Rotator cuff

<languages /><translate> Rotator cuff is a structure made up of four muscles, and tendons that reinforces the shoulder joint.

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Rotator cuff syndrome

Anatomy

The rotator cuff is a group of muscles and tendons that attach to the bones of the shoulder joint, allowing the shoulder to move and keeping it stable.

The following four muscles comprise of the rotator cuff:

1. Supraspinatus - a muscle that holds the humerus and upper arm stable
2. Infraspinatus. helps rotate and extend your shoulder.
3. Teres Minor. This is the smallest of the rotator cuff muscle.
4. Subscapularis.

Rotator cuff tear

Rotator cuff tendinitis

• Rotator cuff tendinitis refers to irritation of these tendons and inflammation of the bursa.
• A rotator cuff tear occurs when one of the tendons is torn from the bone from overuse or injury.

Shoulder joint inflammation

• The tendons of the rotator cuff pass underneath a bony area on their way to attaching the top part of the arm bone.

When these tendons become inflamed, they can become more inflamed over this area during shoulder movements. Sometimes, a bone spur narrows the space even more.

• Rotator cuff tendinitis is also called impingement syndrome. Causes of this condition include:
• Keeping the arm in the same position for long periods, such as doing computer work or hairstyling
• Sleeping on the same arm each night
• Playing sports requiring the arm to be moved overhead repeatedly such as in tennis, baseball (particularly pitching), swimming, and lifting weights overhead
• Working with the arm overhead for many hours or days, such as in painting and carpentry
• Poor posture over many years
• Aging
• Rotator cuff tears

Rotator cuff on MRI imaging

Rotator cuff tears

Rotator cuff tears may occur in two ways:

• A sudden acute tear may happen when you fall
• A chronic tear of the rotator cuff tendon occurs slowly over time

There are two types of rotator cuff tears:

• A partial tear
• A complete

Symptoms

Tendinitis symptoms

• Early on, pain is mild
• Pain is more likely in the front of the shoulder and may travel to the side of the arm.
• The pain always stops before the elbow.
• If the pain goes down the arm to the elbow and hand, this may indicate a pinched nerve in the neck.
• There may also be pain when you lower the shoulder from a raised position.

Inflamed shoulder tendons Over time, there may be pain at rest or at night, such as when lying on the affected shoulder. You may have weakness and loss of motion when raising the arm above your head. Your shoulder can feel stiff with lifting or movement. It may become more difficult to place the arm behind your back.

Rotator cuff tear surgical repair procedure

Rotator cuff tears

The pain with a sudden tear after a fall or injury is usually intense. Right after the injury, you will likely have weakness of the shoulder and arm. It may be hard to move your shoulder or raise your arm above the shoulder. You may also feel snapping when trying to move the arm.

With a chronic tear, you often do not notice when it began. This is because symptoms of pain, weakness, and stiffness or loss of motion worsen slowly over time.

Torn rotator cuff Rotator cuff tendon tears often cause pain at night. The pain may even wake you. During the day, the pain is more tolerable, and usually only hurts with certain movements, such as overhead or reaching toward the back.

Over time, the symptoms become much worse, and are not relieved by medicines, rest, or exercise.

Exams and Tests

• A physical examination and history.
• X-rays of the shoulder
• An ultrasound test to look for a tear in the rotator cuff.
• MRI of the shoulder may show swelling or a tear in the rotator cuff.
• With a joint x-ray or CT called arthrogram

Treatment

Treatment varies based on whether there is tendinitis and or tear.

Shoulder motion with rotator cuff

Treatment of tendinitis

• Ice packs applied 20 minutes at a time, 3 to 4 times a day
• Taking medicines, such as ibuprofen and naproxen, to help reduce swelling and pain
• Avoiding or reducing activities that cause or worsen your symptoms
• Physical therapy to stretch and strengthen the shoulder muscles
• Corticosteroid injected into the shoulder to reduce pain and swelling
• Surgery

Treatment of tears

• Rest and physical therapy
• Surgery to repair

Prognosis

With rotator cuff tendinitis, rest, exercise and other self-care measures often improve or even relieve symptoms.=

Prevention

• Avoid repetitive overhead movements.
• Exercises to strengthen shoulder and arm muscles can also help prevent rotator cuff problems.
• Practice good posture to keep your rotator cuff tendons and muscles in their right positions.

Alternative Names

Swimmer's shoulder; Pitcher's shoulder; Shoulder impingement syndrome; Tennis shoulder; Tendinitis - rotator cuff; Rotator cuff tendinitis; Shoulder overuse syndrome

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