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 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. To fully comprehend rotator cuff injuries, it’s essential to understand its structure and function.

The rotator cuff 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 rotation and elevation. The tendons attach these muscles to the bone, providing the necessary support for shoulder function.

Do all rotator cuff injuries affect all four muscles simultaneously. Not necessarily. Injuries can occur in one or multiple parts of the rotator cuff, leading to similar symptoms but potentially requiring different treatment approaches.

Identifying Rotator Cuff Injuries: Key Symptoms and Warning Signs

Recognizing the symptoms of a rotator cuff injury is crucial for early diagnosis and effective treatment. While the severity of symptoms may vary, there are several common signs to watch for:

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

Is shoulder weakness always indicative of a rotator cuff injury. While it’s a primary symptom, other conditions can also cause shoulder weakness. A comprehensive evaluation by a medical professional is necessary for an accurate diagnosis.

Can rotator cuff injuries occur without noticeable pain. Yes, in some cases, particularly in older adults, rotator cuff tears can develop gradually without causing significant pain. Regular check-ups and attention to any changes in shoulder function are important for early detection.

Types of Rotator Cuff Injuries: From Tendonitis to Full Tears

Rotator cuff injuries exist on a spectrum, ranging from minor inflammation to complete tendon tears. Understanding these different types can help in recognizing the severity of the condition:

Rotator Cuff Tendonitis

Tendonitis occurs when the rotator cuff tendons 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.

Rotator Cuff Impingement

Impingement syndrome happens when the rotator cuff tendons become compressed or “pinched” between the bones of the shoulder. This can lead to inflammation and pain, particularly when raising the arm.

Partial Rotator Cuff Tears

In partial tears, the tendon is damaged but not completely severed. The extent of the tear can vary, affecting the tendon’s strength and function to different degrees.

Full-Thickness Rotator Cuff Tears

A full-thickness tear represents a complete disconnection of the tendon from the bone. This type of injury often results in significant weakness and may require surgical intervention.

Are all rotator cuff tears the result of sudden injury. No, while traumatic tears can occur from falls or accidents, many rotator cuff tears develop gradually due to age-related wear and tear, known as degenerative tears.

Risk Factors and Causes of Rotator Cuff Injuries

Several factors can increase the likelihood of developing a rotator cuff injury. Understanding these risk factors can help in prevention and early intervention:

• Age: The risk of rotator cuff injuries increases significantly after age 40
• Repetitive overhead motions: Common in certain sports and occupations
• Poor posture: Can lead to shoulder misalignment and increased strain
• Genetics: Family history may play a role in susceptibility
• Previous shoulder injuries: Can weaken the rotator cuff and increase vulnerability

Does participating in certain sports increase the risk of rotator cuff injuries. Yes, sports that involve repetitive overhead motions, such as tennis, baseball, and swimming, can put additional stress on the rotator cuff and increase the risk of injury.

Can occupational activities contribute to rotator cuff problems. Absolutely. Jobs that require frequent lifting, reaching overhead, or repetitive arm movements can lead to rotator cuff strain and potential injury over time.

Diagnostic Procedures for Rotator Cuff Injuries

Accurate diagnosis of rotator cuff injuries is crucial for determining the appropriate treatment plan. Healthcare providers utilize various diagnostic tools and procedures to assess the extent and nature of the injury:

Physical Examination

A thorough physical exam is the first step in diagnosing a rotator cuff injury. The doctor will assess range of motion, strength, and specific movements that may provoke pain or weakness.

Imaging Tests

Several imaging techniques can provide detailed information about the rotator cuff:

• X-rays: While not showing soft tissues directly, they can reveal bone spurs or arthritis
• Ultrasound: Offers real-time imaging of the rotator cuff during movement
• MRI (Magnetic Resonance Imaging): Provides detailed images of soft tissues, including partial and full tears

Specialized Tests

Doctors may perform specific maneuvers to isolate and test individual rotator cuff muscles, helping to pinpoint the location and extent of the injury.

Is an MRI always necessary for diagnosing rotator cuff injuries. While MRI provides detailed information, it’s not always required. In many cases, a combination of physical examination and less invasive imaging techniques can provide sufficient diagnostic information.

Treatment Options for Rotator Cuff Injuries: Conservative to Surgical Approaches

The treatment of rotator cuff injuries varies depending on the severity of the condition and the individual patient’s needs. A range of options is available, from conservative management to surgical intervention:

Conservative Treatment

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

Surgical Options

For more severe injuries or cases that don’t respond to conservative treatment, surgical options may be considered:

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

How long does recovery from rotator cuff surgery typically take. Recovery time can vary significantly depending on the extent of the injury and the type of surgery performed. Generally, patients can expect a recovery period of several months, with full healing potentially taking up to a year.

Are there non-surgical alternatives for treating severe rotator cuff tears. While surgery is often recommended for large or complete tears, some patients may benefit from non-surgical treatments, including targeted physical therapy and regenerative medicine techniques. The choice depends on individual factors and should be discussed with a healthcare provider.

Prevention Strategies: Maintaining Rotator Cuff Health

While not all rotator cuff injuries can be prevented, there are several strategies to reduce risk and maintain shoulder health:

• Regular shoulder strengthening exercises
• Proper warm-up before physical activities
• Maintaining good posture
• Avoiding repetitive overhead motions when possible
• Using proper technique during sports and work activities
• Taking regular breaks during repetitive tasks

Can specific exercises help prevent rotator cuff injuries. Yes, exercises that focus on strengthening the rotator cuff muscles and improving shoulder flexibility can significantly reduce the risk of injury. A physical therapist or sports medicine specialist can provide guidance on appropriate exercises.

Is it possible to continue sports or physical activities with a minor rotator cuff injury. In some cases, yes. However, it’s crucial to consult with a healthcare provider to ensure that continuing activities won’t exacerbate the injury. Modifications to technique or intensity may be necessary.

Living with Rotator Cuff Injuries: Long-Term Management and Lifestyle Adjustments

For individuals diagnosed with rotator cuff injuries, long-term management often involves a combination of ongoing care and lifestyle adjustments:

Ongoing Physical Therapy

Continued exercises and stretches can help maintain shoulder strength and flexibility, even after initial treatment or surgery.

Ergonomic Modifications

Adjusting workspaces and daily activities to reduce strain on the shoulder can prevent further injury and manage symptoms.

Activity Modifications

Adapting sports techniques or choosing alternative activities that put less stress on the rotator cuff may be necessary.

Regular Check-ups

Periodic evaluations with a healthcare provider can help monitor the condition and address any changes promptly.

Can rotator cuff injuries lead to long-term complications if left untreated. Yes, chronic rotator cuff injuries can lead to progressive weakness, reduced range of motion, and even shoulder arthritis. Early intervention and appropriate management are crucial for preventing long-term complications.

Is it possible to regain full shoulder function after a severe rotator cuff injury. While complete recovery is possible in many cases, especially with proper treatment and rehabilitation, some individuals may experience lasting limitations in strength or range of motion. The outcome depends on factors such as the severity of the injury, age, overall health, and adherence to treatment protocols.

Understanding rotator cuff injuries, from their causes and symptoms to diagnostic procedures and treatment options, is essential for anyone experiencing shoulder pain or weakness. By recognizing the signs early and seeking appropriate medical care, individuals can significantly improve their outcomes and maintain healthy, functional shoulders. Whether through conservative management, surgical intervention, or long-term lifestyle adjustments, there are numerous ways to address rotator cuff injuries and restore shoulder health.

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.