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[S425]Shoulder Rotator Cuff Injuries

by Mike Carroll, Mik

When you go into your physician with complaints of longstanding shoulder pain, he may or may not recommend imaging of the shoulder. The fact of the matter is much of shoulder pain can be diagnosed without the use of any imaging technologies. However, if the physician is interested in finding more information, the specific technology that he uses depends upon his own diagnosis and the questions he is trying to answer.

It is because of the different results that will come from each type of imaging technology that physicians can simply go through a process to decide which tool to use - a process of elimination according to what each reveals.

Plain x-rays - the old fashioned x-rays - will give you good information about the bones. Is there any arthritis? Are there any bone fractures? In deed, in one of the fairly common problems called calcific tendonitis, one of the tendons becomes calcified and essentially starts to turn to bone - this is a phenomenon that can be picked up on x-rays. Certainly cancer, tumors, all these things, if they involve the bone, can be picked up on plain x-rays as well. However, the ability of an x-ray to reveal cancer is restricted because if it is not within the bone, than cancerous bodies escape the attention of the basic x-ray film.

Magnetic Residence Imaging, or MRI, is technology that's been around since the early 80s and it is the best way we have to look at soft tissues. This means that the MRI will reveal tumors that are not involved in the bone, and even more information about the soft tissues in the area being surveyed. An MRI will also show abnormalities, ruptures, or inflammation of the tendon - all which are hidden to an x-ray. The MRI technology will also reveal bone fractures that are not seen on plain x-rays - which happens up to 10% of the time. When it comes to an MRI, it essentially gives the most information without any cutting into the shoulder to look at it.

Ultrasound is a new modality, and it is very useful. You do need to understand its limitations. Ultrasound will basically tell you how someone superspinatis tendon is. Now, keep in mind, the superspinatis tendon is where most of the problems originate with the rotator cuff. And many times, we will get an ultrasound if we want to find out if its' worth while to try to treat someone conservatively. Basically, if a superspinatis tendon is just showing partial tears or inflammation or swelling, then this person will likely get better without any type of surgery. Even moderate tears can shown on ultrasound, can very frequently be healed without surgery; however, if there is a complete tear in the tendon then there is actually retraction on both sides - so there is basically a separation between the tear - there's not a great place for physical therapy in my opinion. So, the ultrasound is a one trick pony, but it can be quite practical and can give us a dream life if we really push the non-surgical rehabilitation aggressively.

By being aware of what each imaging technology reveals about the tissues and bones underneath the skin, doctors are able to get a lot more information about a shoulder condition without having any invasive procedure. Whether its an x-ray, MRI or ultrasound, all are informational tools physicians can use to help patients who are suffering from long-term shoulder pain.

The acromioclavicular joint (AC Joint or Rotator Cuff) of the shoulder facilitates the largest range of motion of any joint in the body. It is comprised of muscles, ligaments and tendons that work in harmony to coordinate movement in both the scapulae (shoulder blade) and arm. When functioning optimally, the rotator cuff allows an extremely wide range of motion, accounting for more than 1600 different positions, providing function for multiple activities, from work to recreation. When the rotator cuff is injured, the associated pain and dysfunction can completely disable a person???s ability to perform normal activities.

A variety of injuries can occur that result in symptoms ranging from a general ache to dehabilitating pain and dysfunction of the shoulder joint. The most acute form of injury usually results from direct force trauma that occurs from impact on the shoulder joint. This can occur from a car accident, football tackle or fall, and generally results in at least one or more ligaments being detached as well as tendons being torn.

Another from of serious shoulder injury occurs from a muscle imbalance resulting from repetitive overuse. Unidirectional (one way) movement patterns cause the muscles that are controlling the movement direction to become stronger, larger and shorter than the opposing muscle groups, resulting in imbalanced muscles and therefore an imbalanced joint. Most often, the muscle imbalance results from excessive over utilization of the anterior (front) portion of the shoulder, resulting in the humerus riding forward in the joint capsule, which in turn, causes Impingement Syndrome or Thoracic Outlet Syndrome to occur. Although there are a number of shoulder injuries, these two are very common and are associated with overuse.

Impingement syndrome occurs from the anterior shoulder muscles pinching the supraspinatus muscle, resulting in severe pain when trying to reach above the hard or across the body towards the opposite shoulder. Thoracic Outlet Syndrome results from compression of the Brachial Plexus, the main branch consisting of the Radial, Median and Ulnar nerves, which control feeling and function of the entire extremity. Symptoms usually consist of the entire hand falling asleep when the hands are out in front of the body at chest level or above the head, as raising the arms causes increased pressure on the anterior shoulder/ upper pectoral region where the Brachial Plexus lies.

With this in mind, many physicians and therapists recommend exercises to strengthen the musculature in and around the shoulder joint in order to eliminate or prevent muscle imbalances, while simultaneously increasing overall shoulder strength and joint integrity. When properly devised, an exercise regimen can build strength and provide flexibility for both muscles and tendons. This in turn prevents undue stress and strain on the acromioclavicular joint and its ligaments and tendons.

Rotator cuff exercises provide a safe, easy way to both prevent and rehabilitate shoulder injuries. Creating more strength and integrity in the shoulder joint than is going to be used by a particular activity can greatly protect the area from injury. If the joint is made to withstand 400lbs of pressure and it is only asked to use 300 lbs, it is going to be less prone to injury as it is stronger than the force that it is being subjected to. This is such an important key in preventing injuries. Prepare the body for the activity; do not perform the activity in order to prepare the body for that activity. And if an injury does occur and rehabilitation is necessary, it is again important to realize that the injured muscles will never regain their original strength unless specifically isolated and subjected to resistance training to bring them up to pre-injury levels and beyond. Research suggests that within as little as 4-6 weeks, performing a regular strengthening routine using free weights, resistance bands and/or flextend, most patients report substantial improvement.

Remember to always consult your primary care physician about an injury that may have occurred so that you receive a correct diagnosis.

Article Source : heart medical conditions

About Author

Both Mike Carroll & Ben Needles are contributors for EditorialToday. The above articles have been edited for relevancy and timeliness. All write-ups, reviews, tips and guides published by EditorialToday.com and its partners or affiliates are for informational purposes only. They should not be used for any legal or any other type of advice. We do not endorse any author, contributor, writer or article posted by our team.

Mike Carroll has sinced written about articles on various topics from Other Conditions. Michael Carroll, MD is a board certified family physician with a special interest in sports medicine and pain management. He is the founding partner of Creekside Clinic, LLC, a progressive primary care center in Traverse City, Michigan and a member. Mike Carroll's top article generates over 720 views. to your Favourites.

Ben Needles has sinced written about articles on various topics from Business Credit Cards, Anger Control and Business Credit Cards. About the Author (text)Jeff P. Anliker, LMT, is a Therapist and Inventor of training systems that are utilized by corporations, consumers, musicians, athletes and medical facilities around the world for rehabilitation and performance e. Ben Needles's top article generates over 550000 views. to your Favourites.