ROTATOR CUFF INJURIES NEWS

The shoulder is one of the most complex joints in the body, therefore shoulder pain is difficult to diagnose properly. It is easily subject to injury because the ball of the upper arm is larger than the shoulder socket that holds it. To remain stable, the shoulder must be anchored by its muscles, tendons, and ligaments. We've outlined most of the components of the shoulder to help you get a better understanding of what may be involved in a shoulder pathology.

Shoulder Movement

Flexion	Extension	External Rotation	Internal Rotation	Adduction	Abduction

What is a Rotator Cuff Tear?

Some shoulder problems arise from the disruption of  soft tissues as a result of injury or from overuse or under use of the shoulder. Other problems arise from a degenerative process in which tissues break down and no longer function well. Symptoms may appear gradually or acutely (quickly).Symptoms include pain with overhead activities, combing hair, fastening buttons on the back of clothing, stiffness and loss of motion. If there is a tendonitis of the biceps tendon,  you may see pain on the front side of the shoulder that radiates down to the elbow and forearm. Pain may also occur when the arm is forcefully pushed upward overhead.

Shoulder pain may be localized or may be referred to areas around the shoulder or down the arm. Disease within the body (such as gallbladder, liver, or heart disease, or disease of the cervical spine of the neck) also may generate pain that travels along nerves to the shoulder.

A healthy tendon is made up of parallel cells (striated tissue) resembling many strings lined up next to each other. When a tear occurs it can range from one or several  of those strings being torn. In medical terminology the words "micro tears" are used to describe a tendon that has received a small amount of damage. Micro tears can lead to either a tendonitis or a tendinosis.

A tear in a rotator cuff tendon may occur after trauma, such as a fall on the shoulder, or in people  who are continually performing overhead activities i.e. swimmers, painters, construction, pitchers and tennis players. Acute tears are commonly signified by a "snapping" sensation, with immediate pain and weakness in the arm. Gradual tears are typically as a result of  rotator cuff degeneration over time. In fact, autopsy studies have shown rotator cuff tears in up to 70% of people over the age of 80 and 30% of the population under the age of 70. Most patients notice that at first the pain may be mild and only present with overhead activities such as reaching or lifting. It may be relieved by over-the-counter medication such as aspirin or ibuprofen. Over time the pain may become noticeable at rest or with no activity at all. There may be pain when you lie on the affected side and at night.

Tendon'itis' is characterized by the presence of inflammation (redness, swelling, heat, pain) within a tendon. When the rotator cuff or the bicepital tendon become inflamed they may get "squeezed" by the aromion and the humerus, leading to a condition called impingement syndrome.

Tendono'sis refers to a pathology within the tendon in which the vascular response to the tear was not significant enough to cause inflammation.  Research has proven that most patients diagnosed with tendonitis show no signs of inflammation, and therefore do not respond to treatment to reduce inflammation (anti-inflammatories).

A tendon receives the most stress at the tenoperiosteal junction, meaning where the tendon attaches to the bone. Imagine that area as the "weakest link". Your body will lay down calcium deposits, in order prevent further damage and strengthen the attachment. A condition called calcific tendonitis occurs, a similar thing happens in plantar fasciitis patients (bone spurs).

Rotator Cuff Facts

• Factors that increase the risk of getting RCI are  old age, poor posture, weak shoulder muscles
• Rotator cuff tear is most common in people who are over the age of 40
• about 12.3 million people went to the doctor's office in 2002 for a shoulder problem, including 4.2 million visits for shoulder and upper arm

Painkillers May Slow Rotator Cuff Healing
Rat study finds NSAIDs inhibit bone growth

By Amanda Gardner
HealthDay Reporter

FRIDAY, June 25 (HealthDayNews) -- Widely used pain-relief drugs may actually interfere with the healing in a common shoulder-repair surgery, researchers report.

Nonsteroidal anti imflamatory drugs (NSAIDs) -- which include aspirin, ibuprofen, and arthritis drugs such as Celebrx and Vioxx -- are often the medication choice to relieve post-operative pain following rotator cuff surgery.

But according to a new study, these drugs may also have adverse effects on bone healing, which is a necessary part of rotator-cuff recovery. Read More

Topical Creams

ProFlex: Contains generous amounts of menthol, camphor, thymol, ecalyptus and wintergreen oil known to help joint pain. The addition of glucosamine sulphate, MSM, chondroitin sulphate and sea cucumber abstract enhances the effectiveness of the cream.

Zellulisan: Highly effective in treating acute and chronic tendonitis', aides in the detoxification of connective tissues

Inflamyar: For treatment of sports injuries, sprains, bruises, joint problems, muscle strains and acute and chronic imflammation.