The all too familiar "pop!" immediately followed by weakness, pain, and immobility; the classic signs of a shoulder injury. Many shoulder injuries affect the rotator cuff. "Each year approximately 200,000 American require surgery related to the repair of the rotator cuff" (Yamaguchi). This vast number of surgeries makes shoulder injuries a popular topic in the medical field. Physicians have been researching ways to improve patients' recovery and return their range of motion back to normal. One such improvement is the release of the long head of the biceps tendon.
One major injury suffered in the shoulder is to the rotator cuff. The rotator cuff is a group of muscles and its surrounding tendon in the shoulder. These muscles and tendons (rotator cuff) serve to stabilize the shoulder. Many athletes are at risk of injuring the rotator cuff through repetitive impact and sudden movements.
Surgical treatment of the rotator cuff is necessary in several cases. The most common of those cases being a complete or full length tear of the rotator cuff. This occurs when there is a tear across the rotator cuff creating two separate pieces. Another reason surgical intervention may be required is for a degenerative tear. A degenerative tear is one that begins as a small or partial tear and becomes progressively worse over time. Degenerative tears are usually the result of overuse of the shoulder, whereas full length tears tend to be from an acute injury. According to the American Academy of Orthopedic Surgeons, Rotator cuff surgery is recommended if a patient presents any of the following: “symptoms that have lasted 6 to 12 months, a large tear (more than 3cm), significant weakness and loss of function in the shoulder, or the tear was caused by a r...
... middle of paper ...
...N.p., n.d. Web. 17 Apr. 2014.
"Biceps Tenotomy." Biceps Tenotomy. N.p., n.d. Web. 17 Apr. 2014.
"Frozen Shoulder-OrthoInfo - AAOS." Frozen Shoulder-OrthoInfo - AAOS. N.p., n.d. Web. 17 Apr. 2014.
"Humeral Fracture Following Biceps Tenodesis in a Baseball Pitcher - Mike Reinold." Mike Reinold. N.p., n.d. Web. 17 Apr. 2014.
"Missoula Bone and Joint and Surgery Center." Patient Education. N.p., n.d. Web. 17 Apr. 2014.
"Rotator Cuff Tears: Surgical Treatment Options-OrthoInfo - AAOS." Rotator Cuff Tears: Surgical Treatment Options-OrthoInfo - AAOS. N.p., n.d. Web. 17 Apr. 2014.
"Shoulder Subluxation | Shoulder Instability | Treatment Options." Shoulder Subluxation | Shoulder Instability | Treatment Options. N.p., n.d. Web. 17 Apr. 2014.
Yamaguchi, Ken. "New Guideline on Rotator Cuff Problems." New Guideline on Rotator Cuff Problems. N.p., n.d. Web. 17 Apr. 2014.
Many factors like patients age, symptoms, size of the tear, and nature of onset (traumatic or degenerative) are responsible for determining the prognosis of the physical therapy treatment 9. Since it’s a partial thickness tear of the rotator cuff, the non-operative treatment is reasonable unlike, a full thickness tear where surgery will be required to treat the patient 9. The patient shows symptoms of moderate irritability without significant functional deficit which makes him a good candidate for conservative treatment 10. The pain reported by the patient is 6/10 so the patient participates well in physical therapy exercise to increase shoulder strength, and flexibility. There was a study done from Finland which asserted that physical therapy alone can produce results which are equal to those produced by arthroscopic surgery and open surgical repair in cases of rotator cuff tears 11. In this case, with three weeks of physical therapy the patient has showed a decrease in pain and reported it as 4/10 on pain rating scale and showed improvements in abduction (140̊) and external rotation (65̊). The MMT for shoulder abduction was 4-/5 and external rotation is still same as
Patient returned the next day still complaining of pain. The PT applied heat, then initiated the exercise program, but the patient could not perform theem to same extent as previously, secondary to pain. Therefore, the PT told the patient to schedule an appointment with his physician. The patient was seen by the MD the next day and an arthrogram performed that revealed a reinjure to the repaired site. And a second surgery repaired the rotator cuff.
A rotator cuff is simply a group of four tendons and muscles that are located right on the shoulder and on top of the humerus bone. (Source 1) The rotator cuff is what controls the shoulder and allows it to move and be mobile. The four main muscles that consist of the tendons are the supraspinatus, infraspinatus, teres minor, and subscapularis muscles. (Source 2). Too much wear and tear on these muscles (such as too many thrown fastballs) is precisely what causes the rotator cuff to begin to tear, as well as swelling in the tendons.
Shoulder injuries are very common amongst people of all ages. If you think about it, we use our shoulders for numerous daily activities like driving, reaching up in cupboards, washing and brushing our hair, picking up items off the floor, reaching in our pockets whether it be in the front or the back, putting a belt on, and many others. A common injury that occurs in the shoulder though, is the rotator cuff. This structure is very often torn in individuals who use a lot of overhead reaching motions or are forcefully pulling objects constantly. A couple examples of people that do these motions constantly are athletes and construction workers. A rotator cuff tear can be caused by a direct-blow to the shoulder or it can happen over a period of time with wear and tear. Normally when an individual has a rotator cuff tear, they will present with pain or weakness when trying to lift their arm.
The Arm and Shoulder Release technique helps relieve common pain and stiffness in the muscles, tendons and joints of the shoulder girdle. It is especially goo...
The shoulder is the most complex joint in the body. It is capable of moving in more than 16,000 positions. Many of its ailments, including the most common ones, involve biomechanical mechanisms that are unique to the shoulder. The most common shoulder problem for which professional help is sought out for is shoulder impingement (Haig 1996). Shoulder impingement is primarily an overuse injury that involves a mechanical compression of the supraspinatus tendon, subacromial bursa, and the long head of the biceps tendon, all of which are located under the coracoacromial arch (Prentice 2001). Impingement has been described as a continuum during which repetitive compression eventually leads to irritation and inflammation that progresses to fibrosis and eventually to rupture of the rotator cuff. Because impingement involves a spectrum of lesions of tissue in the shoulder, a working knowledge of its structural relationships will facilitate an understanding of the factors that result in abnormalities. This paper will provide knowledge of the anatomy, biomechanics, and correct rehabilitation involved with shoulder impingement.
Supraspinatus tendonitis is inflammation of the supraspinatus/rotator cuff tendon and/or the contiguous peritendinous soft tissues, according to Medscape. It is usually identified with shoulder impingement syndrome and is a recognized phase in the second stage of the disease. There are both extrinsic and intrinsic factors that can lead up to this condition. Primary and secondary impingement are what make up the extrinsic factors. Primary impingement is the outcome from increased subacromial loading, trauma, or overhead activities. Secondary impingement is the outcome from rotator cuff overload and muscle imbalance. The condition can also be caused by the diminishing in the supraspinatus outlet space because of the unstable glenohumeral joint.
The rotator cuff is a group of tendons and muscles that form a cuff over the humerus to the scapula. This group of muscle includes teres minor, infraspinatus, supraspinatus, and subscapularis. These muscles provide stability to the shoulder and allow the shoulder to rotate and function properly during shoulder movement. The tendons and muscle can be damage by overuse, injury, or gradual aging. This damage may cause significant pain, fluid accumulation within the joint due to inflammation, arthritis, calcium deposits, and decrease range of motion. Rotator cuff tear, rotator cuff tendinitis, rotator cuff impingement, frozen shoulder, subacromial bursitis are conditions or injuries for rotator cuff. (Ma, 2015)
Rotator cuff tears are classified as either partial thickness or full-thickness tears, with the full-thickness tears being more severe.9 Before treatment occurs, the characteristic of the tear needs to be evaluated. First, the tear size can be evaluated by measuring the maximum diameter and cross-sectional area of the involved region of the tendon. 9 As described by DeOrio and Cofield, tears can be classified as small (one cm.), medium (one to three cm.), large (three to five cm.), and massive (more than five cm.). 9 Second, rotator cuff tears are evaluated based on the tear shape. 9 The first shape is a crescent shaped tear, which involves the insertions of the tendons torn from the head of the humerus. 9 To repair this, the tendon insertions must be reattached to the head of the humerus. 9 The second shape of tear is the U-shaped or L-shaped, which is the tearing between tendons and tearing between tendon and bone. 9 To repair this tear, the tearing of tendon to tendon is sutured, and the tearing of tendon to bone is fixed by the reattachment of the tendon to the bone. 9 The last parameter of assessing rotator cuff tears is tissue quality. 9 Muscle, bones, and tendons are all assessed through MRI for fatty infiltration/degeneration and for muscle atrophy. 9
Rotator cuff tear – The muscles adjoining the shoulder joint are required for rotating the shoulder, amid other movements. The tendons of these muscles furthermore influence the structural strength of the shoulder joint. Harsh, rapid actions, for example in tennis and baseball, can result in tearing of one of these tendons. This then causes pain as well as a decline in range of motion. Surgery possibly will be necessary to repair a torn
Corticosteroid injections - injecting a steroid around the affected tendon, or even into the tendon sheath may help alleviate
Web MD. Knee Pain Health Center. “Knee Problems and Injuries- Treatment.” August 5, 2011. www.webmd.com/pain-managment/knee-pain-problems-and-injuries-home-treatment. Retrieved on 1/24/14.
Therefore, “baseball is America’s sport and has been played longer than football, basketball or any other professional sport” (Baseball). However, baseball comes with some dangerous injuries. Each year out of “627,000 baseball injuries occurring each year, 117,000 of them occur in children age 5 to14 year olds, according to American Association of Orthopedic Surgeons and the University of North Carolina” (Baseball). According to Cooper University Hospital, “baseball has the highest rate of death among children of that age group, with three to four deaths per year” (Baseball). Tommy John surgery repairs and injured elbow ligament (Tommy). However, Tommy john Surgery is most commonly done on college and pro athletes, especially pitchers (Tommy). The surgery is names after former Los Angeles Dodger pitcher Tommy John (Tommy). Although in 1974, he underwent the first surgery of this type (Tommy). This injury is also known as UCL, ulnar collateral ligament (To...
Decker, Fred. "What Is the Annual Income of an Orthopedic Surgeon?" Everyday Life. Globalpost. 2014. Web. 11 Feb. 2014.
That's basically it. A surgery that baseball players and fans have grown to appreciate, and one of the more scientific breakthroughs in modern sports medicine. And after doing this report I’m fascinated by the modern science and how a tendon in your wrist can be used as a ligament.