Rotator Cuff Injuries
Dr. Howard Liss treats disorders that cause pain and disability by providing consultative services and soft tissue and joint injections when needed. When medically appropriate, he makes specific referrals for diagnostic testing (lab work, imaging, electrodiagnosis), physical and occupational therapy, interventional procedures (epidurals and facet joint injections), and surgery.
As a small group of muscles that move and control the ball and socket joint of the shoulder, the rotator cuff holds the humerus (arm) onto the scapula (shoulder blade). The acromion (small bony portion of the shoulder) and surrounding ligaments provide protection for the rotator cuff tendons. Also located among the acromion and rotator cuff tendons is the bursa, which is a fluid-filled sac or pad that provides a smooth surface for tendons to move over. Given the positioning of the rotator cuff muscles, the bony arch of the shoulder and the bursa, it’s easy to imagine how injury to any of these structures can impact the other. For instance, though the acromion provides protection for the tendons of the rotator cuff, it can also intermittently trap and press them. This in turn, damages the bursa, resulting in painful shoulder movements.
Whether a rotator cuff injury is sustained due to a sports injury or overuse, there are different signs and symptoms, as well as varying levels of pain. Common rotator cuff injuries include:
- Rotator cuff impingement
- Rotator cuff tendonitis
- Calcific tendonitis
- Rotator cuff tear
- Bicipital tendonitis
- Shoulder bursitis
Individuals often note an arc of shoulder pain, particularly when their arm is at shoulder height or above the head. Weakness when reaching overhead and a clicking sound is also a common complaint. Depending on the type of injury, pain may extend from the shoulder to the elbow. It may continue even when the individual is at rest. Pain is often felt when placing the hand behind the head or back or when reaching or pulling across the midline of the body (reaching for a seat belt).
Treatment and Rehabilitation for Rotator Cuff Injuries
Without question, the rotator cuff serves an important function in regard to stability and control of the shoulder joint, as well as injury prevention. For instance, when the ball and socket joint are in place and secure, this relationship guards against impingement, subluxation or dislocation. At the same time, easy shoulder movement is made possible by the correction placement of the rotator cuff in relation to the bursa while also serving as a critical foundation for the joining of the arm to the chest wall.
Understanding the anatomy and precise orientation of the rotator cuff muscles and structures of the shoulder emphasize the importance of appropriate diagnosis, treatment and rehabilitation following a rotator cuff injury.
Early treatment for rotator cuff injuries will center on pain management and reducing inflammation. This may be accomplished by ice or heat therapy, pain relievers, anti-inflammatory medication, steroid injections, ultrasound therapy, electrical stimulation, TENS machine or magnetic field therapy. Once pain and inflammation become managed, patients engage in exercises and movements to restore full range of motion and the connection between the neck, scapula, shoulder and thoracic region. In addition, training is designed to increase rotator cuff strength, while a series of conditioning techniques help individuals regain speed, power, proprioception and agility.
Under the direction of the physiatrist, other modalities may be incorporated into a complete rehabilitation program. Some of these include the use of assistive devices such as bracing and splinting, kinesiology tape or joint mobilization support. In addition, patients are likely to receive counsel in biomechanics and modifications that will maximize the effects of their treatment. Ultimately, the aim of treatment, as developed by the physiatrist, is to help patients live pain-free while obtaining their highest level of functioning.
At the Howard Liss, M.D. Rehabilitation Institute in Englewood, patients can rely on Dr. Liss to put together the right treatment, therapy and rehabilitation plan to ensure the most optimal outcome. Dr. Liss works closely with other specialists required to rehabilitate patients suffering from chronic pain or serious injuries, and Dr. Liss will refer patients as needed to ensure appropriate treatment. With extensive education and exposure to a variety of conditions that affect the cervical and lumbar spine, bones, nerves, joints, ligaments, tendons, muscles, brain, and spinal cord, Dr. Liss is uniquely positioned to help patients manage their pain and maximize their functioning.
To schedule an appointment with Dr. Liss, contact the Howard Liss, M.D. Rehabilitation Institute in Englewood today.