Rotator Cuff Tear Symptoms, Diagnosis and Treatment

• What is Rotator Cuff?

• Rotator Cuff Common Injuries:

• Understanding Rotator Cuff Tears:

• Symptoms of Rotator Cuff Tear:

• Physical Therapies for Treatment of Rotator Cuff Tear:

• Rotator Cuff Tendinitis:

• Symptoms of Rotator Cuff Tendinitis:

• Treatments of Rotator Cuff Tendinitis:

Our shoulders are involved in so many activities. Shoulders help to pick something, put something on, comb the hair, throw something or even play a game such as the golf or tennis. No doubt, the body or physical procedures sound very simple but these are based on complex working. The rotator cuff is an important part of this complex working. It makes the joints move around and also provides protection. The role of the rotator cuff is very obvious in sports such as tennis, basketball, swimming, and hockey.

What is Rotator Cuff?

A rotator cuff is based on tendons and muscles keeping the ball (head) of the femur (upper arm’s bone) in the socket of the shoulder. It also supports the arms while rotating or raising.

The following are components of the rotator cuff and supports in different activities.

• Supraspinatus: It keeps the upper arms stable while holding the humerus in its place. It is important to lift the arms.
• Infraspinatus: It is the main muscle which supports the body to extend and rotate the shoulders.
• Teres Minor: This is a small muscle of rotator cuff. It provides assistance while you move the arms away from your body.
• Subscapularis: This muscle holds the bone of upper arm connecting it with the shoulder blade. It also supports in arm rotation and keeps the arms straight.

Read More: How to Relieve Shoulder Pain Quickly

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Rotator Cuff Common Injuries:

In a broad manner, the rotator cuff tear occurs because of the daily wear and tear. The chances of rotator cuff tear will be higher if you perform a job in which you move the arms up and down in a repetitive manner. For example, the carpenters, painters, and people who play sports including baseball, basketball, tennis or hockey. The rotator cuff tear may also occur suddenly especially if you try to lift something heavier than your capacity or you fall on the arms. Both medication and physical therapies can be used to treat this injury. However, the doctors may recommend surgical treatments in more serious cases.

Tendinitis: It is a type of inflammation of the tendon. It is also considered a tendon irritation. The injured areas show pain and burning sensation. Swimmer’s shoulder and Pitcher’s shoulder are some common types of this injury.

Bursitis: It is a condition of bursa irritation. Bursa is a fluid-filled sac which protects the rotator cuff. Irritation in the bursa happens when someone repeats the similar motion again and again. For example, it may happen while lifting something overhead or throwing the baseball.

Both bursitis and tendinitis can be treated with the help of simple strategies. Take proper rest until you feel improvement. Use ice or heat (Coldest Ice Pack) on the wounded area. Take some over the counter painkillers such as ibuprofen, naproxen, and aspirin. Both the injuries can get better or heal with the passage of time if you use the above-mentioned combination. Other treatments include:

• Avoid overhead sports such as swimming, volleyball, baseball, and others.
• Avoid repetitive motions.
• Try a combination of cold and heat therapy.
• Use painkillers (over the counter).
• Promote mobility by using stretching or other workouts.

Call the physician if swelling or pain lasts more than 15 days or if pain disturbs your daily routines.

Understanding Rotator Cuff Tears:

It is a common injury which occurs during sports such as tennis or volleyball. It is also common among people who perform jobs involving repetitive motions such as painters, window cleaners, sweepers and carpenters. Normally, it happens with the passage of time when someone repeats the arms in a similar motion again and again. However, it can happen suddenly in case of an accident or fall on the arm. The rotator cuff is a combination of tendons and muscles. These are important to stabilize the shoulder joints. It also supports an arm lifting and rotating.

The rotator cuff tear is of two types. The first one is known as “Partial Tear” in which tendon (supporting the top of shoulder) gets damaged or frayed. The second type is a complete tear. It happens when a tendon gets disconnected from the bone.

Read More: Repetitive Motion Injuries Causes, Systems, Prevention

Symptoms, Diagnosis, and Treatment

Symptoms of Rotator Cuff Tear:

Normally, the patients don’t feel when rotator cuff tear happened. Following symptoms can help the patients to identify this injury.

• Facing difficulty while raising the arms.
• Pain in the arms while moving or lying on them.
• Shoulder weakness.
• Inability to lift different things such as a light shopping bag.
• Hear popping or clicking when moving the arms.

Immediately visit the doctor if you notice one of these symptoms. A torn rotator cuff left untreated could create more troubles in future if you ignore it. This can lead to arthritis or frozen shoulder. Both are difficult to treat injuries.

Diagnosing Rotator Cuff Tear:

A doctor will examine the shoulder and take the history of your physical activity while diagnosing the torn rotator cuff. Muscle strength and range of motion are two main points of this physical checkup. The doctor will also see what type of movement makes the shoulder hurt.

In addition, the doctor may recommend one of these technologies.

• MRI: This is a modern imaging technology which uses a powerful magnet and radio waves to take a picture of the infected area.
• X-rays: These are used to find the location or placement of the top arm bone as well as space between it and rotator cuff.
• Ultrasound: This technology is useful to recognize damage to soft tissues including the tendons, bursas, and muscles of shoulders.

Treatments Rotator Cuff Tear:

The doctors usually begin with a special combination of therapies such as physical therapy. This combination makes the shoulder muscles powerful and stronger. The doctors also recommend medicines such as NSAID’s and painkillers to control swelling and pain. In some major cases, doctors may choose surgical treatments.

In minor injuries, the doctors prefer to use home remedies and exercises. They will recommend simple or comfortable workouts to improve the shoulder muscles, tendons, and bones. This will bring improvement day by day.

Surgery would be required if all these things don’t show any positive outcome. This frequently happens in case of a complete tear. In this case, the doctor will have to reattach the bones with tendons or stitch the torn area of the tendon. The doctors may also need to remove small pieces of bones, tendons or muscles creating trouble in range of motion or he may remove these completely before inserting a new one. Following are common surgeries for the rotator cuff.

Arthroscopic: It involves a small cut in the shoulder. A tool called arthroscope is used to make this cut. This tool is equipped with a little camera and several instruments to treat the tear. This ensures a quicker recovery.

Open surgery: The doctors utilize bigger tools to fix tears. These tools are inserted in the bones or muscles of shoulders for the treatment.

Mini-open: This is a combination of open and arthroscopic techniques. The surgery is started with an arthroscope and ended up with bigger tools.

Rotator Cuff Tear Recovery:

Doctors recommend using sling after surgery for a period of 4 to 6 weeks. He may also suggest following workouts to speed up the recovery process.

• Move the arm parts such as wrist and elbow several times a day. You will need to remove the sling for this purpose. This improves the blood circulation in the injured area.
• In case of swelling and pain in the shoulder, coldest ice pack provides quick relief with an application of 20 minutes two to three times a day.
• Most important: Never pick anything heavier. Don’t put pressure or weight on shoulders. You can resume previous activities after the permission of the doctor.

The time of recovery depends on the severity of the injury or how the injury happened. It also depends on the duration of rotator cuff tear or level of ignorance after injury. The recovery chances would be higher if tears are small and minute. Be consistent and patient. Rotator cuff tear recovery is a slow but gradual process. It may take more than 12 months to bring the shoulder back to normal activity.

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Physical Therapies for Treatment of Rotator Cuff Tear:

Rotator cuff tear is a common injury and millions of people around the globe face it every year. It is a major cause of pain in the shoulder. Choosing the right treatment is important to heal the injury properly and to keep the small injuries from being serious. Physical therapy is the most suitable option for most patients. In most cases, physical therapy acts as a first but last treatment to heal the shoulder pain.

Physical therapy is an excellent approach to improve the movement and strength of arms. It includes many different steps such as cold and heat massage, workouts and others. All the types of physical therapies and workouts improve range of motion.

Rotator Cuff for you:

Actually, the rotator cuff is a combination of muscles and tendons in the shoulders. Over the arms, there is a cuff which is usually made by the rotator cuff. This is essential to move and lift the arms as well as for movement of shoulders.

People above 40 years have a higher risk of getting rotator cuff tear. As mentioned above, this injury happens because of the daily wear and tear so it is necessary to use a careful approach. Repeating similar motions or activities over and over is the main cause of this injury. The rotator cuff tear could be mild to severe. In a severe injury, the tear could separate the tendon from the bone.

Is Physical Therapy For Me?

First of all, see the doctor if you think that there is a rotator cuff tear. The doctor will examine your shoulder, bones, joints or tendons. It would be better to visit the specialist such as an orthopedic surgeon. Based on physical examination and other tests, the doctor will talk about surgical as well as nonsurgical treatments including physical therapy of rotator cuff tear.

Physical therapy is also taken as the first step in case of severe injury. The therapist will start a discussion with your daily routines and activities. He will also want information about the accidents or falls. The therapist may ask to conduct some tests such as stretching to recognize the level of pain. Therapists usually raise the patient’s arm, push it against a wall or something and move the arm to the side. These things are to evaluate the situation.

Regular use of physical therapy provides support in various ways. According to a medical study, physical therapy is very useful to treat the rotator cuff tear for people who have used surgical or nonsurgical treatments. Hiring a therapist for rotator cuff tear treatment will help you to:

• Maintain the range of motion.
• Identify workouts to strengthen the shoulder tendons and muscles.
• Improve your posture (the way you sit or stand).
• Learn to pick weights in a safe way.
• Use cold or heat massage of the injured area.
• Identify why the continuous movement is necessary.
• Find safe ways to avoid injury in the future.
• Retain the previous activities. Don’t rush. You need to consistent and patient in this matter.

The physical therapies are also important for people who have received rotator cuff surgery. The idea of using this strategy is to improve the muscle strength for the regular range of motion. It will also help to avoid the injury in the future.

Monitor any change such as swelling or pain after the complete recovery. It is necessary to notice little changes if you want to avoid further injury. This is the best approach to keep this issue away from your shoulders.

Read More: What are the Benefits of Cold Therapy?

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Rotator Cuff Tendinitis:

The rotator cuff tendinitis is more common among the older people. This type of pain is common for the people who have crossed the age of 30 years. Ignoring the pain or swelling in rotator cuff may lead to severe stiffness as well as weakness in the shoulder. It is very easy to treat the rotator cuff tendinitis if you diagnose it early.

The rotator cuff is a special band of muscles and tendons. This combination makes the upper arm move easily around. There is another structure which is shoulder socket where this cuff fits. This provides strength to move and rotate the arms. The rotator cuff tendinitis is a condition of the frayed, damaged or swollen rotator cuff.

Symptoms of Rotator Cuff Tendinitis:

Patients having rotator cuff tendinitis will notice swelling and pain in the upper arm. This pain will move to top and front of shoulder gradually. The pain will be unbearable when you try to move the arms above the head or behind the shoulders. Other symptoms include:

• Tenderness and swelling: This will occur in the front of shoulders.
• Clicking sound in the shoulder: This sound will come when you move the arms overhead or behind.
• Strength loss: This will affect the range of motion.

Diagnosing Rotator Cuff Tendinitis:

There are several causes of pain in the shoulder. Arthritis or pinched nerve could be possible agents. In order to diagnose the issue, it is recommended to contact the doctor. The doctor will try to find out reasons behind the injury. He will ask questions about the daily routines, your occupation, nature of job or others. He may organize simple tests such as stretching, raising or lifting weights. These things are used to see the level of the range of motion. MRI and ultrasound are imaging tests. These tests are useful to find the exact location of tendinitis. It also helps the doctors to see the tear and swelling in the tendons.

Treatments of Rotator Cuff Tendinitis:

It is easy to treat the injury at home if it happened suddenly. However, timely diagnosis is very important in this matter. The R.I.C.E technique is normally suggested by therapists. Following steps are also useful for the treatment of this injury.

Rest: It provides shoulder tendons, bones and joints to rest. This rest minimizes swelling and pain.

Ice: Icing the injured area is helpful to reduce swelling and pain. Use of Ice pack is also useful to heal the injury quickly.

Heat: This technique is good to reduce stiffness. Heat therapy is mostly used after the pain is gone.

Stretching: Doctor will suggest some stretching workouts to improve the range of motion. It also brings flexibility in the shoulder. It would be better to stretch the shoulders while taking a hot shower.

In most cases, rotator cuff takes 2 to 5 weeks but it may take longer if the injury is severe. If you feel pain creating disturbing in your daily routines then you should see the doctor. The doctor may suggest the following options.

• Steroid: Shot injections of steroids are used to reduce soreness in the shoulder joints.
• Physical therapy: This is a special option. Physical massage can help to improve the strength and activity level of the shoulders.
• Surgery: This is used in rare cases. Surgery is the last option if you have used all the treatments.

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