| The term "rotor" cuff, actually- the
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| | intense at night. The pain may radiate
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| rotator cuff- refers to a group of
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| | down the side of the upper arm. This is
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| muscles and associated tendons that
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| | called referred pain. Rotator cuff
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| connect the scapula (shoulder blade) to
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| | problems are diagnosed by taking a
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| the humerus (upper arm bone). The rotator
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| | careful history and doing a thorough
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| cuff tendons sit on top of the humerus
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| | physical examination. Plain x-rays are of
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| and permit movement in all directions. In
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| | limited usefulness unless the patient
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| fact, the shoulder is the most mobile
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| | also has concomitant arthritis. An MRI is
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| joint in the body. Because of the wide
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| | probably the most accurate method for
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| range of motion that the shoulder joint
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| | imaging the entire shoulder including the
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| has... plus the amount of work that the
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| | soft tissues, tendons, and bone.
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| shoulder has to do doing activities of
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| | Diagnostic ultrasound is another less
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| daily living, the rotator cuff becomes
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| | expensive technology which is probably as
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| prone to overuse and injury. Excessive
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| | effective for visualizing the rotator
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| stress on the rotator cuff leads to
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| | cuff. Partial tears can be treated with
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| shoulder pain. Rotator cuff injury is
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| | anti-inflammatory medication and physical
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| fairly common and can be due to
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| | therapy. In patients with more severe
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| repetitive stress, trauma, and aging.
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| | pain or who do not respond to
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| Repetitive stress can be occupational-
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| | conservative measures, injection of
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| people who do work with the arms raised
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| | glucocorticoid (cortisone) can be
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| above the level of the shoulder- can
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| | effective. Injections should be done
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| develop shoulder problems easily.
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| | using ultrasound needle guidance.
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| Examples would be auto mechanics, dry
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| | Otherwise, the injection may not be done
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| wall installers, house painters, and
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| | in the proper location. Larger rotator
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| electricians. Sports activities such as
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| | cuff tears generally don't heal without
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| golf, tennis, softball, and other
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| | intervention. Depending on the age of the
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| athletic endeavors that require repeated
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| | patient, length of duration of the tear,
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| shoulder movement can also be a problem.
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| | size of the tear, and the patient's other
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| Trauma, particularly falls are a common
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| | medical problems, surgery may be a
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| cause of rotator cuff injury. As people
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| | solution. In cases where more
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| get older, the tendons that comprise the
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| | conservative measures fail to provide
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| rotator cuff become more prone to injury
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| | relief from pain and improved function,
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| and degeneration. The tendons of the
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| | surgery is also an option. Most rotator
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| rotator cuff are made of tough fibrous
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| | cuff surgery is performed
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| connective tissue similar to connective
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| | arthroscopically using small incisions
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| tissue located elsewhere in the body.
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| | for the insertion of a tiny camera and
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| Examples of connective tissue include
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| | surgical cutting instruments. As
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| ligaments, tendons, and cartilage.
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| | mentioned earlier, multiple factors go
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| Connective tissue tends to degrade with
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| | into deciding whether a patient is a good
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| age. Combining repetitive use with the
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| | surgical candidate. Other factors
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| aging process is a recipe for significant
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| | determine prognosis. Factors that can
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| rotator cuff injury. Injuries to the
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| | influence healing include the size of the
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| rotator cuff usually are due to
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| | tear, the number of tendons that are
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| inflammation. This is called tendonitis
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| | torn, smoking and patient age. Physical
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| or tendonopathy. More serious injuries
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| | therapy following surgery is essential to
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| result in partial tearing of the tendons.
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| | restore full mobility and to protect the
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| Even more serious is a "full-thickness"
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| | surgical repair. This may be arduous,
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| or complete tear. While there are many
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| | taking several weeks before function is
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| causes of rotator cuff injury, the most
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| | restored adequately. For prevention of
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| common is when the rotator cuff tendons
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| | rotator cuff tears, it is good practice
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| are squeezed between the humerus and the
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| | to consult a knowledgeable physical
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| scapula. This squeezing occurs when the
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| | therapist who can teach specific
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| arm is raised above the level of the
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| | exercises. Warming up and stretching
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| shoulder. Symptoms of rotator cuff
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| | before activities is recommended.
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| related malfunction usually are pain
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| | Patients should avoid exercises that
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| related. Pain at night is very common and
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| | place the arm at extreme positions, that
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| is caused by inflammation in the both the
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| | involve lifting a large amount of weight,
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| tendons as well as the adjacent bursa.
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| | or which involve repetitive motion
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| This bursa- called the subacromial bursa-
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| | particularly with the arms higher than
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| is a sack that contains a small amount of
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| | shoulder level.
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| fluid and cushions the shoulder. When it
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| | Nathan Wei, MD FACP FACR is a
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| becomes inflamed, the condition is called
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| | rheumatologist and Director of the
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| bursitis. Muscle spasm may also
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| | Arthritis and Osteoporosis Center of
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| contribute to the pain. Pain is most
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| | Maryland.
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