How can you identify a rotator cuff injury. What are the common symptoms of rotator cuff tears. Which treatments are most effective for rotator cuff problems. When should you seek medical attention for shoulder pain.

Understanding the Rotator Cuff: Anatomy and Function

The rotator cuff is a crucial component of the shoulder joint, playing a vital role in arm movement and stability. It consists of four muscles and their associated tendons:

• Supraspinatus
• Infraspinatus
• Subscapularis
• Teres minor

These muscles work together to stabilize the shoulder joint and enable various arm movements, including lifting and rotation. Understanding the anatomy of the rotator cuff is essential for recognizing potential injuries and seeking appropriate treatment.

Common Symptoms of Rotator Cuff Injuries

Rotator cuff injuries can manifest in various ways, but some common symptoms include:

• Shoulder weakness
• Pain when lifting or rotating the arm
• Difficulty sleeping on the affected side
• Clicking or popping sensations during movement
• Reduced range of motion

Do all rotator cuff injuries cause immediate pain? Not necessarily. Some individuals may experience gradual onset of symptoms, while others might notice a sudden loss of strength or mobility.

The Importance of Shoulder Weakness as a Key Indicator

According to Dr. Christopher Kim, an orthopaedic surgeon specializing in sports medicine, shoulder weakness is the primary sign of a rotator cuff injury. If you struggle to lift your arm above your head, it’s likely that there’s an issue with your rotator cuff. This weakness can be present even if you don’t experience significant pain, making it a crucial symptom to watch for.

Types of Rotator Cuff Injuries

Rotator cuff injuries can range from minor inflammation to complete tears. Understanding the different types can help in seeking appropriate treatment:

Rotator Cuff Tendonitis

Tendonitis occurs when the tendons of the rotator cuff become irritated and inflamed. This condition often develops over time due to repetitive motions or prolonged pressure on the shoulder, such as sleeping on the same side every night. Symptoms may include pain and discomfort, especially when raising the arm above the head.

Impingement and Bursitis

Impingement syndrome occurs when the space around the rotator cuff narrows, causing the tendons to rub against other parts of the shoulder. This can lead to inflammation of the bursa, a fluid-filled sac that allows for smooth movement in the joint. The result is a condition known as bursitis, which can cause pain and limited mobility.

Partial Rotator Cuff Tears

In partial tears, the tendon is damaged but still partially attached to the bone. These tears can vary in severity and may be caused by either acute injury or gradual wear and tear.

Full-Thickness Rotator Cuff Tears

A full-thickness tear is a complete disconnection of the tendon from the bone. These tears create a hole where the muscle should attach and often require surgical intervention for proper healing.

Causes and Risk Factors for Rotator Cuff Injuries

Rotator cuff injuries can result from various factors, including:

• Age-related degeneration
• Repetitive overhead motions
• Acute trauma (e.g., falls or sports injuries)
• Occupational hazards
• Poor posture or improper lifting techniques

Is age a significant factor in rotator cuff injuries? Indeed, the risk of rotator cuff problems increases with age. Dr. Kim notes that individuals over 40 are more susceptible to degenerative tears, and those in their 60s, 70s, and 80s may have rotator cuff tears without even realizing it.

Diagnosis of Rotator Cuff Injuries

Accurately diagnosing a rotator cuff injury requires a comprehensive approach:

1. Physical examination
2. Range of motion tests
3. Strength assessments
4. Imaging studies (e.g., X-rays, MRI, or ultrasound)

A sports medicine physician or orthopedic specialist will typically perform these evaluations to determine the nature and extent of the injury. They will also rule out other potential causes of shoulder pain, such as cervical spine issues or biceps tendon problems.

The Role of Specialized Tests

Physicians may use specific tests to evaluate rotator cuff function and identify areas of weakness or pain. These may include:

• Empty can test
• Drop arm test
• External rotation lag sign
• Hawkins-Kennedy impingement test

These tests help pinpoint which part of the rotator cuff is affected and guide treatment decisions.

Treatment Options for Rotator Cuff Injuries

The appropriate treatment for a rotator cuff injury depends on the type and severity of the problem. Options may include:

Conservative Treatments

• Rest and activity modification
• Ice or heat therapy
• Anti-inflammatory medications
• Physical therapy exercises
• Corticosteroid injections

How effective are conservative treatments for rotator cuff injuries? Many patients experience significant improvement with non-surgical approaches, particularly for minor tears, tendonitis, or impingement syndrome.

Surgical Interventions

In cases of severe or complete tears, or when conservative treatments fail to provide relief, surgery may be necessary. Surgical options include:

• Arthroscopic repair
• Open repair
• Tendon transfer
• Shoulder replacement (in severe cases)

The choice of surgical technique depends on factors such as the size and location of the tear, the patient’s age, and overall health status.

Prevention and Rehabilitation Strategies

Preventing rotator cuff injuries and promoting optimal recovery involves several key strategies:

Strengthening Exercises

Regular exercises targeting the rotator cuff and surrounding muscles can help maintain shoulder stability and prevent injuries. Some effective exercises include:

• External and internal rotation exercises
• Scapular stabilization exercises
• Shoulder blade squeezes
• Wall slides

Proper Technique and Posture

Maintaining good posture and using proper form during activities that involve overhead motions can reduce the risk of rotator cuff injuries. This is particularly important for athletes and individuals whose occupations require repetitive shoulder movements.

Gradual Progression in Activities

When starting a new exercise routine or returning to activities after an injury, it’s crucial to progress gradually. This allows the muscles and tendons to adapt and strengthen over time, reducing the risk of re-injury.

Stretching and Flexibility

Regular stretching exercises can help maintain flexibility in the shoulder joint and surrounding muscles. This can improve range of motion and reduce the risk of impingement or other rotator cuff problems.

How often should you perform rotator cuff exercises? For prevention, aim to incorporate rotator cuff strengthening exercises into your routine 2-3 times per week. If you’re recovering from an injury, follow your healthcare provider’s specific recommendations.

When to Seek Medical Attention

While some minor rotator cuff issues may improve with rest and home care, certain symptoms warrant prompt medical attention:

• Sudden, severe pain following an injury
• Inability to lift the arm or perform daily activities
• Persistent pain lasting more than a few weeks
• Noticeable weakness or loss of function in the shoulder
• Night pain that interferes with sleep

Early intervention can prevent further damage and improve outcomes for rotator cuff injuries.

The Importance of Proper Diagnosis

Given the complex nature of shoulder injuries, it’s crucial to obtain an accurate diagnosis from a qualified healthcare professional. A sports medicine physician or orthopedic specialist can differentiate between various shoulder conditions and develop an appropriate treatment plan tailored to your specific needs.

Can rotator cuff injuries heal on their own? While minor strains or inflammation may improve with rest and conservative care, complete tears or significant partial tears typically require medical intervention for proper healing and restoration of function.

Long-Term Outlook and Management

The prognosis for rotator cuff injuries varies depending on the severity of the injury, the patient’s age, and overall health. With proper treatment and rehabilitation, many individuals can regain strength and function in their shoulder. However, some key considerations for long-term management include:

Ongoing Maintenance

Even after successful treatment, it’s important to continue with appropriate exercises and activity modifications to maintain shoulder health and prevent future injuries.

Lifestyle Adjustments

Depending on the extent of the injury, some individuals may need to make long-term adjustments to their activities or occupations to avoid re-injury.

Regular Check-ups

Periodic evaluations with a healthcare provider can help monitor the shoulder’s condition and address any new concerns promptly.

Is it possible to regain full strength after a rotator cuff injury? Many patients can achieve significant improvement in strength and function with proper treatment and rehabilitation. However, the extent of recovery may vary based on factors such as the severity of the injury and the individual’s commitment to the rehabilitation process.

Emerging Treatments and Research

The field of rotator cuff treatment continues to evolve, with ongoing research into new approaches and technologies. Some promising areas of investigation include:

Biological Augmentation

Researchers are exploring the use of growth factors, stem cells, and other biological agents to enhance healing and improve outcomes in rotator cuff repairs.

Advanced Imaging Techniques

Innovations in imaging technology, such as high-resolution ultrasound and advanced MRI protocols, are improving the accuracy of diagnosis and helping guide treatment decisions.

Minimally Invasive Procedures

Continued refinement of arthroscopic techniques and the development of new minimally invasive approaches aim to reduce surgical trauma and improve recovery times.

What role might regenerative medicine play in treating rotator cuff injuries? While still in the experimental stages, regenerative medicine techniques such as platelet-rich plasma (PRP) injections and stem cell therapy show promise in promoting tissue healing and potentially improving outcomes for certain rotator cuff injuries.

Understanding the complexities of rotator cuff injuries and staying informed about treatment options can help individuals make informed decisions about their shoulder health. By recognizing the signs of rotator cuff problems early and seeking appropriate care, patients can optimize their chances of successful recovery and maintain long-term shoulder function.

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.

How Sports Medicine Can Help You Prevent Injuries and Stay in the Game

Pushing your limits on the field shouldn’t mean risking your well-being. Teaming up with a sports medicine professional can be a game-changer. Uncover how this partnership helps you stay healthy and in the game.

Are You Experiencing These Telltale Signs of a Rotator Cuff Tear?

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.

Here’s When Arthroscopy Is the Right Course of Action

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.

Is PRP Right for Me?

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.

How to Tell If You Have Shoulder Instability

Shoulder instability is not only painful but risky if left untreated. Having a specialist examine your shoulder is the first step to diagnosing shoulder instability. Once diagnosed, treatment eases pain and restores function.

Why You Should Consider Sports Medicine If You’re Not an Athlete

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.