Rotator Cuff / Impingement
What is it?
The rotator cuff is a group of muscles draped over the humeral head (ball) which maintains the position of the head in the glenoid (socket) and assists with shoulder movement. The rotator cuff muscles include the supraspinatus superiorly, the subscapularis anteriorly, and the infraspinatus and teres minor posteriorly.
The muscles can be strained or torn by a single event or can sustained repetitive trauma over time. The bursa overlying the muscles can also become inflamed and painful. The acromion, a part of the scapula which covers the joint superiorly, may develop a bone spur which irritates the rotator cuff, especially with overhead use. With time, this can inflame and weaken the tissues which may lead to a rotator cuff tear.
What are the symptoms?
Symptoms may include pain at rest and with activities, weakness, and stiffness in the shoulder. The pain may be experienced at night as well and interfere with sleep.
How is it evaluated?
In addition to a full history and physical, an X-ray and/or MRI of the shoulder may be obtained to assist with the diagnosis.
How is it treated?
Rest, medication, and therapy may be recommended to stretch and strengthen the muscles and tissues around the shoulder. A cortisone injection may also be recommended to decrease inflammation in the shoulder.
Your doctor may recommend surgery if the rotator cuff is torn or if you have not responded to other treatments. During shoulder arthroscopy, a small camera and other instruments are placed inside the shoulder joint to evaluate and treat the damaged structures. These structures include the labrum, biceps tendon, rotator cuff, bursa, acromion, and the AC Joint(link to this area). In some instances, an open incision may be necessary as well.
Postoperatively, therapy is crucial to obtaining a good result. Your surgeon and therapist will work together with you during the recovery process.