Symptoms You May Not Realize Are Caused By A Rotator Cuff Tear
Do you feel pain in your shoulder when doing simple activities, such as getting dressed or combing your hair? Chances are you may have a rotator cuff tear. In this post, Otis R. Drew, MD, will walk you through the causes and symptoms of rotator cuff tears and explain what you can do about them.
The rotator cuff is a group of muscles and tendons that help strengthen and stabilize your shoulder joint. They hold the head of your humerus in the shoulder socket, enabling you to turn and lift your arms. Injuries or damage to these tissues can cause discomfort, pain, and other complications.
Reverse Shoulder Replacement Surgery
Another type of shoulder replacement is called reverse shoulder replacement surgery. It is generally used for people who have completely torn rotator cuffs with severe arm weakness cuff tear arthropathy or severe arthritis with a torn rotator cuff had a previous shoulder replacement that failed.
For these patients, a conventional shoulder replacement can still leave them with severe pain or unable to lift their arm up past a 90-degree angle. In the “reverse” procedure, the socket and metal ball are switched, meaning the metal ball is attached to the shoulder bone, and a plastic socket is attached to the upper arm bone. This allows the patient to use the deltoid muscle instead of the torn rotator cuff to lift the arm.
How Painful Is Shoulder Surgery
Unfortunately, all surgery causes pain. But your hospitals anesthesia staff focus on keeping you comfortable during surgery. They will discuss options with you.
During surgery, shoulder arthroscopy often uses nerve blocks injected into your neck or shoulder. These nerve blocks numb your shoulder and arm. They also help with pain relief after surgery. In some cases, you may have general anesthesia, where you are asleep during your surgery.
Pain during recovery is a natural part of healing. Talk with your healthcare providers about your concerns. They can advise you on how to manage pain as your body heals.
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How Is Shoulder Impingement Treated
With rest, many of the causes of impingement syndrome can get better on their own. But , you need to be clear about what has caused the pain before you can treat it.
This means seeing a sports medicine professional or an orthopaedic consultant for a diagnosis. Ongoing shoulder pain can be caused by many conditions, and you will usually need an MRI or ultrasound scan to work out what that might be.
A physical therapy programme of stretching and strengthening exercises is usually necessary for complete recovery. Injection therapy may be necessary.
More serious conditions, such as bone spurs, or severe cartilage or rotator cuff tears may need to be treated surgically.
Simon Moyes is an internationally renowned orthopaedic surgeon and leader in the field of arthroscopic surgery. His Capital Orthopaedics team works at Basinghall Clinic in London, with its state-of-the-art diagnostic and surgical equipment, and top sports medicine professionals. Contact Simon Moyes for an expert diagnosis and treatment of shoulder injuries.
What Is The Acromion
Acromion is a hook-like process present laterally out of the shoulder blade of scapula bone of the shoulder joint. It acts like a hood over the rotator cuff and gives it protection. The rotator cuff runs underneath surface of acromion. Occasionally the spurs in acromion or the spurs out of the acromioclavicular joint, a joint formed between acromion and clavicle, may cause injury to the rotator cuff leading to inflammation called tendinitis or tearing of the rotator cuff.
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How Do You Release A Shoulder Impingement
Treatments for impingement syndrome include rest, ice, over-the-counter anti-inflammatory medications, steroid injections and physical therapy.
What Are Common Tennis Elbow Symptoms
Tennis elbow symptoms are often related to pain, which usually starts gradually and worsens over weeks or months. If your tennis elbow symptoms last for more than three months, your tennis elbow is considered chronic.
Pain associated with tennis elbow can often have the following characteristics:
- Starts as a dull ache, burning, or soreness on the outer elbow
- Progresses so that pain occurs with any movement, especially when you grasp or twist objects
- Increases in the evening and interferes with sleep
- Makes your elbow feel stiff in the morning
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When To Get Medical Help
See a GP if you have shoulder pain that does not go away after a few weeks or is stopping you from doing your normal activities.
They’ll look at your shoulder and ask you to move your arm in different ways to see how easily you can move it and if movement makes the pain worse.
They may suggest some treatments you can try or refer you to a physiotherapist for treatment advice. You probably will not need to go to hospital for any scans.
You can also go straight to a physiotherapist without seeing a GP, but you might need to pay.
Tailored Shoulder & Elbow Treatment
When using RICE and home remedies, such as exercise, medicines to reduce pain and swelling, are not enough, we design individualized treatment plans tailored to each patients needs and goals, and we maximize use of non-surgical options before considering surgery. When surgery is necessary, our orthopaedic surgeons offer innovative and advanced operative therapies to repair shoulder and elbow conditions, including both minimally invasive and open surgery options. We strive to help patients regain full function and return to their daily activities as soon as possible.
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Shoulder And Neck Pain Radiating To The Face Or Scalp
Shoulder pain can cause pain radiating to the base of the neck. This is because most shoulder problems especially those that cause stiffness cause other muscles particularly the ones that control the shoulder blade to overwork and compensate for the other muscles around the shoulder. The trapezius muscle runs from the side and back of the neck to the shoulder blade. Spasm in this muscle can cause neck pain. However, neck pain that radiates up into the face or scalp is not caused from shoulder problems and is again most likely a result of nerve irritation in the face or upper neck.
If you are struggling with pain in your shoulder and neck its worth having it checked. We would take a thorough history of the problem, examine your shoulder and neck, and do the relevant tests and investigations to work out if the problem is in the shoulder, the neck or both. If we diagnose a neck problem we will arrange a referral to one of our top Neurology or Spine Consultant colleagues for a review. Having the right diagnosis is the key to working with you to determine the right treatment plan to get you on the road to recovery.
What Is Shoulder Impingement
Shoulder impingement syndrome occurs at the top of the shoulder. The shoulder is made up of three bones:
- Humerus: upper arm bone
- Scapula: shoulder blade
- Clavicle: collar bone
The shoulder bones are connected together by ligaments, and one of them is the coacoacromial ligament, which connects the acromion and the coracoid process, bony projections off the scapula.
The acromion and the coracoacromial ligament form a sort of bridge or roof over the top of the shoulder known as the coracoacromial arch. The space underneath this arch is known as the subacromial space.
Each of the rotator cuff muscle tendons run through the subacromial space and as the arm moves up and down, the rotator cuff tendons slide backwards and forwards through this space.
Sitting between the subacromial space and the rotator cuff tendons is the subacromial bursa, a small fluid filled sac that protects the tendons and prevents friction against the bone.
The space underneath the acromion is fairly small, and the gap gets narrower as you lift your arm up because of how the bones and tendons move.
Shoulder impingement syndrome refers to a number of problems that can develop in this area, the common characteristic being that the subacromial space narrows more than usual leading to pinching or friction on the soft tissues.
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C Hand Grip Exercises
Once your medial epicondylitis pain is starting to settle and you are progressing well with your eccentric wrist exercises, you can add in some gripping and twisting exercises to help with functional activities. Again, start slowly and take your time increasing the hold and the number of reps so you dont overload the tendon too quickly.
Who Suffers Shoulder Impingement Syndrome
Impingement syndrome is more likely to occur in people who engage in physical activities that require repeated overhead arm movements, such as tennis, golf, swimming, weight lifting, or throwing a ball.
Occupations that require repeated overhead lifting or work at or above shoulder height are also at risk of rotator cuff impingement.
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What Causes Shoulder Impingement
Your rotator cuff tendon passes through a space below the acromion. The acromion is the bony tip of the outer edge of your shoulder blade that comes off the top of the back side of this bone. It meets with the end of your collar bone at your shoulder. Shoulder impingement occurs when the tendon rubs against the acromion.
The causes of this impingement include:
- Your tendon is torn or swollen. This can be due to overuse from repetitive activity of the shoulder, injury or from age-related wear and tear.
- Your bursa is irritated and inflamed. Your bursa is the fluid-filled sac between your tendon and the acromion. Your bursa helps your muscles and tendons glide over your bones. Your bursa can become inflamed due to overuse of the shoulder or injury.
- Your acromion is not flat or you have developed age-related bone spurs on your acromion.
Look At The Scapular Stabilizers
When it comes to Scapular Stabilizers I want to end up looking and seeing how those shoulder blades are when people are exercising or moving.
Are those shoulder blades staying flat up against the thoracic spine ? Or do they end up winging so the medial border of the scapula ends uplifting or even the bottom part of the scapula ends up tilting up?
If I end up getting winging of the scapula, lets say with pushing movements, pressing movements, overhead, diagonal pattern movements, its my cue that I need work on the scapular muscles. And I need to look at working on the activation, endurance, and strength of those scapular muscles. I end up utilizing what I cover-up in the Scapular Stabilization Exercise Program to help with this problem.
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How Can You Tell The Difference Between Impingement And Frozen Shoulder
How Do I Know If I Have Frozen Shoulder or Shoulder Impingement? Frozen shoulder causes a person to not be able to turn their arm out and can be quite painful even when motionless and especially at night. While there is some overlap in symptoms, shoulder impingement is caused by a swollen rotator cuff.
What Are The Treatment Options
Many cases can be treated without surgery, particularly if you receive treatment as soon as symptoms appear. Common non-surgical treatments include:
- Rest Taking a break from sports or work activities can help, as can wearing a brace over the back of your forearm.
- Applying ice or cold packs to relieve pain Use them for 10 to 15 minutes several times a day, and make sure to put a washcloth in between your skin and the ice.
- Non-steroidal anti-inflammatory medications Medications such as ibuprofen or aspirin may help reduce pain and swelling.
- Physical therapy Exercises can help decrease your pain and increase your range of motion.
- Corticosteroid injections These can help relieve pain and inflammation.
- Surgery If more conservative treatments dont provide enough relief, surgery may be considered. Most tennis elbow surgeries are performed to remove diseased muscle and reattach healthy muscle to the bone.
If youre experiencing tennis elbow symptoms, schedule an appointment today with Mirza Orthopedics by calling 361-5302. We specialize in the latest nonsurgical and minimally invasive surgical options that can help relieve your pain and restore your active lifestyle.
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What Is A Type Ii Acromion
Acromion is a lateral process out of the shoulder blade of the shoulder joint. On x-rays, it has been classified into four types. Type II is the most common type and is gradual curve along the head of the shoulder. Type II acromion may occasionally cause impingement of the shoulder joint. The type III acromion is the one which is usually involved with impingement syndrome of the shoulder joint as it is curved like a hook over the rotator cuff and lead to injury and possible tearing of the rotator cuff.
Supinated Golfers Elbow Stretch
This golfers elbow stretch is very similar to the previous one but targets slightly different muscles as the forearm is twisted round pick whichever one feels best for you.
- Sit or stand and straighten your affected arm out at shoulder level in front of you, palm facing the ceiling
- Use you other hand to gently pull the palm and fingers down and back as shown until you feel a stretch
- Hold for 15-30 seconds and repeat 3 times
Top Tip: having the fingers straight will increase the strength of the stretch so vary as needed.
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Things You Can Do If You Have Shoulder Impingement
- Avoid things that make the pain worse avoid activities that involve repeatedly lifting your arm above your head for a few days or weeks. Ask a GP or physiotherapist when you can restart these activities.
- Do not stop moving your arm completely try to carry on with your normal daily activities as much as possible so your shoulder does not become weak or stiff. It’s usually best to avoid using a sling.
- Gently hold an ice pack wrapped in a towel on your shoulder for 15 to 20 minutes a few times a day.
- Take painkillers anti-inflammatory painkillers or paracetamol may help. A GP can prescribe stronger painkillers if needed.
Conservative Shoulder Impingement Treatment
Since a majority of the patients with impingement syndrome get better with conservative shoulder impingement treatment management, this is my initial approach to your painful shoulder. This consists of physical therapy, oral anti-inflammatory medicine and/or the use of a local anti-inflammatory injection into the shoulder. My goal is to decrease the swelling or inflammation in the rotator cuff so that it will not get pinched. With less inflammation, you will have less pain. As the inflammation decreases, you will also have less damage to your rotator cuff tendons.
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How Long Is Shoulder Impingement Recovery
Every shoulder impingement is different. Some impingements will respond positively to a short treatment session, whereas a more complicated case may take many weeks or a few months to settle. Others may require shoulder surgery.
There is no specific time frame for when to progress from each stage to the next. Many factors will determine your injury rehabilitation status during your physiotherapists clinical assessment.
In most cases, youll find that your physiotherapist will seamlessly progress between the rehabilitation phases as your clinical assessment and function improve. It is also important to note that a highly skilled shoulder physiotherapist will carefully monitor and guide each treatment progression since premature progression can lead to re-injury and frustration.
Please contact your physiotherapist or doctor for more specific advice about your shoulder impingement.
Treatmentpopular Treatments Dr Drew Offers Include:
- Anti-inflammatory injections and medications to relieve pain and reduce inflammation
- Counseling on adjusting your activities so you can use your shoulder more comfortably and safely
- Physical therapy to improve mobility and strengthen your shoulder muscles
- Surgery to treat injured tissues or replace joints
To find out more about treating rotator cuff injuries or to learn ways to prevent them, book an appointment online or over the phone with Otis R. Drew, MD today.
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Ease An Aching Shoulder Through Physical Therapy
Physical therapy can be part of your shoulder impingement treatment plan, too. With our physical therapy services, your shoulder can feel and move better.
- Manual Therapy We can help restore proper movement to your shoulder through manual therapies like joint adjustments.
- Corrective Exercises Well also include range-of-motion and strengthening exercises in your treatment plan. They may help improve your shoulders movement and your rotator cuffs strength.
- Patient Education In this phase of physical therapy, well help you maintain the right posture. We can also make suggestions like how to improve your work station, for instance.
Create More Space In Shoulder Joint
The first step here is to create more space in your shoulder joint. This helps relieve the pinching on your tendon. And, as a result, the pain that youre feeling. To do so, we need to activate the various muscles youve been neglecting and have weakened over time. As for what these muscles are, as shown in the following graphs, most of the studies that have analyzed subjects with impingement find a:
- Weakness in the external rotators of the shoulder
Meaning that to fix shoulder impingement, we want to focus our efforts on activating and strengthening these specific muscles .
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Understanding The Shoulder And Elbow
A shoulder is what is known as a ball-and-socket joint. This is because the upper arm has a rounded shape that fits into a hollow socket in the shoulder blade. The joints within the shoulder are very flexible, in fact, more flexible than any other joint in the body.
The elbow is a hinge joint connecting the forearm to the upper part of the arm. A hinge joint allows for flexibility in the lower part of the arm.
The shoulder and elbow are held together with ligaments, tendons and various soft tissues. Ligaments connect bones to other bones, where tendons connect bones to muscles. A thin layer of cartilage covers these areas and eases any friction during movement. If there is damage, from disease or injury, you may experience pain, numbness or a weakened range of motion. Because the shoulder and elbow are so heavily utilized, they are commonly prone to injury or disorder.