ROTATOR CUFF INJURIES / TEAR
Web of four tendons and muscles:
That surround the shoulder joint and firmly intact the upper arm bone in the shallow shoulder socket are called Rotator Cuff. They enable the joint to function by assisting in their all direction movement and holding the arm bone firmly in place by surrounding it. Shoulder joint being the most flexible but unstable can sustain injury even with very minute stress making the tendon in the rotator cuff either pull away or get torn.
Age and overhead motions:
Are the biggest contributories to rotator cuff injuries as repeated stress and overuse might trigger off the tendon to be torn apart from the cuff and this susceptibility increases with age. Weakness, extreme pain, inability to move the shoulder and arm normally, crackling sound in moving the shoulder and difficulty in sleeping on the side of the affected shoulder are the common signs that signify that the rotator cuff might have been injured.
Thorough examination and evaluation:
Are tools which aid the prognosis of the orthopedic surgeon to adopt to methodology to reduce pain and rehabilitate the rotator cuff. The rotator cuff injuries might vary from being mild to complete and severe tears thus helping in determining whether the injury has to be treated surgically or by conservative techniques. Without treatment the rotator cuff injury can impair the movement of the shoulder permanently.
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Rationale:
When rotator cuff muscles located in the shoulder joint sustain an injury or get affected by traumatic conditions such as, falling on an outstretched arm, debilitation by being lifted overhead repeatedly or by degenerative tendons they damage rotator cuff tendons such that they result in mild strains, tendonitis or partial and complete tear causing intense pain and loss of mobility in the joint. It is only after complete physical examination and early diagnosis that the most effective treatment technique is determined.
Approach considerations:
Besides traumatic injury due to fall or repeated overhead use of the arm, the risk of rotator cuff injuries or tear increases substantially if the person is an athlete, works as a painter or carpenter, has a poor posture or person who has weak shoulder muscles.
Conservative treatment techniques are taken up as first line of treatment for rotator cuff injuries and are helpful in reducing pain and improving flexibility but are unable in restoration of strength. They bring down persistent symptoms but fail to decrease the size of the tear. They are customarily prescribed to the patients for a period of at least six months before considering relief by surgical intervention.
The patient should consult our medical team >>click here for appointment
Deliverance of techniques:
When the presence of rotator cuff injury or tear is ascertained by diagnostic tests and physical examination, conservative techniques are taken as the beginning of the treatment procedure. The techniques comprise of –
Oral Medications-medicines in the form of NSAIDs i.e. non steroidal anti inflammatory drugs are prescribed by the shoulder specialist to alleviate the pain in the shoulder and arm. They are given to the patient at regular intervals and are not harmful as they do not have steroid effect. Physical Therapy-Specific exercises performed by the patient under monitoring of a skilled therapist are an important tool of conservatively treating rotator cuff injuries. The exercising regime restores strength and functional movements in the affected shoulder. Stretching and strengthening exercises are the base of the regime. Corticosteroid Injections-The steroids are directly inserted into the joint as a tool when oral medications and physical therapy fail to provide relief. Not more than two injections can be taken as the course of treatment else they might potentially harm the patient.The patient should consult our medical team >>click here for appointment
Benefits of conservative techniques:
The conservative techniques save the patient from anxieties of surgery at one end and prevention of infection is another common advantage of treatment by it. They do not cause permanent stiffness and recovery time is less than surgery. Mild rotator cuff injuries are best and most effectively provided restoration of mobility by conservative techniques.
Complications of conservative techniques:
Conservative techniques are inadequate in decreasing the size of the tear and in carelessness the tear size may just increase causing complications. The patient has to strictly prohibit activities and limit shoulder movements in spite of which the strength may not be restored.
Outcome of conservative techniques:
Conservative techniques have a high success ratio in provision of relief in pain within two weeks with assurance that patients usually return to their normal tasks after four to twelve weeks. This is achievable when the patient continues with therapy sessions thrice a week with periodic evaluation and adaptation to changes in the treatment according to severity.
Preventive measures:
To prevent rotator cuff injuries a person should do regular shoulder exercises, rest the shoulder for short periods when the work involves repeated and stressful overhead activities, constantly keep applying ice or heat therapies if there is shoulder pain at the backdrop.
More about shoulder specialist:
Dr. Vikas Gupta, an eminent and skilled professional is the best hand and shoulder specialist in India today. Being in the field of upper extremity for more than 25 years and having conducted over 6000 successful surgeries, Dr. Gupta ensures complete provision of relief by principles- diagnosis- deliverance- rehabilitative care. Completing his graduation as MBBS and MS in Orthopedics from All India Institute of Medical Sciences, New Delhi, he went on to USA and Germany to complete his fellowship. He rejoined AIIMS as an associate professor and has served patients from various hospitals over this long period such as Consultant Hand & Upper Extremity Surgery (orthopedics) At Fortis Hospitals, Director, Hand & Upper Extremity Surgery (orthopedics) At Medanta – The Medicity, Gurgaon and at present as head of Hand and Shoulder division at Max Healthcare, Gurgaon and Saket. Max Healthcare is considered to be the best hospital in Delhi- NCR region because of their strife and dedication to bring a revolutionary change in the techniques of treatment. With an ingenious team of professionals and a highly technological set up for treatment techniques Max is the best in deliverance of painless and cost effective techniques.