Rotator cuff injuries are typically caused by a strain or tear to the muscles or tendons that make up the rotator cuff. The rotator cuff is comprised of the muscles and tendons that connect the humerus to the scapula and hold the ball-shaped head of the humerus into the shoulder socket joint. Rotator cuff injuries are quite common as a result of the wide range of motion of the shoulder joint. The pain associated with rotator cuff injuries comes from the inflammation that occurs during a sprain or tear. Inflammation can cause swelling and irritation in the muscles and tendons causing a decreased range of motion. Rotator cuff injuries have three classifications:
Grade 1 strains: Injuries in the rotator cuff occur when the fibers of the muscles or tendons are stretched beyond their capacity.
Grade 2 strains: Injuries in the rotator cuff occur when the fibers of the muscles or tendons are strained too far and partially tear.
Grade 3 strains: Injuries in the rotator cuff occur when the fibers of the muscles or tendons completely tear.
Rotator cuff injuries can develop from numerous causes including:
- Repetitive actions: Baseball pitchers and painters can develop chronic tears from overworking their rotator cuff.
- Over the head activities: Activities such as climbing a tree or reaching items on a tall shelf can cause strain or tear.
- Acute injuries: Injuries from car accidents, weight-lifting accidents or a sudden fall.
- Tendinitis: Chronic inflammation of the tendon can lead to weakening and deterioration of the rotator cuff.
Mild rotator cuff injuries will heal themselves with rest and self-care. However, moderate to severe injuries may require one or several treatment options.
Genesis Orthopedics & Sports Medicine uses cortisone injections for reducing pain and inflammation for an array of joint injuries. In certain injuries that are solely inflammation based, such as tendonitis, cortisone injections can act as a cure but with injuries that involve tearing of ligaments or tendons, cortisone injections are used more judiciously.
Rest and ice after the initial injury are the first response treatment for a strain or sprain. However, physical therapy is a recommended course of action for grade 1, 2 and 3 sprains and tears. The severity of the classification will designate the amount of therapy needed. Consult your physician at Genesis Orthopedics & Sports Medicine for a recommended physical therapy plan. Therapy is conducted with the goal of decreasing the injury’s pain, restoring the shoulder’s range of motion, and helping it gradually regain strength.
Platelet Rich Plasma (PRP)
Platelets found in blood are the body’s natural growth factors. Genesis Orthopedics & Sports Medicine can use PRP therapy to accelerate the healing process. Platelet rich plasma from your own blood is injected into the damaged or inflamed areas of the shoulder. Once injected, the PRP releases potent bioactive proteins that enhance the healing process. As a result, stem cells are recruited to the area, thus jump-starting the body’s natural response to heal. The PRP injection site can take up to a month to heal after the initial injection.
A rotator cuff can be repaired using either an arthroscopic or mini-open technique, depending on the complexity or nature of the tear. Both techniques are minimally-invasive and allow for a quick recovery.
Genesis Orthopedics & Sports Medicine also provides debridement surgery if needed. Debridement can be performed arthroscopically by removing debris and fibrillated tissue in the shoulder joint. Loose fragments of tendons or thickened areas of the bursa are common extractions through debridement surgery. The gravity of the damage to the shoulder joint will determine the extent of the debridement.
Additionally, subacromial decompression surgery is typically used for impingement syndrome in conjunction with a rotator cuff injury. Subacromial decompression surgery is used after physical therapy and all other non-surgical treatment options have had zero to minimal effect. Subacromial decompression is an arthroscopic procedure in which the inflamed bursa is removed creating more room for the rotator cuff. If a bone spur is present in this region it is also removed to stop the pinching against the rotator cuff that is associated with impingement syndrome.