ROTATOR CUFF INJURIES
The rotator cuff is a structure composed of four muscle-tendon units. The four muscle-tendon units are the supraspinatus, infraspinatus, subscapularis, and teres minor. The most important function of the rotator cuff is to keep the proximal humerus (ball) well-positioned within the glenoid (socket). A secondary role of the rotator cuff is to provide one the ability to elevate, raise and rotate his/her arm and shoulder.
Rotator cuff injuries are relatively common. There are three distinct types of rotator cuff injuries:
- Bursitis/Impingement
- Tendinitis
- Tear (partial-thickness or full-thickness)
Bursitis/impingement implies that the fat tissue sac above the rotator cuff is inflamed. Bursitis can occur with overuse of the shoulder or in patients who have irritated the rotator cuff tendons. Tendinitis implies that the tendon(s) of the rotator cuff are inflamed, but not torn. Tendinitis is common in patients with overuse injuries, such as in patients who play certain sports or in laborers. A tear of the rotator cuff may occur from a lifting injury, a fall on the shoulder, or with chronic wear and tear.
Symptoms
- Sharp shoulder pain with overhead activity
- Shoulder pain when sleeping
- Weakness with shoulder use
Diagnosis And Treatment
Dr. Welch considers each patient’s symptoms, as well as a detailed physical examination and x-rays to make the diagnosis of rotator cuff injury. Dr. Welch usually orders an MRI or ultrasound to confirm the diagnosis and evaluate the injury type and/or tear pattern. Most patients with tendinitis, bursitis, and partial thickness tears can be treated successfully without surgery. Treatment options include a physical therapy program, oral analgesics, as well as targeted injections (for example, steroid injections).
In those patients with full thickness rotator cuff tears or those with bursitis who fail non-surgical management, Dr. Welch may recommend surgery. Surgery is minimally invasive; Dr. Welch uses an arthroscope (surgical camera) and surgical instruments to remove the inflamed bursa, and if necessary, repair the torn rotator cuff.
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