Rotator Cuff Injuries: Symptoms and Treatment

Rotator Cuff Injuries

What is a rotator cuff injury?

The rotator cuff is a term used to describe the tendons and muscles that support, stabilize and allow the arm to move up and down, as well as rotate. The four muscles include the supraspinatus, infraspinatus, subscapularis, and teres minor. Injury to muscles or tendons that attach to bones comprise contractile units. These units stabilize the shoulder and allow its motion. A strain occurs at a unit’s weakest point.

How do you prevent a rotator cuff injury?

Warm up adequately prior to any physical activity, practice or competition. The athlete should participate in a strength and flexibility program appropriate for their sport especially a shoulder strengthening and conditioning program prior to throwing sports. For participation in contact sports, protect shoulders with special equipment such as the Antibody Angle Shoulder brace™ or shoulder pads. After recovery, strapping or elastic wraps may protect against re-injury.

What are the signs of a Rotator cuff injury?

The signs of a rotator cuff injury are:

1. Noticeable pain in the soft tissues surrounding the strain, including nerves, periosteum (covering of bone), blood vessels and lymph vessels at the time of injury.
2. Loss of strength (moderate to severe strain)
3. A common symptom of a rotator cuff injury is aching, and weakness in the shoulder when the arm is lifted overhead.
4. Crepitation (“cracking” feeling and sound when the injured area is pressed with finger).
5. Calcification of the shoulder muscle or tendon (visible with x-rays).
6. Inflammation of the tendon sheath. A less severe injury may result in swelling, bleeding and bruising. This creates pain and inflammation as the swollen muscle pushes on the nearby bone. This can last several months before the muscle is entirely healed. Continued activity can increase the swelling, and lengthen the recovery time.

What body parts are involved in a Rotator cuff injury?

The specific body parts involved are four muscles including the supraspinatus, infraspinatus, subscapularis, and teres minor. The bones in the shoulder area, including the humerus, scapula and clavicle.

What are the main causes of a rotator cuff injury?

The main causes of a rotator cuff injury are:

• Prolonged overuse of muscle-tendon units in the shoulder.
• Single violent blow or force applied to the shoulder. Powerful muscle twisting or a violent muscle contraction.

Am I at risk for a rotator cuff injury?

The risk of sustaining a rotator cuff injury increases with contact sports, especially boxing, wrestling or rugby. The risk increases with:

1. Any activity that involves forceful throwing, lifting or throwing sports such as baseball, football, basketball or tennis.
2. Any cardiovascular medical problem that results in decreased circulation.
3. Medical history of any bleeding disorder.
4. Obesity
5. Poor nutrition
6. Poor muscle conditioning
7. Previous shoulder injury.

What is the proper care for a rotator cuff injury?

The appropriate health care for a shoulder dislocation is a doctor’s diagnosis. This will include:

1. A tear needs to be seen and evaluated by a physician to determine if surgery is needed to repair the muscle. If large tears are left alone, they often lead to arthritis, due to continual rubbing and inflammation of the joint. Surgical repair of a torn rotator cuff muscle can often be done with arthroscopic techniques, which use a very small incision, and the patient can go home the same day. Recovery involves medication to reduce inflammation, and physical therapy exercises to increase range of motion and strength.
2. Physical therapy (Moderate or severe strain)
3. Self-care during rehabilitation.

Are there any complications with rotator cuff injuries?

Some possible complications can be:

1. Prolonged healing time if activity is resumed too soon.
2. Proneness to repeated injury.
3. Unstable or arthritic shoulder following repeated injury
4. Inflammation at the attachment to the bone(periostitis).
5. Prolonged disability, usually weakness and pain, when using arm in the overhead position.

How long does a rotator cuff injury take to heal?

If this is a first time injury. Proper care and sufficient healing time before resuming activity should prevent permanent disability. Torn ligaments and tendons require as long to heal as fractured bones do. The average healing times are:

1. Mild strain: 2 to 10 days
2. Moderate strain: 10 days to 6 weeks
3. Severe strain: 6 to 10 weeks.

If this is a repeat injury the complications listed above are more likely to occur.

What treatment should I use for a rotator cuff injury?

The most important part about treating a rotator cuff injury is to get the right diagnosis. Some supplemental first aids are the “R.I.C.E.” instructions: Rest, Ice, Compression, and Elevation (if possible). It is helpful, as continuing care, to use an ice pack 3 or 4 times a day for 15 minutes at a time. Place ice chips or cubes in a plastic bag. Wrap the bag in a moist towel, and place it over the injured area. After the first 72 hours, application of localized heat promotes healing by increasing blood circulation in the injured area. Use heat lamps, hot baths, showers, heating pads or heat liniments and ointments. Take whirlpool treatments, if available. Massage gently and often to provide comfort and decrease swelling. Wrap the injured shoulder with an elasticized bandage between treatments.

What medications, if any, are recommended?

Your doctor may prescribe: (1) Aspirin, Acetaminophen or ibuprofen to relieve minor pain. Topical liniments and ointments (2) Your doctor may prescribe stronger pain relievers or an injection of a long-acting local anesthetic to reduce pain. Your doctor may also prescribe injections of corticosteroids, such as triamcinolone to reduce inflammation .

What activity is proper during rehabilitation and recovery?

Resume your normal activities gradually. For a moderate to severe strain, use a sling for at least 72 hours. As far as diet, balance the amount of food you eat with any change in your level of physical activity. During recovery eat a variety of foods to get the energy, protein, vitamins, minerals and fiber you need for good health and healing.. You can begin daily rehabilitation exercises when supportive sling is no longer needed and with the blessing of your doctor. Use ice massage for 10 minutes before and after exercise. Fill a large Styrofoam cup with water and freeze. Tear a small amount of the foam from the top so the ice protrudes. Massage firmly over the injured area in a circle about the size of a softball. Recovery involves medication to reduce inflammation, and physical therapy exercises to increase range of motion and strength. The treatment of a strain is different that a tear, so see your physician if you have an injury to the shoulder that results in pain. Stretching and strengthening the shoulder can help prevent injuries, and should be a part of a warm up and general conditioning program.

Call your Doctor if:

Be certain to call your doctor if you have symptoms of a moderate or severe rotator cuff strain or a mild strain persists longer than 10 days. Call your doctor if any of the following occurs after surgery: (1) Increased pain, swelling or drainage in the surgical area.(2) Signs of infection (headaches, muscle aches, dizziness or a general ill feeling and fever Drugs used in treatment may produce side effects.

How does the Angle Shoulder Brace™ work to prevent some rotator cuff injuries?

The Bodyguard™ Angle Shoulder brace provides muscle compression, joint stabilization and support, muscle heat circulation to increase blood flow and promote healing, strain distribution and it absorbs and spreads direct impact. The inner surface of the The Angle Shoulder brace™ attaches to the surface of the shoulder, bicep, chest and upper back to spread strain over all those surfaces instead of concentrating it on the shoulder as is the case with the unprotected shoulder under an injury condition.

How does the Angle Shoulder Brace™ help if you have an existing rotator cuff injury?

When used to protect an existing shoulder injury, The Bodyguard™ Angle Shoulder brace and the Angle Double Shoulder Brace stabilize and supports the shoulder joint, spreads strain and impact over the entire surface of the garment, raises muscle temperature to increase blood flow and promote healing in the joint and surrounding tissue.