Friday, 29 August 2014

Rotator Cuff Injuries

The shoulder is a complex ball-and-socket joint, which is able to move in many different planes. It is, therefore, susceptible to numerous injuries, two common types being injuries to the rotator cuff and impingement syndrome. In this blog, I will discuss rotator cuff injuries; in the next blog, I will discuss impingement syndrome.

The rotator cuff is made up of four muscles that surround the shoulder joint, providing stability to the joint. These muscles are supraspinatis, infraspinatus, teres minor and subscapularis. Chronic tears of these muscles can be caused by repetitive microtrauma to the muscles as a result of overuse.


Prevalence
Partial tears are more commonly seen in younger individuals, whereas complete tears are usually seen in adults over 30 years of age. The risk of a complete tear increases with age. Partial tears are treated conservatively, whereas complete tears may require surgical treatment.

Symptoms
·         Dull ache deep in the shoulder joint
·         Pain in the shoulder joint that can wake one when lying on the affected side
·         Difficulty with actions such as combing ones hair and putting on a jacket
·         Weakness in the arm and shoulder may also be present

Causes
·         Traumatic injury, such as a fall
·         Lifting something that is too heavy for the muscles to cope with
·         Repetitive overhead movements, such as swimming, bowling and serving in tennis
·         Bone spurs, causing rubbing of the tendons

Risk Factors
·         Age – the risk of developing a rotator cuff injury increases with age
·         Sporting activities requiring repetitive overhead movements, such as swimming, bowling and serving in tennis, increase the risk of developing a rotator cuff injury
·         Jobs that require repetitive overhead movements, such as construction jobs, increase the risk for rotator cuff injuries

Management
Conservative treatment is usually adequate to treat a rotator cuff injury:
·         Rest, ice and non-steroidal anti-inflammatory drugs
·         Physiotherapy to reduce inflammation and increase range of movement
·         Biokinetic therapy to improve muscle strength and stability around the joint
Surgical treatment may be required in the case of a complete tear.

References
Foundations of Athletic Training: Prevention, Assessment and Management

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