Rotary cuff injuries
Rotational cuff injuries Along with the tendons of the rotational cuff, in the supraspinatal “exit” there is a subacromial sac, which on top borders two ligaments – medial-acromial and beak-acromial. If one of them is damaged or swollen, the so-called “pinch syndrome” or impingement syndrome occurs in this area, but this phenomenon is secondary to the actual injuries. If there is swelling or muscle hypertrophy in the supraspinatal “exit”, then the second and all subsequent movements of the athlete above the head will only lead to an increase in swelling and the appearance of reactive inflammation. As a result, bone injuries may occur, and further repetitions may even lead to rupture of the rotational cuff. Most often, injuries of the tendon of the supraspinatus muscle occur, because it is located between the acromion of the scapula and the humerus. In this case, inflammation can spread to the subacromial bag, which is a possible cause of subacromial bursitis.
The first symptoms of rupture of the rotator cuff are pain and weakness in the shoulder. Sometimes the gap can be partial, in this case, the athlete feels pain, however, he can make hand movements in the usual mode. If there is a significant gap, weakness in the shoulder will be more pronounced. A complete gap is characterized by the fact that the athlete cannot move his hand at all, and pain occurs in the shoulder, although it is not clearly localized. Some patients may experience some “clicks” in their shoulders with hand movements. Another sign of a rupture is that the patient cannot lie on his side from the side of the sore shoulder.
How is rotational cuff injury treated? Initially, therapy will be prescribed, the purpose of which will be to reduce pain and stop the inflammatory process. Most likely, the patient will be prescribed anti-inflammatory non-steroid drugs. As soon as the pain decreases, you can proceed to light physical exercises to develop the joint, periarticular ligaments and arm muscles. A little later, you can add strength exercises that will strengthen the muscles. Gradually, the ability to move from the previous amplitude will return to the sore arm. Conservative therapy usually lasts 6-8 weeks, during which the shoulder pain will completely disappear and the muscle strength will partially recover.
If there is a complete rupture of the rotational cuff, surgical treatment is indicated. Only in this way will the normal range of motion in the joint be fully restored, and the operation must be carried out no later than three months after the injury. If the athlete has a partial rupture of the rotational cuff, then the operation is prescribed only in the patient, there is a prolonged pain syndrome that does not give a person rest.
If a tendon was torn, then its restoration is not always possible, especially if enough time has passed after the injury. In this case, there is a chance that cicatricial degeneration of the tendon and muscle has occurred, and even the operation will not tighten the tendon in order to fix it to the bone. Sometimes in the tendon there are bright processes of degeneration, and this can lead to a sufficient decrease in the burden on the gap. And even if the tendon reconstruction is successful, relapse is possible, and in the very near future. And then, during the operation, the surgeon must remove all damaged tissue – only in this way can all problems be eliminated, which lead to the occurrence or intensification of pain in the shoulder.