Rotator Cuff Injury Research Paper

Your rotator cuff consists of four muscles in your shoulder that allows you to move your arm away from your body. These muscles have tendons, which connect them to the head of your upper arm bone or humerus. When a tear occurs in these muscles, you will experience extreme pain on motion. A rotator cuff tear is also extremely painful at night. If left untreated, it may result in arm weakness.

Walch et al first described the internal impingement as an intraarticular impingement of the rotator cuff in the abducted and externally rotated shoulder. With 90 degrees of both abduction and external rotation, the articular surface of the posterior superior rotator cuff becomes pinched between the labrum and the greater tuberosity.5 The authors separated the labral lesions from SLAP lesions which extended anteriorly to the biceps anchor at the supraglenoid tubercle, concluding that internal impingement may be responsible for a subset of patients with isolated posterior SLAP tears.5

Elbow fractures are often the result of either a fall or a direct blow to the elbow. The fracture type will depend in large part upon how the person falls or gets hit. For example, someone who falls onto an outstretched arm will hurt a different part of the elbow

Often these bone spurs helped to create the tear. Sometimes an MRI is ordered - this can show the doctor with great detail the rotator cuff tendon and where it is torn. If your doctor suspects a partial thickness tear (the tendon is not torn all the way through, just part of the way), an MR-arthrogram may be ordered, this involves an injection into your shoulder before the regular MRI.

The baseball star, David Wright, is having another setback in his game because the newly diagnosed right shoulder impingement that requires immediate care and treatment. According to Mets General Manager, Sandy Alderson, Mets third baseman will have to sit out the games for the following few weeks and concentrate on the complete recovery.

A rotator cuff tear is an injury that plagues much of the elderly population as well as a variety of athletes. The etiology of a rotator cuff tear is primarily due to the degeneration of the tendons or more specifically the thinning and disorientation of collagen fibers and degradation of various cells and tissues. 1 Rotator cuff tears are more likely to occur with age. Rotator cuff tears may occur due to direct trauma such as falling or shearing linked to a simple throwing or rotation of the arm and shoulder.2

Your rotator cuff is where your shoulder is attached to your body via tendons. A rotator cuff injury is when those tendons are pulled away from the head of your humerus or upper arm bone.

When repairing any organ or part of the human body, it is important to know the anatomical structures that are in the area you will be working and the areas neighboring that specific area. An article I came across regarding the Suprascapular nerve caught my attention, because it is important to know the anatomical location of the Suprascapular nerve in rotator cuff repairs. The article, “Anatomical Considerations of the Suprascapular Nerve in the Rotator Cuff Repairs” by James A. Tom, Addisu Mesfin, Mitesh P. Shah, Mirta Javandel, Dan J.Lee, Douglas L. Cerynik, and Nirav H Amin, is an article that presents how to determine a safe area around the suprascapular nerve when repairing a rotator cuff.

^8,5 ASI occurs when the arm is in adduction with the shoulder internally rotated. The biceps complex pulley, also known as a capsuloligamentous complex, adjoins the anterior glenoid causing injury when in extreme motions. With the PSI, the pulley is put into risk with abduction and external rotation on the posterosuperior glenoid. ^8 PSI is also associated with partial-thickness tears on the deep side of the articular surface of the rotator cuff. ^5 This can be a common cause for a peel-back mechanism associated with a SLAP lesion. ^8 Peel-back mechanisms can be produced many different ways, but are mostly seen with a SLAP lesion or internal impingement. These can occur when the shoulder is placed into abduction and extreme external rotation with a torsional force added to the labro-bicipital complex that is at the base of the biceps on the posterior superior labrum. ^1,5 This causes fatigue and failure of the humeral head that rotates medially over the upper rim of the glenoid fossa creating a shearing force. ^1,5 Increased superior labral strain in overhead athletes occurs during the late-cocking phase of throwing when arm is externally rotated. ^1

As this is an internal and permanent injury without reparative surgery, there are no home remedies for healing or treatment. In the cases that do require surgery, the patient undergoes a procedure nick-named Tommy John surgery, named such in honor of the first pitcher to undergo the surgery, Tommy John. Prior to the implementation of this practice, pitchers and players that damaged their ulnar collateral ligament were subject to an abrupt and definite end to their careers as they had no hope of ever recovering. In Tommy John surgery, the operating surgeon obtains a graft of ligament from either some other area of the patient’s body, such as the wrist, or ligaments are grafted from cadavers of organ and tissue donors and replace the damaged ligament with the new, undamaged graft. Following surgery, rest and physical therapy as well as recovery time for the arm to heal are still required. Ulnar collateral ligament tears can be prevented by resting your arm between games and practices and observing your range of motion in your elbow and shoulder to prevent undue stress on your elbow and ligaments

There are three different options for rotator cuff repair. Surgical techniques have become more advanced and less invasive. Each technique has advantages and disadvantages, but the goal is the same: to reattach the tendon and allow it to heal. The type of repair chose depends on the size of the tear, the anatomy of the individual, and the quality of remaining healthy tendon tissue and bone. Most repairs can be performed on an outpatient basis and do not require overnight hospitalizations. The three techniques most commonly used include the traditional open repair, arthroscopic repair, and the mini-open repair. Overall, all three have been rated similarly by patients in terms of pain relief, strength improvement, and overall satisfaction.

*insert article *attachedBesides being able to see the inside of a shoulder, doctors use different physical tests to evaluate the shoulder in order to determine what type of injury and how severe an injury may be. One such test was recently developed by Dr. Carl J. Basamania at the Womack Army Medical center in Fort Bragg, N.C. The test was developed to evaluate shoulder instability in a patient. During the test the Dr. or examiner stands next to the patient who is to lay flat on his/her back. The hand of the examined should is held firmly by the examiner. The examiner then pushes against the clavicle to stabilize th scapula, while they also gently hold the pectoral muscle with their thumb in order to be able to assess relaxation. The examiner then rotates the arm form neutral to full external rotation. If the patient has AIGHL incompetence there is a lack of tightening as the arm reaches full external rotation. The test has appeared to be highly accurate and may be of value to Dr.'s and surgeons alike. After doctors have determined what type and what degree of injury a patient has sustained using various tests it is on to the next step, rehabilitation.

The shape or thickness of the acromion sometime plays into effects of the rotator cuff. In some people the space between the undersurface of the acromion and the humeral head is very narrow, which can lead to being more likely to pinch the supraspinatus tendon. In some cases, there are people who have bone spurs on the front of the acromion, which increases the risk of impingement syndrome. Muscle imbalance is another situation

A 22-year-old male triple-A baseball pitcher presents with gradual pain in the right shoulder area. Pain is dull, with occasional sharp pains with overhead movement and backward motion of the right arm. Pain radiates from the shoulder down into the right elbow. No numbness or tingling of the right arm. No perceived weakness of right arm. You inform the athlete that he likely has a rotator cuff injury. Which one of the following tendons is NOT likely to be injured?

Non-traumatic tendinopathies usually have an insidious onset of localized pain over the anterosuperior shoulder, during the arc range of 60 – 120 degrees. However, as the disorder progresses, it causes pain at night, interfering with the sleep pattern of patients. The sequale following inadequate sleep is vast, as it can disrupt the homeostasis of the body. Rotator Cuff Tendinopathy might cause only a mobility restriction but its impact on the individual as a whole is not as minor as it seems. The disorder initially starts as an inflammatory tendinitis causing pain within the arc range, however as it progresses, it results in the development of secondary adhesive capsulitis. The capsulitis greatly restricts the global movement of the shoulder,