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Are you experiencing shoulder pain?

  • Do you have weakness or tenderness in the shoulder?
  • Do you have difficulty moving your shoulder, especially when trying to lift your arm above your head?
  • Do you hear snapping or cracking sounds when moving your shoulder?
  • Trouble sleeping on your shoulder?

Most rotator cuff injuries develop gradually. But, they also can happen suddenly, you might feel a pop, intense pain, and weakness in the arm. The most common rotator cuff injuries are caused by falling on to your shoulder, using an arm to break a fall or improperly lifting objects.

What Is The Rotator Cuff?

The rotator cuff is a group of four tendons and muscles that converge around the shoulder joint at the top of the humerus, the upper arm bone above the elbow. Together, they form a ”cuff” that both holds your arm in place and allows it to move in different directions. The shoulder is a ball-socket joint that allows the arm to move in many directions. It is made up of the humeral head (the upper end of the bone of the upper arm) fitting into the glenoid fossa of the scapula (shoulder blade). The humeral head is kept in place by the joint capsule and labrum, thick bands of cartilage that form an elongated cone where the humeral head fits. The rotator cuff muscles are the dynamic stabilizers and movers of the shoulder joint and adjust the position of the humeral head and scapula during shoulder movement.

The four rotator cuff muscles include the

  • supraspinatus,
  • infraspinatus,
  • subscapularis,
  • teres minor.

Other muscles that help move and stabilize the shoulder include the deltoid, teres major, corachobrachialis, latissimus dorsi, and pectoralis major.

Damage to any or all of the four muscles and the ligaments that attach these muscles to bone can occur because of acute injury, chronic overuse, or gradual aging. This damage can cause significant pain and disability with decreased range of motion and use of the shoulder joint.

What Are the Symptoms of a Rotator Cuff Tear?

Acute rotator cuff tear:

  • This injury usually develops from falling on a shoulder or from lifting too heavy of an object, for example lifting weights with improper form.
  • Symptoms can be a sudden tearing sensation followed by severe pain shooting from the upper shoulder area (both in front and in back) down the arm toward the elbow. There is decreased range of motion of the shoulder because of pain and muscle spasm.
  • Large tears may cause the inability abduct the arm (raise it away from the side of the body) due to significant pain and loss of muscle power.

Chronic rotator cuff tear:

  • Found among people in occupations or sports requiring excessive overhead activity. For examples, painters, baseball pitchers, tennis players and construction workers.
  • Chronic injuries may be a result of a previous acute injury that has caused a structural problem within the shoulder and affected the rotator cuff anatomy or function For example, bone spurs that impinge upon a muscle or tendon, causing inflammation.
  • Symptoms usually present as pain, usually is worse at night, and may interfere with sleep. Gradual weakness and decreased shoulder motion develop as the pain worsens.

Rotator cuff tendinitis: (tend=tendon +itis=inflammation)

  • More common in women 35-50 years of age
  • Deep ache in the shoulder also felt on the outside upper arm over the deltoid muscle
  • Point tenderness may be appreciated over the area that is injured
  • Pain comes on gradually and becomes worse with lifting the arm to the side (abduction) or turning it inward (internal rotation)
  • May lead to a chronic tear

Why Does Your Rotator Cuff Hurt?

When a rotator cuff tendon becomes inflamed, it runs the risk of losing its blood supply, causing some tendon fibers to die. This increases the risk that the tendon can fray and partially or completely tear. Injuries to muscle/tendon units are called strains and are classified by the amount of damage to the muscle or tendon fibers. Grade I strains involve stretching of the fibers without any tears. Grade II injuries involve partial muscle or tendon tearing, and grade III injuries are defined as a complete tear of a muscle or tendon.

When the rotator cuff is damaged, a variety of issues arise:

  • Pain and spasm limit the range of motion of the shoulder.
  • The muscles do not make the small adjustments within the joint to allow the humeral head to move smoothly.
  • Fluid accumulation within the joint due to inflammation limits movement.
  • Arthritis and calcium deposits that form over time limit range of motion.

How Dr. Fuhrmann Can Help?

A proper history and physical exam will determine what is injured and once we diagnose your problem (s), a specific treatment plan will be designed to get you pain free as fast as possible.

To properly diagnose a shoulder problem, you may be asked to move your shoulder in different directions to see what causes pain. In addition, you may be referred for diagnostic imaging. This may include X-Ray, MRI or Arthrogram. Once a diagnosis is reached, Dr. Fuhrmann has several treatment options available to reduce and eliminate your pain:

  • Soft Tissue Therapy /KT tape / Trigger point Therapy
  • Instrument Assisted Soft Tissue Mobilization
  • Cold Laser / Low Level Laser
  • TENS / Muscle Stimulation
  • Rehabilitative Exercises
  • Patient Education
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