Rotator Cuff Tear
The rotator cuff is one of the most important components of the shoulder. It is comprised of a group of muscles and tendons that hold the bones of the shoulder joint together. The rotator cuff muscles provide individuals with the ability to lift their arm and reach overhead. When the rotator cuff is injured, people sometimes do not recover the full shoulder function needed to properly participate in an athletic activity. Surgery is often necessary to repair a torn rotator cuff.
Rotator Cuff Tendonitis
Pain associated with arm movement, pain in the shoulder at night – especially if lying on the shoulder – and pain associated with overhead activities like reaching for objects may all be symptoms of rotator cuff tendonitis. An inflammation of the tendons of the shoulder, rotator cuff tendonitis can occur following activities in which you repeatedly raise your arm over your head. Swimming, tennis, lifting weights and household tasks such as washing windows are some of the more common causes of rotator cuff tendonitis.
Resting the injured shoulder and ice packs will help reduce inflammation and pain. A steriod injection may reduce pain enough for physical therapy to help strengthen the shoulder muscles. If the rotator cuff has sustained a complete tear, arthroscopic surgery can repair small tears, remove bone spurs and inflamed tissue around the shoulder. Large tears may require open surgery.
Impingement is caused by excessive rubbing of the shoulder muscles against the top part of the shoulder blade, called the acromion. Impingement has many potential causes. The subacromial space becomes irritated, causing the patient to have pain in the shoulder, especially with overhead activities. Physical therapy is often required to help with the symptoms, as well as possible injections. Refractory impingement may require surgery to help restore function and alleviate pain.
Sometimes, one of the shoulder joints moves or is forced out of its normal position. This condition is called instability and can result in a dislocation of one of the joints in the shoulder. Individuals suffering from an instability problem will experience pain when raising their arm. They also may feel as if their shoulder is slipping out of place.
Bursitis can occur with overuse from repetitive activities, such as swimming, painting, or weight lifting. These activities cause rubbing or squeezing (impingement) of the rotator cuff under the acromion and in the acromioclavicular joint. Initially, these problems are treated by modifying the activity which causes the symptoms of pain and with a rehabilitation program for the shoulder.
Osteoarthritis (OA) and rheumatoid arthritis can destroy the shoulder joint and surrounding tissue. They can also cause degeneration and tearing of the capsule or the rotator cuff. Osteoarthritis occurs when the articular surface of the joint wears thin. Rheumatoid arthritis is associated with chronic inflammation of the synovium lining which can produce chemicals that eventually destroy the inner lining of the joint, including the articular surface. If non-surgical options fail to provide adequate relief, patients may benefit from total shoulder replacement.
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