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Your arm is kept in your shoulder socket by your rotator cuff. The rotator cuff consists of four muscles, the supraspinatus muscle, the infraspinatus muscle, the terres minor muscle, and the subscapularis muscle. These muscles attach the humerus to the shoulder blade and help lift and rotate your arm.
Your shoulder is made up of three bones: your upper arm bone (humerus), your shoulder blade (scapula), and your collarbone (clavicle). The shoulder is a ball-and-socket joint: the ball, or head, of your upper arm bone fits into a shallow socket in your shoulder blade.
There is also a lubricating sac called a bursa between the rotator cuff muscles and the bone on top of your shoulder (acromion). The bursa allows the rotator cuff tendons to glide freely when you move your arm. Sometimes it may become inflamed and painful due to overuse.
There are two main causes of rotator cuff injury and degeneration.
If you fall down on your outstretched arm or lift something too heavy with a jerking motion, you can tear your rotator cuff at that moment.
Many rotator cuff tears are the result of a wearing down of the tendon occurring slowly over time. They are more common in the dominant arm.
Several factors contribute to degenerative, or chronic, rotator cuff tears.
The most common symptoms include:
Tears that happen suddenly, such as from a fall, usually cause intense pain immediately. There may be a snapping sensation or feeling of something giving way, followed by immediate weakness/severe pain in moving your upper arm.Tears that develop slowly due to overuse also cause pain and arm weakness but the increase in pain intensity occurs over time. You may have pain in the shoulder when you lift your arm, or pain that moves down your arm. At first, the pain may be mild and only present when lifting your arm over your head, such as reaching into a cupboard. Over time, the pain may become more noticeable at rest, and no longer goes away with medications. You may have pain when you lie on the injured side at night. The pain and weakness in the shoulder may make routine activities such as combing your hair or reaching behind your back more difficult.
There are different types of tears.
Magnetic resonance imaging (MRI) or ultrasound are probably the best way to confirm tears, bursitis, tendinopathies or bone spurs in the rotator cuff area.
If you have a partial rotator cuff tear and you keep using it despite increasing pain, you may cause further damage. A rotator cuff tear can get larger over time.
Chronic shoulder and arm pain are good reasons to see your doctor. Early treatment can prevent your symptoms from getting worse. It will also get you back to your normal routine that much quicker.
The goal of any treatment is to reduce pain and restore function. There are several treatment options, and the best option is different for every person. In planning your treatment, your doctor will consider your age, activity level, general health, and the type of tear you have.
Nonsurgical treatment options may include:
Your doctor may recommend surgery if your pain does not improve with nonsurgical methods. Continued pain is the main indication for surgery. If you are very active and use your arms for overhead work or sports, your doctor may also suggest surgery.
Other signs that surgery may be a good option for you include:
Surgery to repair a torn rotator cuff most often involves re-attaching the tendon to the head of humerus (upper arm bone).
Home rehab exercises for the rotator cuff muscles click here
Physiotherapist in Tralee : Phone 086-7700191