BACKGROUND: The rotator cuff is made up of tendons and muscles in the shoulder. The tendons and muscles connect the upper arm bone with the shoulder blade and they hold the ball of the upper arm bone in the shoulder socket. The combination means greater range of motion of any joint in the body. A rotator cuff injury can include any type of irradiation or damage to the tendons and muscles. Causes of an injury can include lifting, falling, and repetitive arm activities (usually those that are done overhead like throwing a baseball). About 50 percent of rotator cuff injuries can heal with self-care or exercise therapy. (Source: www.mayoclinic.com).
SYMPTOMS: Rotator cuff injury symptoms can include: shoulder weakness, loss of shoulder range of motion, inclination to keep the shoulder inactive, and pain and tenderness in the shoulder. The most common symptom is pain. A lot of times it is experienced when a person reaches for a comb, for example. Lying on the shoulder can also be painful. (Source: www.mayoclinic.com)
INJURY: The four major muscles, supraspinatus, infraspinatus, teres minor, and subscapularis, and their tendons connect the upper arm bone with the shoulder blade. A rotator cuff injury, which is common, involves any type of damage or irritation to the muscles or tendons, including:
- Tendinitis: tendons in the rotator cuff can become inflamed due to overuse, especially if you are an athlete.
- Strain or tear: if tendinitis is left untreated, it can weaken a tendon and lead to chronic tendon degeneration or to a tendon tear.
- Bursitis: the fluid-filled sac between the shoulder joint and rotator cuff tendons can become inflamed and irritated. (Source: www.mayoclinic.com)
NEW TECHNOLOGY: In the United States, at least ten percent of people over sixty, or close to six million people, will develop a rotator cuff tear. Usually treatment for rotator cuff injuries involves exercise therapy. Other treatments can include surgery, steroid injections, and arthroplasty. Now, the physical therapy program out of Vanderbilt University Medical Center can effectively treat most patients with full-thickness rotator cuff tears and shoulder pain, without the need for surgery. The study included 396 patients ages 18 to 100 who had atraumatic full-thickness tears that were documented by magnetic resonance imaging and no other abnormality. Most patients were assigned to a physical therapy program, which included daily postural exercise, active-assisted motion, active training of scapula muscles, and active range of motion, also with anterior and posterior shoulder stretching. They also performed three weekly rotator cuff and scapula exercises. The patients returned at six and 12 weeks. At this point they could decide that treatment was successful and did not need a follow-up, they had improved but would like to continue therapy, or the non-operative treatment had failed and they need arthroscopic rotator cuff repair. The researchers contacted the patients by phone at one and two years to determine whether they had undergone surgery since their last visit. At six weeks, the data showed that fewer than 10 percent of patients had decided to go forth with the surgery. For patients to whom follow-up data was available at the two year mark, only two percent had the surgery. The finding suggests that pain may be a less suitable indication for rotator cuff repair than is weakness or loss of function. Researchers hope that future studies will identify risk factors that can predict progression to rotator cuff tears and symptom onset, but also which repaired tears are likely to fail. (Source: http://www.medscape.com/viewarticle/737461)