Post by Joey Smith on Jul 23, 2006 0:46:46 GMT -5
Rotator Cuff Injury
What are the rotator cuff muscles?
The rotator cuff muscles control rotation of the shoulder. They consist of the infraspinatus, teres minor and supraspinatus which rotate the shoulder outwards and the subscapularis which is one of the muscles which rotate the shoulder inwards.
These rotator cuff muscles are put under a great deal of strain especially in throwing events and racket sports where your arm is above your head a lot. A sudden sharp pain in the shoulder would indicate a possible rupture of a tendon, while a gradual onset is more likely to be inflammation
Symptoms of rotator cuff muscles include:
Pain on overhead activity such as throwing or racket sports.
Pain when you bend the arm and rotate it outwards against resistance.
Pain on the outside of the shoulder possibly radiating down into the arm.
Pain in the shoulder which is worse at night.
Stiffness in the shoulder joint.
What can the athlete to combat rotator cuff injury?
Rest and ice the shoulder for 2 to 4 days depending on how bad the injury is.
If the acute stage is over, pain and inflammation have settled down apply heat.
See a sports injury professional who can advise on treatment and rehabilitation.
It is easier to prevent this injury from occurring in the first place. Careful attention should be applied to strengthening the rotator cuff muscles by doing outward rotation exercises with elastic or light weights.
Rotator Cuff Injury Treatment
Self-Care at Home
Rest the injured shoulder.
Apply ice for 20-minute periods at least 3 times a day for the first 2 days after the injury. A helpful hint for applying ice to the shoulder would be to use a large Ace bandage to wrap over the top of the ice on the shoulder. The wrap can be taken around the injured arm and across the body.
Apply heat after 2 days of applying ice. Warmth may be helpful. You can lay a heating pad over the shoulder while sitting up.
Take ibuprofen to decrease the pain and swelling. Do not take if you have an allergy to it or other medical concerns, such as stomach or kidney problems.
Medical Treatment
Chronic tear
Pain control usually is the goal of treatment. This can be accomplished with rest and ibuprofen.
Occasionally, injections of steroids into the shoulder joint are helpful.
Perform passive range-of-motion exercises (often best initially done with a physical therapist).
People with continued pain may require surgery and follow-up with an orthopedic surgeon.
Acute tear
Apply ice to decrease swelling. Wrap the ice in a cloth to avoid freezing the skin. Apply the wrapped ice 10-15 minutes at a time. This is most helpful in the first 1-2 days.
Anti-inflammatory medications may help reduce pain and swelling. Medicines such as ibuprofen (Advil, Motrin) or naproxen sodium (Aleve) are examples available over the counter.
Support the arm in a sling to rest the rotator cuff muscles. The sling may be taken off at night.
The emergency physician may ask you to be seen for follow-up, either by a primary care doctor or an orthopedic surgeon (specialist).
Further imaging may be required to determine the degree and involvement of muscle tear. This is often done via magnetic resonance imaging.
Early surgery (within 3 weeks) to repair the tendon is often needed, especially for younger, more active people.
Indications for surgical treatment
Usually for people younger than 60 years
For complete tears
An option after failure to improve after 6 weeks of proper treatment
If the person has a job that requires constant shoulder use
Tendinitis
Beginning care
Apply ice packs for 20-minute periods several times a day.
Rest the shoulder in a sling for a short period of time. Prolonged use of the sling can cause stiffness, weakness, and loss of motion of the shoulder joint.
Take anti-inflammatory medicines, such as ibuprofen or aspirin.
More severe cases
Use techniques described for beginning care.
Possible injections of steroids may be made into the shoulder joint.
As things improve (2-3 days), discontinue the use of ice. Apply heat packs with massage.
Perform Codman exercises. These are passive range-of-motion exercises (often initially done with a physical therapist). These exercises are done to increase slowly the amount of motion of the shoulder while putting a low amount of stress on the rotator cuff itself. The exercises are performed as the person leans toward the injured side with the arm hanging freely and slowly moving the arm in a circle. Initially, the circles are small. With improvement and decrease in pain, the circles enlarge.
Also, holding a broomstick with both hands and moving them in a large arc while relaxing the affected shoulder can passively stretch the soft tissues. Later, active motion may be achieved by walking your fingers up a wall with the affected arm.
Next Steps
Follow-up
An orthopedic surgeon (bone doctor) can evaluate further pain or problems and possible need for surgery.
For both routine care and after surgery, work with a physical therapist. Your doctor can refer you.
Prevention
Avoiding a direct landing on the shoulder in sports or falls is the surest prevention but may be easier said than done.
Seek early medical attention if shoulder pain develops because of overuse.
What are the rotator cuff muscles?
The rotator cuff muscles control rotation of the shoulder. They consist of the infraspinatus, teres minor and supraspinatus which rotate the shoulder outwards and the subscapularis which is one of the muscles which rotate the shoulder inwards.
These rotator cuff muscles are put under a great deal of strain especially in throwing events and racket sports where your arm is above your head a lot. A sudden sharp pain in the shoulder would indicate a possible rupture of a tendon, while a gradual onset is more likely to be inflammation
Symptoms of rotator cuff muscles include:
Pain on overhead activity such as throwing or racket sports.
Pain when you bend the arm and rotate it outwards against resistance.
Pain on the outside of the shoulder possibly radiating down into the arm.
Pain in the shoulder which is worse at night.
Stiffness in the shoulder joint.
What can the athlete to combat rotator cuff injury?
Rest and ice the shoulder for 2 to 4 days depending on how bad the injury is.
If the acute stage is over, pain and inflammation have settled down apply heat.
See a sports injury professional who can advise on treatment and rehabilitation.
It is easier to prevent this injury from occurring in the first place. Careful attention should be applied to strengthening the rotator cuff muscles by doing outward rotation exercises with elastic or light weights.
Rotator Cuff Injury Treatment
Self-Care at Home
Rest the injured shoulder.
Apply ice for 20-minute periods at least 3 times a day for the first 2 days after the injury. A helpful hint for applying ice to the shoulder would be to use a large Ace bandage to wrap over the top of the ice on the shoulder. The wrap can be taken around the injured arm and across the body.
Apply heat after 2 days of applying ice. Warmth may be helpful. You can lay a heating pad over the shoulder while sitting up.
Take ibuprofen to decrease the pain and swelling. Do not take if you have an allergy to it or other medical concerns, such as stomach or kidney problems.
Medical Treatment
Chronic tear
Pain control usually is the goal of treatment. This can be accomplished with rest and ibuprofen.
Occasionally, injections of steroids into the shoulder joint are helpful.
Perform passive range-of-motion exercises (often best initially done with a physical therapist).
People with continued pain may require surgery and follow-up with an orthopedic surgeon.
Acute tear
Apply ice to decrease swelling. Wrap the ice in a cloth to avoid freezing the skin. Apply the wrapped ice 10-15 minutes at a time. This is most helpful in the first 1-2 days.
Anti-inflammatory medications may help reduce pain and swelling. Medicines such as ibuprofen (Advil, Motrin) or naproxen sodium (Aleve) are examples available over the counter.
Support the arm in a sling to rest the rotator cuff muscles. The sling may be taken off at night.
The emergency physician may ask you to be seen for follow-up, either by a primary care doctor or an orthopedic surgeon (specialist).
Further imaging may be required to determine the degree and involvement of muscle tear. This is often done via magnetic resonance imaging.
Early surgery (within 3 weeks) to repair the tendon is often needed, especially for younger, more active people.
Indications for surgical treatment
Usually for people younger than 60 years
For complete tears
An option after failure to improve after 6 weeks of proper treatment
If the person has a job that requires constant shoulder use
Tendinitis
Beginning care
Apply ice packs for 20-minute periods several times a day.
Rest the shoulder in a sling for a short period of time. Prolonged use of the sling can cause stiffness, weakness, and loss of motion of the shoulder joint.
Take anti-inflammatory medicines, such as ibuprofen or aspirin.
More severe cases
Use techniques described for beginning care.
Possible injections of steroids may be made into the shoulder joint.
As things improve (2-3 days), discontinue the use of ice. Apply heat packs with massage.
Perform Codman exercises. These are passive range-of-motion exercises (often initially done with a physical therapist). These exercises are done to increase slowly the amount of motion of the shoulder while putting a low amount of stress on the rotator cuff itself. The exercises are performed as the person leans toward the injured side with the arm hanging freely and slowly moving the arm in a circle. Initially, the circles are small. With improvement and decrease in pain, the circles enlarge.
Also, holding a broomstick with both hands and moving them in a large arc while relaxing the affected shoulder can passively stretch the soft tissues. Later, active motion may be achieved by walking your fingers up a wall with the affected arm.
Next Steps
Follow-up
An orthopedic surgeon (bone doctor) can evaluate further pain or problems and possible need for surgery.
For both routine care and after surgery, work with a physical therapist. Your doctor can refer you.
Prevention
Avoiding a direct landing on the shoulder in sports or falls is the surest prevention but may be easier said than done.
Seek early medical attention if shoulder pain develops because of overuse.