The rotator cuff is a group of flat tendons that connect together around the front, back, and top of the shoulder joint as a cuff on the shirt sleeve. These tendons are connected directly to the short, but very important muscles, which come from the scapula. When a muscle enters, it pulls on the rotator cuff, causing the shoulder to rotate upward, inward, or outward. The rotator cuff consists of four muscles, the subscapularis, supraspinatus, infraspinatus and small teres and their musculotendinous appendages. The subscapularis muscle is undetectable by the small nerve and protrudes from the scapula. It infiltrates into the small ignorance of the humerus.
Both supraspinatus and infraspinatus are not taken up by the suprascapular nerve, they come out of the scapula and into a more serious disease. Teres are less sensitive to axillary nerves, come out of the scapula and lead to more serious disease. The subacromial space is located below the acromion, the coracoid process, the acromioclavicular joint and the coracoacromial ligament. The bursa in the subacromial position provides lubrication to the rotator cuff. Continuous irritation of the bursa and rotator cuffs can lead to deterioration and rupture of the rotator cuff tendons. The supraspinatus tendon tendon is the most active tendon among the rotator cuff muscles.
It suffers from the most tightness of all the muscles of the rotator cuff. Rotator tube tears may be the result of a traumatic injury or temporary deterioration. Symptoms may be present, but in most cases, the patient experiences symptoms. For young adults, full tears of fabrics of full thickness are not uncommon. When they do occur, they are usually the result of a high-powered injury to the rotator cuff that is associated with shooting or high sports activities. In older people, tears of the rotator cuff are often the result of temporary wear and tear.
There are a number of factors that can cause a person to have an incontinence problem and a rotator cuff problem. The most common are the shape and thickness of the acrobatics (the bone that forms the shoulder girdle). If the acrobatics have a bone stimulus in the frontal lobe, there is a high probability of holding the rotator cuff while the arm is raised forward. Activities that involve lifting the front arm by hand can put a person at greater risk for injury to the rotator cuff. Sometimes the shoulder muscles can be balanced with injury or weakness, and balance can cause the shoulder to move forward with other activities that can lead to resistance.
The rotator cuff impingement syndrome is a common source of pain in the shoulder
Pain can be the result of:
- Tendinitis; Tendons cuff tendons can be irritated or damaged.
- Bursitis; The bursa can become inflamed and swollen with more fluid that causes pain.
- Impingement; When you raise your arm to shoulder height, the space between the acrobat and the rotator cuff decreases. The acromion can rub against the tendon and bursa, causing itching and pain.
Symptoms of rotator cuff impingement syndrome
Rotator cuff pain usually causes internal swelling and tenderness in front of the shoulder. You may experience pain and stiffness when you raise your arm. There may also be pain when the arm is lowered from a raised position. Early symptoms may be mild. Patients often do not seek treatment early. These symptoms may include:
- Minor pain that is accompanied by activity and relaxation
- Pain extending from the front of the shoulder to the side of the arm
- Sudden pain and lifting and reaching movement
- Athletes in high sports may experience pain when throwing or serving a tennis ball
As the problem progresses, symptoms increase:
- Pain at night
- Loss of strength and motion
- Difficulty performing activities that place the hand behind the spine, such as a button or zipper plug
If the pain comes on suddenly, the shoulder may become too soft. All movements can be limited and painful.
Causes of rotator cuff impingement syndrome
The most common cause of this shoulder problem is weakness of the rotator cuff muscles. The primary function of the rotator is to hold the shoulder ball in the socket while the person is working. If the muscles become weak or injured, the humeral head will be allowed to move further. The problem is probably the most well-known injury of abuse and the people who work on top athletes suffer from this problem. Other complications that cause weakness of the rotator cuff often include partial tendinitis.
Rotator cuff pain is common in young athletes and middle-aged people. Young athletes who use their hands up for swimming, baseball, and tennis are at greater risk. Those who perform repetitive lifting activities or do manual labor, such as hanging paper, construction, or painting are also involved.
In adolescents, athletes, rotator cuff injury can occur with repetitive strain, high-impact sports, or swimming. This type of injury results from the constant stretching of the rotator cuff during the next stage of the operation. The tears that occur are not caused by the insertion, but rather by the balance of the joint. This may be associated with looseness in the front of the shoulder caused by weakness in the supporting ligaments.
Diagnosis of rotator cuff impingement syndrome
Diagnosis of rotator cuff tendon disease includes a careful history taken and examined by a physician, x-rays to visualize the anatomy of the shoulder bones, in particular the search for acrobatic impulses, and physical examination. Atrophy may be present, as well as weakness, if the rotator cuffs of the rotator cuffs are injured, and special insertion tests may suggest that impingement syndrome is involved.
MRI scans often provide the final confirmation of the condition of the rotator cuff tendon. Although none of these tests have been proven to be 100% accurate, many loop injuries can be identified using this combination of tests.
Treatment of rotator cuff impingement syndrome
If minor impingement or rotator cuff tendinitis is diagnosed, the rest period will be combined with oral medications, and physical therapy will consistently reduce inflammation and restore tone to the affected muscles. Let’s look treatment options of rotator cuff impingement syndrome;
1. Exercise
Isometric stretching is important in restoring high motion. Isotonic exercise is better than multi-weight exercise. Therefore, shoulder exercises should be performed with a set weight rather than a contrasting weight such as a rubber band. Repetition is emphasized, and light weights are used. Sometimes, special sports techniques are necessary, especially when strengthening the throwing motion, serving motion or swimming motion. In addition, physical therapy methods such as electrical stimulation, ultrasound treatment and massage for passing friction may also be helpful.
2. Strengthening
Once the acute pain is over, a specific strengthening program for the rotator cuff is recommended for prevention of future injuries. The rotator cuff motion that is emphasized by tightening is internal rotation, external rotation and abduction. It is important to remember that the function of the rotator enhancer, in addition to generating torque, is to strengthen the glenohumeral cohesion; thus, the strong muscles of the rotator cuff result in better glenohumeral joint stability and less inhibition. A typical exercise program includes weight loss exercises of 4 to 8 oz, with 10 to 40 repetitions performed three to five times a week.
3. Medication
For patients with a stage of inclusion stage, conservative treatment is often sufficient. Conservative treatment includes resting and quitting offensive activities. It may also involve long-term treatment of the body. Sports and career adjustments can be beneficial. Non-steroidal anti-inflammatory drugs and ice treatments can reduce pain. Ice packs used for 20 minutes three times a day can help. Sling is never used, because adhesive capsulitis can cause immobilization.
4. Surgery
While non-surgical treatment does not reduce 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 burned part of the bursa. He can also remove part of the acrobatics. This is also known as subacromial reduction. These procedures are usually performed with an arthroscopic technique.
Your surgeon may also treat other shoulder conditions during surgery. These may include arthritis between the clavicle (collarbone) and acromion (acromioclavicular arthritis), inflammation of the biceps tendon (biceps tendonitis), or the rotator cuff part of the tear.
5. Rehabilitation
After surgery, your hand can be placed on a slingshot for a short time. This allows for early healing. As soon as your comfort allows, your doctor will remove the slingshot to begin the exercise and use of the hand.
Your doctor will provide a rehabilitation plan based on your needs and the results of the surgery. This will include exercises to restore shoulder motion and arm strength. It takes 2 to 4 months to achieve complete pain relief, but it can take up to a year.
Other treatment options
Although non-surgical treatment can take several weeks to months, most patients experience gradual improvement and return to work.
- Rest; Your doctor may recommend resting and changing activities, such as preventing high activity.
- Non-steroidal anti-inflammatory drugs; Medications like ibuprofen and naproxen reduce pain and swelling.
- Physical therapy; The physiotherapist will initially consider restoring normal motion to your shoulder. Stretching exercises to improve mobility are very helpful.