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Rotator Cuff Injuries

post #1 of 11
Thread Starter 
The term "rotator cuff" refers to a group of tendons which fuse together to surround the front, back, top of the shoulder like the cuff of a shirt sleeve. They are connected to muscles whose origins are in the scapula. Contraction of these muscles pull on the rotator cuff, which in turn causes the shoulder to rotate inward, upward, or outward.

Repetitve foward raising of the arm can cause the bursa and/or tendons to become inflamed. This can cause the tendon to break down near its attachment. Sometimes, it tears away completely from the bone.

Repetitive throwing or racquet sports, as well as swimming can also dammage the rotator cuff, not always by impingement, but by joint imbalance.

Symptoms usually involve aching at the top, front and side of the arm, and are often worse at night. Pain is present if you try to lift your arm overhead, or in some cases, foward or outward.

If the cuff is not repaired, it sometimes forms a patch to close the defect. But this is synonomous to a bandaid. Although the pain may be temporarily decreased, The tendon edges may become worn, possibly causing the muscle to atrophy. True repair at that point may not be possible.

There are different types of rotator cuff injuries.

Rotator Cuff Tendinitis
Sometimes called impingement syndrome or shoulder bursitis. Usually occurs in people 30-80. Only a mild weakness will be present.

Rotator Cuff Tear
Tendinitis gets so bad it wears a hole through the cuff to the tendon. Symptoms include pain,weakness, stiffness popping sensation, and being unable to sleep on that side.

Instability Impingement

Usually happens to 15-30 year olds, active in throwing sports or swimming. Two types of injury can occur. Dislocation, when the head of the humeus slips out of the socket, or subluxation, when the shoulder temporarily out of the socket, then back to place. this occurs in loose jointed people, which is why hyperflexible women need to stay away from some Yoga classes.

Its important to get diagnosed by a physician, and then go to PT. Some conditions require surgery, some do not. Here are some Post Rehab exercises:


post #2 of 11
There may be some changes in treatment protocols since this was written:

"Taking aspirin or another anti-inflammatory drug after each workout will also help reduce pain and swelling."

My doctor said to avoid anti-inflammatories, as inflammation is part of the healing process...

Thanks for the information, Lisamarie. I will try the exercises. I am pretty loose-jointed--it's possible I had a subluxation of the joint when the tree stopped my arm and my body kept moving.
post #3 of 11
Thread Starter 
Yeah, I caught that too. That's why I did a general summary of the rotator cuff info, rather than link to the sites. Glad your doc is up with the times. I was going to link to the exercise images exclusively, but medical sites take the "copyrighted material" thing pretty seriously.
post #4 of 11
Thanks Lisa.

I'll have to check out the exercises since my wife had had Arthoscopic surgery to repair the rotator cuff, a full thickness labrum tear, and bone shaving for impingement. It may have been a ski injury (fall on the shoulder) or maybe not. There was no one defining moment. It was bothering her for awhile, she went for PT, it got worse with PT, MRI ordered and damage confirmed.

She won't be able to smack me around for a while.
But hopefully she'll be able to ski by December, and swim again.
post #5 of 11
Here is a site discussing NSAID therapy in injury cases:

post #6 of 11
Thread Starter 
Sorry! Tried to post some pictures, but it did'nt work!

[ July 29, 2002, 09:25 PM: Message edited by: Lisamarie ]
post #7 of 11
nolo wrote: ... "Taking aspirin or another anti-inflammatory drug after each workout will also help reduce pain and swelling." My doctor said to avoid anti-inflammatories, as inflammation is part of the healing process...

I doubt that such a statement would ever come from a sports doctor (such as a football team doctor) . Inflammation is a reaction to an injury. It is the body's way of protecting further damage to the area. If you had no inflammation or pain and continued to stress the injury you would completely destroy the injured area. Besides, ANY reaction the body has after an injury, can be considered "part of the healing".
Let me ask this: why apply ice immediately after an injury? After all, ice does nothing but keep the inflammation down. I don't advocate that athletes become dependent on anti-inflammatory drugs, but when you truly pull a muscle or a tendon, immediate use of ice/anti-inflammatories will make a world of difference.
post #8 of 11
Actually Tom - I used to work in the ski fields & the docs there preferred NO anti-inflammatories for 24-48 hours.

Ice decreases swelling(yes a sort of inflammation) that is why it is RICE - so does the compression & rest & elevation. The inflammatory response in the injured tissue is necessary to 'muster help' if you want to think of it that way. Once started the inflammation may be useful(stop you doing too much) or not (stop you mobilising. Anti-inflammatories also tend to increase bleeding times....

In managing chronic wounds(like leg ulcers/pressure sores) we often stop anti-inflammatories to allow the inflammatory response to occur to get healing to occur.

Have a look at Maddog's link
post #9 of 11
I did look at Maddog's link and the article supports my position. :

The article says that many doctors do use ice and anti-inflamatories (such as Advil) to control the damage and help recovery. The article seems to indicate that it may be detrimental to mask the pain and continue exercise, but usage of anti-inflamatories is not necessarily bad.
post #10 of 11
From Maddog's article
"Two caveats: Rizzo always warns his patients not to overdo activity when their pain is blunted by medications. And he rarely prescribes aspirin or other NSAIDs for the first day or two following an injury because of the theoretical risk that the drugs' blood-thinning properties will exacerbate initial swelling. Instead, he recommends using acetaminophen until the acute phase of the injury is over, advising his patients to switch over to an NSAID only if their pain continues. "

post #11 of 11
Thread Starter 
Due to the multitude of topics regarding shoulder injury, I 've decided to take a few workshops on this topic.
Currently posting live from boring Santa Clara California, I attended a workshop today which was actually on the Bosu.

But since there are a bunch of Bosu exercises requiring extreme scapula staility, proper alignment of the upper body is crucial.

For that matter, many of the various shoulderinjuries occur due to shoulder misalignment.
Although correcting alignment will not heal the injury, it will help prevent other sorts of problems.
In skiing, many of the incorrect pole positions are a result of a misalignmet in the upper body.

This is about the most simple, eefective way to put the shoulders in their proper position that I hae seen in 30 years of instructing.
Place both hands on top of your head
Elevate your shoulders towards your ears
Pull your elbows back behind you, without clenching the shoulder blades together.
Now drop your shoulders.
Now lower your hands down by your sides.
Your shoulders should nowbe in optimal alignment.
How do you feel?
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