2 ObjectivesTo identify the causes, symptoms, treatment, and prevention of various shoulder injuries.
3 Anatomy of the Shoulder Shoulder made up of 3 bones: Humerus, Scapula, and ClavicleBall of Humerus fits into shallow socket of the ScapulaYour arm is kept in your socket by your rotator cuff, which is a network of four muscles, along with tendons, that form a covering around the head of the Humerus.The bursa (between the rotator cuff and the acromion) allows the rotator cuff tendons to glide freely when you move your arm.
5 Rotator Cuff TearsWhen rotator cuff tendons are torn, they no longer fully attach to the head of the humerus.Partial tear or full tear.In many cases, torn tendons begin by fraying. As the damage progresses, the tendon completely tears.
6 Cause Two main causes: Injury and degeneration. Acute tear: If you fall down on your outstretched arm of lift something too heavy with a jerky motion, you can tear your rotator cuff. This type of injury can occur with other shoulder injury such as a broken collarbone or dislocated shoulder.Degenerative tear: Most tears are the result of wearing down of the tendon that occurs slowly over time or as you age.
7 Degenerative TearRepetitive stress: Repeating the same shoulder motions again and again. Baseball, tennis, rowing, and weightlifting that put you at risk for overuse tears. Many jobs can cause overuse tears as well.Lack of blood supply: As we get older, the blood supply in our rotator cuff tendons lessens, hindering the body’s natural ability to repair tendon damage.Bone spurs: As we age, bone spurs develop under the acromion bone. The spurs rub on the rotator cuff tendon and over time make it more likely to tear.
8 SymptomsPain at rest and at night, particularly if lying on the affected shoulder.Pain when lifting and lowering your arm or with specific movements.Weakness when lifting or rotating your arm.Cracking sensation when moving your shoulder in certain positions.If you have a tear and you keep using it despite increasing pain, you may cause further damage and the tear can get bigger over time.
9 TreatmentThe goal of treatment is to reduce pain and restore function.Nonsurgical treatmentRestActivity modificationNSAID: ibuprofen and naproxen to reduce pain and swellingStrengthening exercises and physical therapy: Stretches to improve flexibility and range of motion. Strengthening the muscles that support your shoulders can prevent injury.Steroid injection: Cortisone is a very effective anti-inflammatory medicine.
10 Treatment cont’dSurgical treatment: Your doctor may recommend surgery if your pain does not improve with nonsurgical methods.Your symptoms have lasted 6 to 12 months.You have a larger tear (more than 3 cm).You have significant weakness and loss of function in your shoulder.Your tear was caused by a recent, acute injuryReattaching the tendon to the head of the humerus.
11 PreventionKeeping the muscles in your shoulders flexible and strong. Daily exercises to maintain strength and flexibility may be the best defense against rotator cuff tears.Not lifting objects that are too heavy for you, especially over your head.Take frequent breaks at work if your job requires repetitive arm and shoulder motionsRest your shoulder regularly during sports that require repetitive arm useApply cold packs when you experience any shoulder pain or inflammation