We often listen to the word “ Responsibility on Shoulders”. It means that the shoulder is a weight-bearing joint, and also indicates one should have strong shoulders in life. Shoulders act as a fulcrum and thus provide the leverage to carry heavy lifting and performing overhead activities.
When your shoulder hurts on raising your hands to your head, or perhaps if you feel pain when rotating your arm outward, then You should know something’s wrong. Understand what happened?
The shoulder joint is the largest and the most crucial in our body. It comprises the upper arm bone and the scapula joined via a ball and socket joint. A group of muscles and tendons called the rotator cuff, help keep the upper hand bone firmly placed into the socket joint. It is the design of this joint which allows us to reach out and use our hands in various positions. The shoulder joint facilitates lifting, reaching above the head level, sorting things, rubbing, pushing, scrubbing, waving, picking, pulling, twisting etc.
Most patients with torn rotator cuff injuries are in their late middle age. However, rotator cuff tears can occur at any age. The tear is brought about by performing repetitive activities over some time. More than 20% of the population currently suffer rotator cuff injuries.
Some doctors immediately recommend surgery to repair an injured rotator cuff,
although resorting to surgery is not always the most comfortable or most effective solution. The good news is that surgery is not necessary. To know more, please continue reading this article provided by Dr Chandra Sekhar, one among the best Shoulder Surgeons in Hyderabad, about rotator cuff function and injuries.
What is a Rotator cuff?
The rotator cuff consists of four muscles that help move and stabilize the shoulder joint. One or all of the muscles and ligaments that attach these muscles to the bone gets damaged by an acute injury, chronic overuse, or gradual ageing. This injury can cause significant pain and damage with limited freedom of movement and use of the shoulder joint.
The shoulder is a ball and socket joint that allows the arm to move in various directions. It consists of the humeral head (the upper end of the upper arm bone) that fit into the glenoid fossa of the scapula (shoulder blades). The humerus head is held by the joint capsule and the labrum, thick cartilage bands that form elongated cones. Rotator cuffs muscles are dynamic stabilizers and movers of the shoulder joint and adjust the position of the humeral head and shoulder blades during shoulder movements.
The rotator cuff muscles are anatomically connected to the shoulder blades. Any change in scapula movement with various shoulder movements can cause the rotator cuff muscles impingement, causing problems with the shoulder movement itself.
Anatomy of the Shoulder Rotator Cuff:
Four muscles make up the rotator cuff:
- Supraspinatus: The supraspinatus muscle is above the spine of the shoulder blade and inserts above the greater tuberosity of the humerus.
- Infraspinatus: The infraspinatus muscle develops below the scapular spine in the infraspinatus fossa and is inserted into the posterior part of the greater tuberosity (the part of the bone attached to the corresponding muscle) of the humerus.
- Minor teres: Teres minor muscles originate from the lateral edge of the shoulder blades and are inserted into the inferior aspect of the greater tuberosity of the humerus.
- Subscapularis: Subscapularis muscle originates on the anterior or front surface of the shoulder blades, sits directly above the ribs and is inserted through lesser tuberosity of the humerus.
Each rotator cuff muscle fulfils specific and important functions for your shoulder joint.
- Stabilization of the humeral head in the shoulder joint:Supraspinatus, Infraspinatus, minor teres and subscapular muscles work together.
- Abduction or elevating of the shoulder joint to the side: This movement is carried out by the supraspinatus muscle.
- External rotation of the shoulder joint: infraspinatus and minor teres muscles are responsible for this movement.
- Depressing the head of the humerus: Subcapsular muscles fulfil this additional function so that the humerus can move freely in the shoulder joint while lifting the arm.
The four rotator cuff muscles work together to centralize the shoulder bones in the shoulder joint when you lift your arms, the rotator cuff muscles contract and stabilize the shoulder.
What causes the rotator cuff to tear, and how do I know if I have it?
Inflammation or damage to the rotator cuff is the most common shoulder injury. Inflammation develops slowly. Bone spurs irritate muscles and tendons. Sometimes only constant use for years can irritate.
Tearing is usually the result of a sudden fall or injury to the shoulder, most often in people over 40 years. Throwing, painting or dismantling by lifting can cause the rotator cuff to tear.
Symptoms of rotator cuff injury are caused by inflammation and swelling of the rotator cuff and include:
- Pain in the shoulder and arm. The pain is often felt at night when you lie on a sore shoulder.
- Pain is felt upon movement in a certain way. The pain stops at the elbow.
- If the injury is acute (sudden), the pain is intense and immediate.
- If the injury is degenerative (damage occurs over time), the pain can be mild at first.
- Weakness and loss of function.
Rotator cuff tears can extend or increase due to repeated use or re-injury. It is common for patients with rotator cuff disease who are known to experience severe pain and weakness after minor injuries. This may be an extension of the existing tear. If you know the rotator cuff is torn, the pain worsens, and the strength that decreases can cause an increased tear.
When should You see a doctor with a rotator cuff tear?
If you have an injured shoulder or chronic pain in the shoulder and arm, and if you live in Hyderabad, it is best to contact the best Shoulder surgeon at Hyderabad. They can then diagnose and start treatment. Your doctor can recommend diagnostic imaging tests, such as X-ray, magnetic resonance imaging (MRI), or ultrasound to confirm the diagnosis. Early diagnosis and treatment of rotating cuffs can prevent symptoms such as loss of strength and loss of movement.
Treatment of injuries with rotator cuff:
Without surgery: Shoulder surgeons first try conservative treatments, including drugs and physiotherapy. This treatment can relieve pain and relieve inflammation. However, if your rotator cuff is torn, surgery is the only way to fix the problem.
When surgery is needed:
It’s time for surgery if:
- Symptoms last 3 to 6 months
- You have recently suffered an acute injury
Partial tears can be fixed by sewing the two parts together. The total tear that flows through the tendon requires tissue to be reconnected to the bone.
Knowing the four rotator cuff muscles and how they work are important components in understanding shoulder treatment. In the hands of an experienced surgeon, rotator cuff surgery can be the most effective way to restore the comfort and function of the shoulder with a tear in the rotator cuff in a healthy and motivated patient. Planning and continuing rehabilitation efforts help achieve the best results for patients.