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Rotator Cuff Tendonitis
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Rotator cuff tendonitis
One of the most common physical complaints is shoulder pain. Your shoulder is made up of several joints combined with tendons and muscles that allow a great range of motion in your arm.
A rotator cuff is a group of muscles and tendons that cover the head of the humerus and hold it in the shoulder socket.
Because so many different structures make up the shoulder, it is vulnerable to many different problems.
When one or more of rotator cuff tendons become damaged, the shoulder can become stiff, sore or can lose mobility.
Because so many different structures make up the shoulder, it is vulnerable to many different problems.
Variations of Rotator Cuff Tendonitis
Shoulder impingement: This occurs when the space under the acromion is so small that the supraspinatus tendon and bursa (a type of lubricating tissue) pinch whenever the arm is raised forward.
The acromion can rub against (or “impinge” on) the tendon and the bursa, causing irritation and pain.
Bursitis: The bursa can become inflamed and swell with more fluid causing pain.
Joint imbalance:
This occurs when the rotator cuff tendons or shoulder muscles are stretched or weakened from misuse, allowing the unstable joint to slide forward. Imbalance can often result from overhead arm motions that are common in many sports, such as throwing in baseball.
Rotator cuff tear:
Over time, the tendon tissue breaks down. Eventually, the tendon may tear away from its attachment to the humerus bone causing pain in the shoulder that worsens when the arm is lifted.
Sometimes, a grinding or popping sound is heard when the arm is moved.
Causes of Rotator Cuff tendonitis
Rotator cuff Injuries are often caused by direct damage, such as a traumatic fall.
They can also develop because of indirect causes such as impingement or shoulder imbalance.
They may also result from progressive degeneration or wear and tear of the tendon tissue.
Repetitive overhead activity or heavy lifting over a prolonged period of time may irritate or damage the tendon.
Factors that may increase your risk of having a rotator cuff tendonitis:
Age. As you get older, your risk of a rotator cuff injury increases. Rotator cuff tears are most common in people older than 40.
Occupations such as carpentry or house painting require repetitive arm motions, often overhead, that can damage the rotator cuff over time.
Enjoy a quick recovery
Non Surgical treatment of Rotator Cuff tendonitis
Rest. Your doctor may suggest rest and activity modification, such as avoiding overhead activities.
Non-steroidal anti-inflammatory medicines. Drugs like ibuprofen and naproxen reduce pain and swelling.
Physical therapy. A physical therapist will initially focus on restoring normal motion to your shoulder. Stretching exercises to improve range of motion are very helpful. Specific stretching of the posterior capsule can be very effective in relieving pain in the shoulder.
Steroid injection. If rest, medications, and physical therapy do not relieve your pain, an injection of a local anesthetic and a cortisone preparation may be helpful. Cortisone is a very effective anti-inflammatory medicine. Injecting it into the bursa beneath the acromion can relieve pain.
Surgical Treatment
When nonsurgical treatment does not relieve pain, your doctor may recommend surgery.
The goal of surgery is to create more space for the rotator cuff. To do this, your doctor will remove the inflamed portion of the bursa. He or she may also perform an anterior acromioplasty, in which part of the acromion is removed.
These procedures can be performed using either an arthroscopic or open technique.
Surgical options available
Arthroscopic technique. In arthroscopy, thin surgical instruments are inserted into two or three small puncture wounds around your shoulder. Your doctor will then examines your shoulder through a fiberoptic scope connected to a television camera. He or she will guide the small instruments using a video monitor, and then remove bone and soft tissue.
Your surgeon may also treat other conditions present in the shoulder at the time of surgery. These can include arthritis between the clavicle (collarbone) and the acromion (acromioclavicular arthritis), inflammation of the biceps tendon (biceps tendonitis), or a partial rotator cuff tear.
Open surgical technique. In open surgery, your doctor will make a small incision in the front of your shoulder. This allows your doctor to see the acromion and rotator cuff directly.
Rehabilitation. After surgery, your arm may be placed in a sling for a short period of time. This allows for early healing. As soon as your comfort allows, your doctor will then remove the sling to begin exercises.
Your doctor will provide a rehabilitation program based on your needs and the findings at surgery. This will include exercises to regain range of motion of the shoulder and strength of the arm.