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Rotator cuff tear symptoms, shoulder rotator cuff pain exercises - PDF Review

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Impingement syndrome is a descriptive term of pinching of the tendons and bursa of the rotator cuff between bones. Impingement syndrome and a rotator cuff tear are different problems, and although they are related, the treatment is different.
Factors Influencing DurationThe size of the tear, the individual's age, occupation, and overall health, dominant side involvement, the need for surgery, and the effectiveness of rehabilitation may affect the length of disability. Overview © Reed GroupA rotator cuff tear occurs when the tendons that form the rotator cuff weaken and tear. Tears are described as either partial-thickness tears or full-thickness, depending on the amount of tissue damage.
SymptomsThe signs and symptoms of a rotator cuff tear depend on the size and extent of the tear and the length of time that it has been present.
Weakness, associated loss of power and movement all occur, depending on the size of the tear. Once the rotator cuff tears, it does not heal, and surgery will be necessary to repair the tendon. Operative TreatmentArthroscopic Acromioplasty, Acromioclavicular Joint Arthroplasty and Rotator Cuff RepairRepair of the rotator cuff tear is indicated for disabling chronic pain and loss of function.
Surgery to repair a tear involves removing the roof of the tendon tunnel (acromioplasty) to make room for the tendon, removing the joint between the clavicle and the acromion (acromioclavicular joint arthroplasty), and repairing the torn tendon. In some cases, the tear is too extensive, and the tendons have retracted to such an extent that they cannot be repaired.
The Reverse Shoulder Prosthesis is mainly used as a last resort option for older patients with rotator cuff tear arthropathy (end stage cuff tear arthropathy) a medical condition in which the rotator cuff muscles (the muscles around the shoulder joint) have degenerated, or weakened to a point where they can no longer hold the shoulder joint intact or allow it to function normally in conjunction with arthritis. For rotator cuff tears, pain may occur when lifting and lowering your arm or with other specific movements. As a result, rotator cuff pathology can affect daily activities such as combing your hair or dressing yourself, it can also disturb sleep patterns. Shoulder bursitis and rotator cuff tendonitis are all ways of saying there is inflammation of a particular area within the shoulder joint that is causing a common set of symptoms. Between these bones lies the tendons of the rotator cuff, and the bursa that protects these tendons.
Tendons in your rotator cuff can become inflamed due to overuse or overload, especially in athletes who perform a lot of overhead activities, such as tennis or racquetball players.

The fluid-filled sac (bursa) between your shoulder joint and rotator cuff tendons can become irritated and inflamed. Left untreated, tendinitis can weaken a tendon and lead to chronic tendon degeneration or to a tendon tear. Increasingly after age 40, normal wear and tear on your rotator cuff can cause a breakdown of fibrous protein (collagen) in the cuff's tendons and muscles.
When you slouch your neck and shoulders forward, the space where the rotator cuff muscles reside can become smaller.
Using your arm to break a fall or falling on your arm can bruise or tear a rotator cuff tendon or muscle. Lifting an object that's too heavy, or doing so improperly — especially overhead — can strain or tear your tendons or muscles.
Repetitive overhead movement of your arms can stress your rotator cuff muscles and tendons, causing inflammation and eventually tearing.
Your doctor or a physical therapist will talk with you about specific exercises designed to help heal your injury, improve the flexibility of your rotator cuff and shoulder muscles and provide balanced shoulder muscle strength. Some long-standing shoulder muscle tears may contribute to the development of rotator cuff arthropathy, which can include severe arthritis. The four muscles of the cuff (supraspinatus, infraspinatus, subscapularis, and teres minor muscles) arise from the scapula and blend together to form a single tendon unit. In good health, there is just sufficient room for the rotator cuff tendons to pass under the acromion bone of our shoulder when we elevate our arm. If extensive tears are not treated, the result is deteriorating shoulder function, the onset of widespread arthritis in the shoulder region, and increasing pain over time.
The cuff will be secured to the bone by a series of anchors with attached sutures, or suturing the tendon by sutures through bone.
Depending on the size of the tear and the security of the repair, this may be a simple shoulder sling immobiliser (small tears), or an abduction brace that holds the arm away from the body, for larger tear repairs.
The best terminology for these symptoms is 'impingement syndrome.' Impingement syndrome occurs when there is inflammation of the rotator cuff tendons and the bursa that surrounds these tendons. In some people, the space where the rotator cuff resides can be narrowed due to the shape of different shoulder bones, including the outside end of the collarbone or shoulder blade. These include having arthritis in the joint, along with extensive tears of multiple muscles and tendons (rotator cuff) that support the shoulder, or having extensive rotator cuff tears and a failed previous shoulder joint replacement.

The larger the tear, and the longer the interval from injury to surgery, the more likely that there will be some residual permanent weakness of the rotator cuff (Safran). Tears can occur in the rotator cuff as a result of disease, wear and tear, trauma and aging. If you have a severe injury, such as a large tear, you may experience continuous pain and muscle weakness. The best signs that differentiate these problems area the strength of the rotator cuff muscles.
With age, you may also develop calcium deposits within the cuff or arthritic bone spurs that can pinch or irritate your rotator cuff. The tendons of these muscles come under stress from activities that require lifting and rotation of the arm often in a throwing type motion. Poor posture, especially as related to your shoulders hunched forward, also can contribute to rotator cuff injury. Your orthopedic doctor will be able to specifically isolate these muscles to better determine if a rotator cuff tear is present. Any abnormalities of the shoulder joint can aggravate the stress, especially joint looseness (laxity), muscle imbalance, rubbing of the front edge of the shoulder blade (acromion) on the rotator cuff (impingement syndrome), bone spurs, and bursitis.
The rotator cuff holds the humerus in place in the shoulder joint and enables the arm to rotate. A MRI can also show the tendons of the rotator cuff and help determine if a tear is present. Daily shoulder stretches and a balanced shoulder-strengthening program can help prevent a recurrence of your injury.In addition, daily exercises can help prevent an injury if you use your rotator cuff often.
Circulation to the rotator cuff decreases with age and the tendons themselves degenerate over time.

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