As we get closer to spring, more outdoors activities will be in order. Whether one is gardening, playing baseball, or golfing, one may be at risk for a variety of musculoskeletal injuries. Shoulder problems are common, so let’s look at these injuries and treatments.
What is the rotator cuff? This is a group of four shoulder muscles deep within the shoulder girdle around the shoulder blade and collarbone that cover the shoulder blade with tendon attachments under the collarbone. The muscles of the rotator cuff provide full range of motion of the shoulder, including lifting the arm over the head, scratching the back, and rotating inward and outward.
What are common injuries? Trauma to the shoulder may result in a variety of conditions. Within the shoulder are bursae - small sacks of synovial fluid that help muscles and tendons slide smoothly across bone. A traumatic injury, repetitive movement or excessive pressure can cause the sacks to fill, leading to bursitis. Movement then becomes painful and rough.
The tendons of the shoulder may become irritated with overuse as well, resulting in tendonitis of the shoulder. With severe tendonitis, an individual may experience some catching of the tendon.
With increased age or prior injury, arthritis may be present. The arthritic changes may also lead to catching of the tendons, altering movement and causing pain.
With a shoulder injury, the rotator cuff muscles typically swell. Because they are surrounded by bone, their swelling can lead to increased pressure within the muscles and compression that reduces blood flow to the muscle. The result is muscle tissue that frays like rope - an impingement syndrome. This can lead to a tear in the rotator cuff.
A tear results in pain, weakness, and limited range of motion. Some people experience chronic tears from overuse, such as baseball players. This can also occur due to prolonged overhead work and repetitive work.
What are the symptoms? After an injury, the patient may have pain in the front and back of the shoulder. There will be weakness, loss of range of motion, and difficultly performing activities of daily living.
What should be done? An evaluation by your health care provider is in order. A history and physical examination will be necessary to isolate the exact muscle involved. X-rays may be necessary, and an MRI may be required to further assess internal damage.
Physical therapy can help improve the condition. Anti-inflammatory medications, like ibuprofen, will help with the pain.
If conservative measures do not help, your doctor will perform outpatient arthroscopic surgery to clean up frayed muscles. This is followed with another course of physical therapy. The results are usually quite favorable.
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