all fibers are damaged, but only part of them. This condition is called a “sprain” of the ligament.

Rotator cuff injuries can be caused by various causes:
– Acute trauma. Most often, this fall on the shoulder or elbow joint, as well as a blow to the shoulder joint area, can be accompanied by damage to the tendons.
– Chronic traumatization of connective tissue structures or muscle fibers against the background of systematic loads and performance of the same type of hand movements. This reason is most often realized in athletes who are engaged in shot put, javelin throwing, rowing, weightlifting, tennis. Also, premature cuff wear occurs in people whose professions are associated with the same type of hand movements raised up: teachers writing with chalk, painters, plasterers.
– Age-related changes. Age-related changes can lead to rupture of the rotator cuff. Over time, the tendons become weaker and more easily injured.
– Congenital or acquired change in the anatomical ratio of various structures of the shoulder joint, leading to an increase in the load on the ligamentous apparatus, capsule and muscles.
– Decrease in the strength of the ligamentous apparatus, which is of a hereditary origin, realized at the genetic level (decrease in the number of collagen fibers in the connective tissue).

The symptoms of rotator cuff injuries depend on the degree of tear (complete or partial). With a partial tear, the patient can move the shoulder through the pain and often not fully. If the tendon is completely torn, a certain movement is almost impossible, and attempts to move it are painful. For example, if the tendon of the supraspinatus muscle is damaged, the abduction of the arm to the side suffers, while the subscapularis – its introduction to the opposite scapula. The patient complains of the inability to sleep on the affected shoulder. With an acute injury, severe pain occurs in the shoulder joint.

In a chronic process, pain first occurs occasionally, associated with raising the arm up. Over time, this unpleasant symptom appears more often, intensifies at night. As a result, the pain becomes constant, and the patient cannot perform the usual hand movements: comb or take off clothes without outside help. In the absence of proper timely treatment, arthrosis of the shoulder joint is formed.

Diagnosis

A reliable determination of the localization, as well as the severity of the violation of the anatomical integrity of the muscles, ligaments and tendons of the joint, is carried out with the help of additional objective diagnostics.
An x-ray examination is mandatory, with which you can detect a sign of tendon rupture – subchondral sclerosis. It is formed due to friction of the head of the humerus against the lower part of the acromion.
If the diagnosis is in doubt and to clarify the nature and severity of the injury, ultrasound or MRI is performed, which allows you to examine the soft tissues, and arthroscopy can also be performed arthroscopy.

The choice of a diagnostic examination method is carried out by a doctor on the basis of a clinical examination (includes a survey, examination of the patient, performance of diagnostic tests), as well as the technical capabilities of the medical institution, providing it with the necessary equipment to perform diagnostic procedures.

Treatment:
Conservative treatment.

If the damage is not significant (partial damage), you will be offered conservative treatment.
Treatment involves ultrasound-guided injection of platelet-rich plasma into the site of injury. If necessary, radiofrequency ablation of the suprascapular and axillary nerves is performed to eliminate pain and facilitate the performance of special exercises, as well as blockades during the recovery period.

Surgical treatment.
With a complete rupture, conservative treatment is futile. Torn ligaments will not heal on their own. To repair the rotator cuff, the operation can be performed by open access or with the help of arthroscopy.

•During a surgical operation (open approach), reconstruction of the rotator cuff in our clinic is performed through a small, 5 cm long incision on the skin. Quite often, 2-3 so-called “anchor fixators” are required to fix a torn tendon. This retainer consists of an anchor and threads. The anchor is attached to the bone, and the tendon is stitched with threads. The choice of a specific type of anchor fixator is carried out by the operating orthopedic traumatologist, however, the patient is informed in detail about which fixator is planned to be used in his case. At the Anesta clinic, we use fixators from world-famous companies that have long established themselves: HEALIX ™ by DePuyMitek (a division of Johnson & Johnson) and TWINFIX ™ by Smith & Nephew.

• During arthroscopy, 4-5 micro incisions will be made around the joint. Arthroscopic surgery begins with the removal of “non-viable” tissues (scar tissue) and bone growths from the area of ​​the shoulder joint. Next, the damaged tendons are sutured under camera control. If there is a separation of the tendon from the bone, the integrity of the anatomical structure is restored using anchor fixators.

Recovery period.
The patient walks for 3 months in a special fixator, after which it is necessary to restore movement in the shoulder. If necessary, special blockades are made to facilitate the exercise and speedy recovery.
The entire rehabilitation period is under the supervision of doctors and is included in the price.

Be attentive to pain in your shoulders – never put off going to the doctor for later, this can lead to injuries and impose permanent restrictions on your ability to work.
Do not tolerate pain in the shoulders, if the pain is not associated with the conditions described above, it can be eliminated non-surgically using blockades!
If in doubt, call us, our emergency telephone line is open 24/7:
+7 (8182) 64-30-02

Treatment of impingement syndrome (rotator cuff injury) in Yaroslavl

Description

The main complaint in this disease is diffuse dull pain in the shoulder, aggravated by raising the arm up. Many note that it interferes with sleep, especially if you lie on the side of the affected shoulder joint.

A characteristic symptom is the occurrence of acute pain when trying to reach the back pocket of the trousers. Later stages are characterized by increased pain, stiffness of the joint. Sometimes when lowering the arms, a clicking in the joint is possible.

Difficulty or impossibility of raising the arm up, weakness are possible with a rupture of the tendons of the rotator cuff – a tendon formation from the tendons of the infraspinatus, supraspinatus and subscapularis muscles. The main function of the tendon formation is the stabilization of the head of the shoulder during the abduction of the upper limb in the glenoid cavity of the scapula and its retention.

The most frequent patients with impingement syndrome are people of middle and older age . Due to post-traumatic or age-related changes, the acromial process of the scapula becomes sharpened, osteophyte spikes form on it, which leads to abrasion of the rotator cuff – which is impingement syndrome.

Treatment

If the rotator cuff is intact, conservative treatment can be started

It is necessary to limit the patient’s activity, anti-inflammatory therapy, physiotherapy, local administration of steroid drugs, it is desirable to wear a scarf. Therapeutic treatment takes from several weeks to several months, and the listed methods are usually sufficient if the disease is not advanced.

If the therapeutic treatment of impingement syndrome has not yielded results, then surgical treatment is performed.

It is also indicated for acute pain or damage to the dominant hand, when the quality of life of the patient decreases. Surgical treatment consists in arthroscopic subacromial decompression: through skin punctures with a special instrument, bone spikes from the acromial process of the scapula, compressing the rotator cuff and causing pain, are removed under the control of an arthroscope, while the joint is simultaneously washed with a large amount of isotonic solution.