Shoulder Injury - Rotator cuff tendonitis
Definition:
An inflammation of the tendons of the shoulder.
Causes and risks:
The shoulder joint is a ball and socket type joint where the top part of the arm bone (humerus) forms a joint with the shoulder blade (scapula). The rotator cuff holds the head of the humerus into the scapula.
Tearing and inflammation of the tendons of the shoulder muscles can occur in sports requiring the arm to be moved over the head repeatedly as in tennis, pitching, swimming, and lifting weights over the head. Chronic inflammation or injury can cause tearing of the rotator cuff.
Risk factors:
Age of over 40 years and participation in sports or exercise that involves repetitive arm motion over the head (such as baseball).
Prevention:
Avoid repetitive overhead movements. Develop shoulder strength in opposing muscle groups.
Symptoms:
• pain associated with the arm movement
• pain in the arm at night
• difficulty reaching behind the back
Signs and tests:
A physical examination will reveal tenderness over the head of the humerus. There is also usually weakness of the shoulder when it is placed in specific positions.
X-rays may show a bone spur and an MRI will demonstrate inflammation in the rotator cuff and can usually determine if there is a tear in the rotator cuff.
Treatment:
The injured shoulder should be rested from the activities that caused the problem and from activities that cause pain. Intermittent ice packs applied to the shoulder and non-steroidal anti-inflammatory drugs will help reduce inflammation and pain.
Physical therapy to strengthen the muscles of the rotator cuff needs to be started. If the pain persists or if therapy is not possible because of severe pain, a steroid injection usually reduces pain and inflammation enough to allow effective therapy.
If the rotator cuff has sustained a complete tear, or if the symptoms persist despite conservative therapy, surgery may be indicated. Arthroscopic surgery can remove bone spurs and inflamed tissue around the shoulder. Small tears can be treated with arthroscopic surgery although larger tears require open surgery through a larger incision to repair the torn tendon.
Prognosis:
Most people recover full function after a combination of medications, physical therapy and steroid injections. For patients with tendonitis and a bone spur, arthroscopic surgery is very successful in restoring them to their pre-injury level of activity. People with tears of their rotator cuff tend to do well, although their outcome is strongly dependent upon the size and duration of the tear.
Source: National Institutes of Health
Read what orthopaedics specialist,
R. Sean Churchill, M.D. with Advanced Healthcare,
recommends for patients with severe shoulder damage or osteoarthritis.
