The shoulder is the most commonly used joint in our body, and it allows an exceptional range of motion, making it one of the most commonly injured joints in human body.
However, this flexibility comes at the cost of stability, which is maintained by a group of muscles known as the rotator cuff, because they are arranged like a cuff around the shoulder. These muscles are the Subscapularis, Supraspinatus, Infraspinatus and Teres Minor. The most commonly involved muscle in rotator cuff pathologies is the Supraspinatus. They act as an interface between the shoulder and arm. Due to this extensive involvement in activities, these muscles and their tendons are prone to getting involved in various pathologies around the shoulder.
Rotator cuff pathologies can result from different causes, including sports injuries, sudden jerky movements around the shoulders, age-related degeneration or in conditions like diabetes, where they may get torn spontaneously. Symptoms include pain around the shoulder, radiating down to the upper arm, and restricted activities involving the affected shoulder.
The Common Rotator Cuff Pathologies
Rotator Cuff Tendinitis – An irritation of the rotator cuff tendons that can cause discomfort and difficulty with movements in the shoulder.
Rotator Cuff Tears – if the tendinitis is not taken care of, or in some cases, sudden jerky movements may result in tears involving the muscles. Tears can be partial or complete depending upon the extent of muscle involvement.
Subacromial Impingement – When the rotator cuff tendons rub against the acromion bone in the shoulder, it leads to discomfort and impingement.
Rotator Sleeve Bursitis – This is an inflammation of the bursa sacs that cushion the rotator cuff tendons.
Diagnosis and Treatment Options
Diagnosis Of Rotator Cuff Pathologies
Diagnosing rotator cuff pathologies involves history and clinical examination, along with certain tests specific to testing the muscle involvement. The history of pain, mode of onset, is a vital clue to diagnosis. This is further supplemented with clinical examination and a few tests to pinpoint the injury to a specific muscle or tendon. The affected shoulder is moved in various planes to ascertain the injury. To diagnose rotator cuff injury, imaging tests may also be helpful, which may include:
X-rays – A rotator cuff tear may not appear on an X-ray, but this test helps doctors see bone problems like bone spurs or signs of arthritis that could be causing your shoulder pain. The most common X-ray finding pointing towards a rotator muscle tear is a superior migration of the head of humerus into shoulder cavity.
Ultrasound – This test uses sound waves to create pictures of the inside of your shoulder, especially soft parts like muscles and tendons. It helps doctors see how your shoulder moves and compare the injured shoulder with the healthy one.
MRI (Magnetic Resonance Imaging) – Certain patients with long-standing injuries may need to get an MRI of the affected shoulder done to confirm the diagnosis and plan treatment accordingly.
These tests confirm the diagnosis of shoulder pathologies.
Treatments for Rotator Cuff Pathologies
Based upon various diagnoses mentioned above, the patient may undergo injections around the tendons in case of tendinitis, or into the bursae in case of bursitis. Rotator cuff tears respond very well to regenerative techniques like:
- Rotator Cuff PRP/injections
- GFC injections
- Shoulder Bursa Injections
- Glenohumeral Joint Injections/PRP
- Suprascapular nerve block – This is done mainly to provide pain relief for the time when the regenerative therapy is taking its effect to heal the tendon.
In complete tears involving the rotator cuff tendons, surgical intervention may be required to fix the tendons, depending on the activity level of the patient.
Get the Best Rotator Cuff Injury Treatment at Pain Medics Clinic
Pain Medics is the only clinic in the region led by a doctor certified by the World Institute of Pain, which makes it a trusted choice for advanced treatment. Dr Rajit Jhingan specialises in diagnosing and treating all types of shoulder and rotator cuff problems, including tendinitis, tears, and impingement.
We use advanced techniques such as PRP injections, physiotherapy, and regenerative treatments to promote natural healing and restore shoulder strength. Trust our experienced specialists for the most effective rotator cuff treatment and complete shoulder rehabilitation.
