| She thought she had a 'rotator cuff,' and she was right! |
|
By: By Dr. MARK KESTNER
|
|
 Email  Print
|
Not too long ago a patient came into the office with her arm held closely to her side in a protective posture. I asked her what I could do for her. "I think I have a rotator cuff" she replied. "That's what my neighbor said. He said he had one once and it hurt like mine does."
Well, I couldn't argue with her. I was sure she did have a rotator cuff, not because of what she said, but because everyone has a rotator cuff. One for each arm as a matter of fact.
The term rotator cuff is not a name for an injury but an anatomical part that can be injured. The rotator cuff is not a single structure, but a group of structures that collectively form a sort of cuff around the ball of the shoulder joint; much like the cuff of a sleeve surrounds the wrist. The term rotator cuff injury is used to describe an injury that occurs to any of these structures.
The rotator cuff injury can be mild, such as an over-stretched muscle or can be severe as in a ruptured tendon or ligament. Mild cases can be helped with rehab, while severe cases usually require surgical repair.
An injury can either occur acutely, as a result of a sudden, abrupt, or powerful force physically tearing the connective tissue of the structures. This can occur during athletics, during work activity that requires forceful movements such as lifting or throwing, or by an outside force such as falling or being struck in or around the shoulder. It is possible to injure the rotator cuff by falling on an outstretched arm, for example. Another scenario could involve throwing a heavy piece of material into a dumpster.
One patient sustained the injury after slamming a door during an argument. The patient had slammed a door in their home two years previously and had experienced shoulder and arm pain ever since. Acupuncture, rehab and manual therapy along with electrical stimulation were helpful in restoring full function and eliminating the pain within a few weeks.
It is also possible to sustain chronic or degenerative rotator cuff injury. If you work with your hands overhead, use vibrating tools in awkward positions, or otherwise endure constant strain in the shoulder joint, you have a risk of rotator cuff injury. Because this type of shoulder pain may begin gradually and may be intermittent, many people neglect this injury. Instead of seeking care for their off-and-on shoulder pain they tough it out, take pain drugs, and continue aggravating the injury. An example of this is a patient that worked in construction and had experienced shoulder pain off-and-on for years. He said he could remember more intense pain in earlier years, but he had adapted his motions to avoid the pain. This resulted in an impaired ability of the shoulder to function. His strength was limited and his ability to elevate his arm was severely restricted.
The pain from a rotator cuff injury varies, depending upon which specific structure is damaged. You may have pain in the front or the rear part of your shoulder. It is common to experience pain when you attempt to raise your arm to the side or over your head. Some people do not experience pain in the shoulder as much as a dull, heavy achy sensation in the arm or in the shoulder blade area. In some cases pain is not constant, but the patient is unable to move their arm fully in all directions.
There are physical tests to determine what structures are damaged. In severe cases, it is sometimes necessary to have an MRI performed to image the internal shoulder structures. In any case of shoulder injury that reduces your ability to move your arm, early evaluation is very important. Remember, it is easier to fix a small problem than wait and try to fix a larger one. Early treatment saves money and improves results.
Which is better for your health; dogs or cats? Next week you'll find out. In the meantime, pay a visit to someone home-bound or ill, it will do you both good.
Dr. Mark Kestner
mkestner@DrKestner.com
|
|
Digg
Facebook
MySpace
StumbleUpon
Google
Yahoo!