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Rotator Cuff Disorder
Geisinger Sports Medicine - Get Back in the Game
Mechanism of Injury
The shoulder’s rotator cuff plays an important role in throwing movements, as in football, baseball, or softball, or racket sports like tennis. Comprised of a group of muscles and tendons, the rotator cuff allows for a large range of movement using the shoulder and also keeps the shoulder joint stable.
A rotator cuff injury can be as simple as tendonitis, an inflammation of the muscles, or a more serious problem involving a muscle tear. A rotator cuff tear is a partial or complete tear of 1 or more of the four muscles of the shoulder. Chronic rotator cuff disorders are seen in athletes who frequently use swift overhead motions, such as baseball or softball pitchers. Acute rotator cuff tears may be found in athletes who, for example, attempt to lessen a shoulder impact in a hard fall by raising an arm.
Athletes with a rotator cuff tear may experience:
- Pain when lifting or lowering the arm
- Atrophy of the shoulder muscles
- Arm weakness
- Crackling sensation during movement
- Intensifying pain at night
- Muscle spasm
- Shoulder tenderness
Diagnosis & Testing
Your physician will most likely utilize physical examination and X-ray technology to reach a diagnosis of rotator cuff tear. Your physician will test for range of motion limits, strength deficits, instability, and examine for areas of tenderness. An MRI test may also be ordered for identification of soft tissue damage and more detailed tear information. Occasionally, an arthrogram, a test involving dye injected into the joint, is utilized.
Treatment
Often, successful treatment for a rotator cuff tear can be achieved using nonsurgical solutions.
Athletes with complete tears or who do not show signs of improvement after rehabilitation may be encouraged to consider surgery.
Treatment options may include:
- Rest and limited overhead activity
- Use of a sling
- Anti-inflammatory medication
- Steroid injection
- Strengthening exercise and physical therapy
Treatment may continue for weeks or months, depending on the severity of your injury.
Surgical Management
Surgery for a rotator cuff tear may be considered if:
- The tear is acute and painful
- It is the dominant arm of an active individual
- You need maximum strength in your arm for overhead work or sports
- Non-surgical treatment methods are unsuccessful
Depending on whether you sustained a partial or complete tear, surgical methods may vary slightly. A debridement is performed at the start of the rotator cuff repair procedure to trim the injured tendon and remove any loose fragments. For a complete tear, you may undergo a procedure involving suturing the two sides of the tendon together. Rotator cuff repair surgery can be performed arthroscopically using a fiber optic scope, with the open method (large incision) or with the mini-open method (small incision). Your physician will discuss all possible techniques with you and recommend the procedure which best suits your injury.
Rehabilitation
Rehabilitation methods will be used for surgical and nonsurgical rotator cuff tear patients to help regain mobility of the shoulder. After a period of immobilization, you will follow a progressive exercise schedule designed to slowly strengthen the muscle and improve range of motion. Generally, athletes will graduate from passive motion exercises to active and resistive motion exercises. Strict adherence to rehabilitation schedules is crucial for success of surgical and nonsurgical treatment. Eventually, with physician permission, you should be able to regain overhead motion use and return to your sport of choice.
At Geisinger Sports Medicine, we help athletes with rotator cuff disorder recover with the best techniques modern medicine has to offer. If you or your child sustains a rotator cuff injury, contact us today for an appointment at our state-of-the-art facility.
Geisinger Sports Medicine Facility
1-866-414-4988
Orthopaedic Services-Woodbine Lane
Corner of Woodbine Lane & Route 11
Danville, PA 17822 MC 52-12
Geisinger Wyoming Valley Medical Center
1-800-921-1467
1000 East Mountain Blvd.
Wilkes-Barre, PA 18711
Geisinger Medical Center
1-800-275-6401
100 N. Academy Avenue
Danville, PA 17822