Between 60 ° and 120 °, the space between the head of the humerus and the scapula’s acromion is reduced, in which the tendon of the supraspinatus muscle runs. For this reason, frequent movements in this joint range can cause inflammation or degeneration of the supraspinatus tendon in the long run. In this article, we will give you a complete guide about torn rotator cuff symptoms.
It is no coincidence that the lesion usually affects the tendon in a specific area. That is about one centimeter away from its insertion on the humerus (bronchitis). This area is quite rich in capillaries, which serve to supply the tendon with oxygen and energy substrates. Sub-acromial conflict with aging, disuse, or excessive use, the blood supply to the tendon decreases, decreasing its elasticity and increasing its fragility. The blood supply to the tendon is further reduced. When the arm works between 60 and 120 °, as, as we have seen. This movement reduces the space between the humeral head and the acromion. This compression traps and partially obstructs blood vessels, considerably increasing the risk of injury.
It is no coincidence that such injuries occur more frequently in disciplines that involve repetitive movements in sport. That requires abduction associated with external rotation of the arm (baseball, javelin throw, tennis, some swimming specialties). In fact, the repetitive use of tendons leads to their significant thickening, further reducing the subacromial space. In young people, a particularly violent movement can damage one or more tendons already compromised by excessive use.
Torn rotator cuff symptoms
In sedentary people, some postural defects associated with work activities that impose bad postures can cause an increase in dorsal kyphosis (forward curvature of the thoracic tract of the spine) in the long run. This postural attitude, commonly called hump, projects the shoulders forward, subjecting the rotator cuff to excessive tension. It is no coincidence that shoulder pain is the second most frequent cause of absenteeism after low back pain.
The weakening of the tendon structures that make up the cuff increases, in the long run, the instability of the entire shoulder, favoring the upward ascent of the humeral head. This rise further decreases the space available to the tendons, causing pain. If the condition becomes chronic, we speak of impingement syndrome precisely to indicate “trapping” of soft tissues in the subacromial space.
An injury to the tendons of one or more muscles that make up the Torn rotator cuff symptoms can also occur due to trauma (fall on the shoulder) or subacromial bursitis. When a person falls with a slam on the shoulder, the acromion experiences pressure that knocks him against the rotator cuff. If the impact is severe enough, the bone can damage the tendons. The extent of the trauma, the shape of the acromion’s lower surface (more or less sharp; uncinate acromion), and the flexibility of the muscles and tendons that make up the rotator cuff will affect the extent of the injury (complete or partial).
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Diagnosis of injuries
The most commonly used instrumental investigation to diagnose a Torn rotator cuff symptoms tear is magnetic resonance imaging. In fact, it is capable of displaying the exact location and extent of the lesion with extreme precision. The X-rays are not able to show clearly the tendons of the state of health. Still, they can highlight the consequences (narrowing the space between tendons and the acromion, acromial spurs, osteoarthritis, osteophytes ), especially if performed by injecting a contrast medium into the shoulder. Even the ultrasound can identify tendon lesions with a certain quality, even though it cannot diagnose any bone pathologies. The use of these tests generally occurs after major trauma or when after a period of adequate rest, the shoulder’s condition does not improve.
In any case, it is possible to diagnose with certainty the true cause of shoulder problems only by integrating the results of several instrumental investigations (for example, resonance + radiography ) with those of the medical examination.
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The shoulder joint and its problems
The shoulder is an extremely complicated area of the human body because it comprises a set of 5 joints. Among these, the main one is called the scapulohumeral or glenohumeral, as it connects the head of the humerus with the glenoid cavity of the scapula. The combination of these five joints, operated by numerous muscle groups (twenty-six muscles in all), makes the shoulder the most mobile “joint” in our body. All this mobility allows the execution of very complex movements but significantly decreases the entire region’s stability. However, the shoulder joint I, protected by numerous anatomical stabilizing structures led by the muscles and tendons that form the rotator cuff. Over the years, the ligamentous and muscular apparatus can go against degenerative phenomena, and only adequate physical activity can keep it efficient over time.
What in the past was erroneously called shoulder periarthritis (pain localized around the shoulder) is now considered a group of different painful pathologies that can affect this delicate joint. Of all these diseases, inflammation of the tendons that form the rotator cuff is undoubtedly the most frequent. It must also be considered that not all shoulder problems arise from this joint complex. Simple cervical arthrosis can, in fact, cause irradiation of pain also along the shoulder and elbow.
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Rotator cuff: anatomy and physiology
The torn rotator cuff symptoms is a muscle-tendon complex consisting of a set of four muscles and their respective tendons :
superiorly we find the tendon of the supraspinatus muscle, anteriorly that of the subscapularis muscle, and posteriorly the tendons of the infraspinatus and teres minor muscles. With their tonic contraction, these muscles stabilize the shoulder preventing its dislocation (exit of the humeral head from the glenoid cavity). The rather large tendons (about five centimeters) protect the entire joint forming a real cuff that surrounds the upper part of the humerus.
- OVER-THRUST or supraspinatus: with its action, it abducts and rotates the arm outside (extra-wheel) in synergy with the action of the deltoid
- UNDERPATHED OR INFRASPINATED: with its action, it externally rotates the arm and strengthens the capsule of the shoulder blade joint, stabilizing it.
- subscapular anatomy SUBSCAPULAR: with its action, it adducts and rotates the arm inwards (internal rotator)
- small round: With its synergistic action against the infraspinatus, it weakly rotates the arm outwards.
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Torn rotator cuff symptoms, diagnosis
Of the four muscles that make up the rotator cuff, the supraspinatus is the most frequently injured. In reality, when we talk about the rupture of the rotator cuff. We are not referring to injuries of a muscular nature but tendon. The type of wound can range from local tendon inflammation, with no permanent damage, to a partial or complete injury that may require surgical repair.
In both cases, there will be a more or less marked deficit in the arm abduction force. In particular, the subject will struggle to keep the arm raised laterally between 60 ° and 120 °. A special test to diagnose the rotator cuff injury will test the patient’s muscle response in these angles of motion.
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Torn rotator cuff symptoms: Remedies
The rotator cuff is the name commonly used to indicate the whole muscle of the shoulder. The most mobile joint in the human body. This joint is as complex as it is delicate and is part of the joints’ list most prone to injury and deterioration. Remedies rotator cuff pain in addition to bone and ligament discomfort ( osteoarthritis, arthritis, fractures, sprains, dislocations, etc.). The shoulder can suffer from the compromise of the tendons and muscles typical of the “cuff.”
The pain triggered by various pathologies is generically defined as ” periarthritis “; however, each clinical picture should require specific and appropriate therapy. Of all the discomforts, the most frequent one is undoubtedly tendinopathy ( tendonitis, calcifications, rupture, etc.), followed by acute injuries, arthrosis, and painful irradiation starting from the cervical. It is a very complex structure, and the lesion could be located in many locations. Statistically, the areas of greatest interest are the tendons of the supraspinatus and infraspinatus muscles.
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Cures and Natural Remedies
- Static or dynamic stretching: inelastic muscles (particularly if hypertrophied) are more prone to injury and tend to over-strain the tendons during stretching. This is why stretching is considered both preventive and rehabilitative.
- Motor exercises for strengthening: used in conservative therapy, in preparation for surgery, and subsequent rehabilitation. They are instrumental in shoulder tendonitis. Where the trigger is a reduction in muscle tone, which causes the tendons to stretch.
- WARNING! It is not advisable to excessive force stretching and strengthening exercises; in addition to generating pain, they could favor a particularly thinned tendon’s rupture.
- Cryotherapy: Cold therapy is useful in reducing pain and inflammation. It should be done 2 or 3 times a day. On the contrary.
- Heat Therapy: Increases blood flow and can speed up the recovery of a tendon injury.
- Braces: of various kinds, they can limit the rotator cuff movements or support them after surgery.
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Inflammation can cause severe tendinopathies that excessively weaken the tendons and generate calcifications. Pharmacological treatments for rotator cuff pain are primarily anti-inflammatory.
Non-steroidal anti-inflammatory drugs ( NSAIDs ):
Systemic for oral use: they are more used than topical ones. As the structures of the torn rotator cuff symptoms are difficult to reach through skin application. They are also more potent than ointments and gels. They may require the use of a gastroprotective. People with liver or kidney disorders are not always able to take them.
- Ibuprofen : e.g. Brufen ®, Moment ®, Spidifen ®, Nurofen ®, Arfen ®, Actigrip fever and pain ® and Vicks fever and pain ®).
- Ketoprofen: for example, Arthrosilene ®, Orudis ®, Oki ®, Fastum gel ®, Flexen “Retard” ®, and Ketodol ®.
- Diclofenac : for example Dicloreum ®, Deflamat ®, Voltaren Emulgel ® and Flector ®.
- Naproxen : for example Momendol ®, Synflex ® and Xenar ®.
For topical use: they are mainly ointments or gels. They have the advantage of acting locally and without excessively straining the stomach and liver; however, they are not very effective. This is NOT the most suitable pharmacological category. And persisting for a long time with their use could favor the worsening of inflammation.
- Ibuprofen salt of lysine to 10% or 2.5% ketoprofen (eg Dolorfast ®, ® Lasonil, Fastum gel ® etc.).
- Injectable or orally: they are used only if oral NSAIDs are not well tolerated for: allergy, stomach ulcer, diabetes, etc. Using injectable ones for long periods can result in many side effects on connective tissues, especially tendons. On the other hand, they represent the most drastic and effective pharmacological solution.
- The prevention of pain localized in the shoulder concerns above all the discomforts linked to tendon inflammation.
- In this case, the first rule is certainly to pay close attention to the movements to be performed:
- An accurate warm-up is essential before sporting gestures.
- Check the movements in the maximum range of motion.
- Do not overload the shoulder in unnatural postures.
- Athletes need to take care of physical preparation and elasticity and mobility (stretching, etc.).
- In postural defects, it is necessary to correct them; for example, dorsal hyperkyphosis can cause or aggravate the rotator cuff’s inflammation.
- In the presence of painful Torn rotator cuff symptoms or symptoms attributable to joint instability, consult a doctor.
- If the diagnosis is positive, take action to:
- Optimize muscle tropism.
- Gain the stability of the joint cuff.
- Improve the integrity of the tendons.
- If necessary, remove the tendon calcifications or bone spurs surgically or medically.
- Avoid creating imbalances between tendon resistance and muscle strength (as happens with anabolic steroids in sports).
- Review manual tools and aids in work, hobbies, and sports, both in terms of ergonomics and weight.
- Tear therapy is a therapeutic method that uses an electric capacitor to treat joint muscle injuries and tendinopathies. The mechanism of Tecartherapy is based on the restoration of the electrical charge in the injured cells for them to regenerate more quickly.
- Laser therapy: is a treatment that uses electromagnetic rays directly on the affected area. The electron beam from the laser acts on the cell membrane. And mitochondria, increasing metabolic activity, reducing pain and inflammation, creating vasodilation, and increasing lymphatic drainage.
- Ultrasound: this system uses high-frequency acoustic waves. It is instrumental as an anti-inflammatory stimulant of edematous reabsorption and dissolves the adhesions that form during healing. It produces heat and increases the permeability of cell membranes.
- Shockwaves (Extracorporeal Shock Wave Therapy): crumble the tendon calcifications of the modest entity. They are based on the localized release of acoustic impulses.
- Kinesio taping: Not very effective for the rotator cuff. Take advantage of the traction of adhesive and elastic bandages. Which sometimes contain small pharmacological concentrations of anti-inflammatories applied to the skin. They should have a draining, slightly pain-relieving – anti-inflammatory, and bracing function.