ParaManiac

Your rotator cuff is made up of the muscles and tendons in your shoulder. Four major muscles (subscapularis, supraspinatus, infraspinatus and teres minor) and their tendons connect your upper arm bone (humerus) with your shoulder blade. They also help hold the ball of your upper arm bone firmly in your shoulder socket, as if holding a golf ball on a tee. The combination results in the greatest range of motion of any joint in your body.
Rotator cuff injuries are fairly common. Causes of the injury may include falling, lifting and repetitive arm activities, especially those done overhead. These activities may include throwing a baseball, reaching up to work on a car on a rack or placing items on shelves above your head. The injury is also common among people whose jobs or hobbies include heavy demands on their shoulders, such as athletes, archers and people in the construction trades. Poor posture, especially as related to your shoulders hunched forward, also can contribute to rotator cuff injury. As you get older, your risk of a rotator cuff injury increases.
Most of the time, treatment involves self-care measures or exercise therapy. Other treatments include steroid injections and surgery.
Signs and symptoms

Signs and symptoms of a rotator cuff injury may include:

• Pain and tenderness in your shoulder, especially when reaching overhead, reaching behind your back, lifting, pulling or sleeping on the affected side
• Shoulder weakness
• Loss of shoulder range of motion
• Inclination to keep your shoulder inactive

The most common symptom is pain. You may experience it when you reach up to comb your hair, bend your arm back to put on a jacket or carry something heavy. Lying or sleeping on the affected shoulder also can be painful. If you have a severe injury, such as a large tear, you may experience continuous pain and muscle weakness.

Causes

A rotator cuff injury involves any type of irritation or damage to your rotator cuff muscles or tendons, including:

• Tendinitis. Tendons in your rotator cuff can become inflamed due to overuse or overload, especially in athletes who perform a lot of overhead activities, such as tennis or racquetball players. In some people, the space where the rotator cuff resides can be narrowed due to the shape of different shoulder bones, including the outside end of the collarbone or shoulder blade.
• Bursitis. The fluid-filled sac (bursa) between your shoulder joint and rotator cuff tendons can become irritated and inflamed.
• Strain or tear. Left untreated, tendinitis can weaken a tendon and lead to chronic tendon degeneration or to a tendon tear. Stress from overuse also can cause a shoulder tendon or muscle to tear.

Common causes of rotator cuff injuries include:

• Normal wear and tear. Increasingly after age 40, normal wear and tear on your rotator cuff can cause a breakdown of fibrous protein (collagen) in the cuff's tendons and muscles. This makes them more prone to degeneration and injury. With age, you may also develop calcium deposits within the cuff or arthritic bone spurs that can pinch or irritate your rotator cuff.
• Poor posture. When you slouch your neck and shoulders forward, the space where the rotator cuff muscles reside can become smaller. This can allow a muscle or tendon to become pinched under your shoulder bones, including your collarbone, especially during overhead activities, such as throwing.
• Falling. Using your arm to break a fall or falling on your arm can bruise or tear a rotator cuff tendon or muscle.
• Lifting or pulling. Lifting an object that's too heavy, or doing so improperly - especially overhead - can strain or tear your tendons or muscles. Likewise, pulling something, such as an archery bow of too heavy poundage, may cause an injury.
• Repetitive stress. Repetitive overhead movement of your arms can stress your rotator cuff muscles and tendons, causing inflammation and eventually tearing. This occurs often in athletes, especially baseball pitchers and tennis players. It's also common among people in the building trades, such as painters and carpenters.

When to seek medical advice

See your doctor as soon as possible if you have severe shoulder pain or you're unable to use your arm. Call your doctor if you've had shoulder pain that has lasted for more than a week.
Screening and diagnosis

If your injury appears to be severe or your doctor can't determine the cause of your pain through physical examination, he or she may recommend diagnostic imaging tests to better delineate your shoulder joint, muscles and tendons. These may include:

• X-rays
• A magnetic resonance imaging (MRI) scan
• An ultrasound scan
• An arthrogram, a special type of X-ray in which dye is injected into the shoulder joint before the X-ray is taken to enhance the image of the joint

Treatment

Most of the time, treatment for rotator cuff injuries involves exercise therapy. Your doctor or a physical therapist will talk with you about specific exercises designed to help heal your injury, improve the flexibility of your rotator cuff and shoulder muscles and provide balanced shoulder muscle strength. Depending on the severity of your injury, physical therapy may take from three weeks to several months.
Other treatments may include:

• Steroid injections. Depending on the severity of your pain, your doctor may use a corticosteroid injection to relieve inflammation and pain.
• Surgery. If you have a large tear in your rotator cuff, you may need surgery to repair the tear. Sometimes during this kind of surgery, doctors may remove a bone spur or calcium deposits. The surgery may be performed as an open repair through a 6- to 10-centimeter incision, or as an arthroscopic repair with the aid of a small camera inserted through a smaller incision.
• Arthroplasty. Some long-standing shoulder muscle tears may contribute to the development of rotator cuff arthropathy, which can include severe arthritis. In such cases, your doctor may discuss with you more extensive surgical options, including partial shoulder replacement (hemiarthroplasty) or total shoulder replacement (prosthetic arthroplasty). A unique treatment option now available involves the use of a reverse ball-and-socket prosthesis. This reverse shoulder prosthesis is most appropriate for people who have very difficult shoulder problems. These include having arthritis in the joint, along with extensive tears of multiple muscles and tendons (rotator cuff) that support the shoulder, or having extensive rotator cuff tears and a failed previous shoulder joint replacement.

Self-care

A minor injury often heals on its own, with proper care. If you think you've injured your rotator cuff, try these steps:

• Rest your shoulder. Stop doing what caused the pain and try to avoid painful movements. Limit heavy lifting or overhead activity for four to seven days until your shoulder starts to feel better.
• Apply ice and heat. Putting ice on your shoulder helps reduce inflammation and pain. Use a cold pack, a bag of frozen vegetables or a towel filled with ice cubes for 15 to 20 minutes at a time. Do this every couple of hours the first day or two. After about two or three days, when the pain and inflammation have improved, hot packs or a heating pad may help relax tightened and sore muscles. Limit heat applications to 20 minutes.
• Take pain relievers. Over-the-counter (OTC) nonsteroidal anti-inflammatory drugs (NSAIDs), such as aspirin, ibuprofen (Advil, Motrin, others) or naproxen (Aleve), may help reduce pain. Acetaminophen (Tylenol, others) also may help relieve pain. Follow label directions and stop taking the drugs when the pain improves.
• Keep your muscles limber. After one or two days, do some gentle exercises to keep your shoulder muscles limber. Total inactivity can cause stiff joints. In addition, favoring your shoulder for a long period of time can lead to frozen shoulder, a condition in which your shoulder becomes so stiff you can barely move it. Once your injury heals and you have good range of motion in your shoulder, continue exercising. Daily shoulder stretches and a balanced shoulder-strengthening program can help prevent a recurrence of your injury.In addition, daily exercises can help prevent an injury if you use your rotator cuff often. Your doctor or a physical therapist can help you plan an exercise routine.

Rotator Cuff Exercises

*Three samples of internal rotation exercises and three external rotation exercises are shown. Choose one. Do not do all three. In the first sample, resistance is provided by using an immovable object (isometric exercises); in the second, resistance is provided by using dumbbells (handheld weights); in the third, resistance is provided by the use of resistance bands. See equipment. (Exercises that use dumbbells may also be performed without weights to decrease difficulty)
Isometric Internal Rotation
Stand near the end of outer corner of wall.
Bend elbow to 90-degree angle and keep elbow close to body, lower arm level with floor.
Press palm of hand into wall for 10 seconds. Repeat exercise on other side.
Internal Rotation using Dumbbells
Lie on side.
Hold dumbbell on same side, Bend elbow to 90-degree angle. Keep elbow against body.
Slowly lift dumbbell upward and toward body.
Pause, and return to start.
Repeat 10 times. Repeat exercise on other side.
Internal Rotation using Resistance Band
Attach resistance band to doorknob / wall.
Stand with right side to wall.
Hold resistance band with right hand.
Bend elbow to 90-degree angle, hand facing frontward and elbow close to body.
Slowly rotate hand toward the middle of the body.
Return to starting position.
Repeat 10 times. Repeat exercise on other side
Isometric External Rotation
Stand with side to wall.
Bend elbow to 90-degree angle. Keep elbow close to body.
Press back of hand into wall for 10 seconds. Repeat exercise on other side
External Rotation using Dumbbells
Lie on left side.
With right arm, hold dumbbell next to body, elbow bent 90-degrees.
Slowly lift upward until back of hand faces backward.
Return to starting position.
Repeat 10 times. Repeat exercise on other side
External Rotation using Resistance Band
Attach resistance band to doorknob / wall.
Stand with left side to wall.
Hold resistance band with right hand.
Start with right hand in middle of body, elbow bent 90-degrees.
Slowly stretch band by moving arm outward until back of hand facing backward.
Do one set (10 repetitions) Repeat exercise on other side.
Lateral Raise using Dumbbell
Stand or sit in chair.
With arms at side and thumbs pointed upward, slowly raise arm to the sides but slightly toward the front (at about a 30 degree angle to the front of the body) until almost shoulder level.
Repeat 10 times.

Lying Lateral Raise using Dumbbell
Lie on left side. Hold dumbbell in right hand in, placed in front of thigh, palm facing leg. Keep elbow slightly bent. Raise dumbbell slowly until arm is at 45-degree angle.
Return to starting position.
Repeat 10 times. Repeat exercise on other side.
Lateral Raise with Internal Rotation using Dumbbell
Stand or sit.
With arms at side and thumbs pointed toward ground (shoulders internally rotated), slowly raise arm to the sides but slightly toward the front (at about a 30 degree angle to the front of the body) until almost shoulder level.
Repeat 10 times.

__________________
When a man opens the car door for his wife, it's either a new car or a new wife.
Prince Philip


To view links or images in signatures your post count must be 0 or greater. You currently have 0 posts.

Slamdog

reps.... from someone with a recurring shoulder injury...

__________________
I'd like to see it your way but I can't get my head that far up my own ar$e

Nine Pack

Good post, but I fear Paramaniac should have quoted the source as he didn't write it himself:

http://nixinne.wordpress.com/2007/02...r-cuff-injury/

This is all very informative but give credit to the author or at least post the link.

__________________

To view links or images in signatures your post count must be 0 or greater. You currently have 0 posts.


''I reject your reality and substitute my own''
Adam Savage.

ParaManiac

Thanks ninepack,my intentions were not self motivated or credit seeking and given the diagrams etc i would have thought it pretty obvious that i did not write it myself,however,you are correct,an oversight on my part.

For information i have used two seperate articles to create the post,which given the frequency of this injury and subsequent question repetition,i thought would be a useful resource.

__________________
When a man opens the car door for his wife, it's either a new car or a new wife.
Prince Philip


To view links or images in signatures your post count must be 0 or greater. You currently have 0 posts.

Nine Pack

Very good collection of info either way though.

__________________

To view links or images in signatures your post count must be 0 or greater. You currently have 0 posts.


''I reject your reality and substitute my own''
Adam Savage.

martinb1

The Pro-Relief can be used in three different ways. You can use it to massage tired or aching muscles, relieving any pain or stiffness and even stress as it makes you feel good. Secondly, you can use it to help stretch muscles, increasing mobility and loosening up joints. And most importantly, it’s most dynamic purpose is in relieving triggerpoints.

http://prorelief.com

dirtymusket1

Excellent post

Cheers ParaManiac