00:01
Let's move on
to a very common injury
called the
rotator cuff injury.
00:06
Rotator cuffs are most often related
to degenerative wear and tear,
especially in middle aged men.
00:13
Here you see a baseball player
about to pitch.
00:17
Sometimes rotator cuff injuries
are associated with overuse,
generally in athletes.
00:24
Particularly with
repetitive overhead motions.
00:27
This is common with pitchers,
weightlifters, for example.
00:31
And of course, it can be traumatic.
00:36
Rotator cuff anatomy is
actually quite complicated,
but it came to a contains
several tendons and several muscles,
the supraspinatus,
the subscapularis,
teres minor and infraspinatus.
00:51
This is behind the
image and not shown.
00:55
This rotator cuff combination
of muscles and tendons
stabilize your shoulders.
01:02
For rotator cuff injuries,
the supraspinatus tendon
is most commonly injured.
01:07
You can elicit this
pain by asking a patient
to do ABduction or abduction
above the head.
01:13
Typically speaking,
they'll generally feel pain
and stop emotion.
01:21
This is called the arc test,
have the pain,
their pain will be present
past 90 degrees of abduction.
01:27
Try it yourself.
01:28
Maybe you will diagnose
rotator cuff tears in yourself.
01:34
Here's some imaging techniques.
01:36
Unfortunately,
because it's the tendon injury,
most plain X-rays are not helpful.
01:44
There is increasing use of
what's called dynamic ultrasound
as the title sounds,
the ultrasound has done
over a range of motion.
01:53
Particularly in the
ABduction or abduction
past 90 degrees
when the pain is elicited,
while may be able to see tears
or edema around the ligaments.
02:04
Ultimately,
MRIs are usually performed.
02:07
In this image,
the white arrow points to an area
where on T2 weighted
image there's edema.
02:13
And edema is an indirect evidence
that there's swelling
and potentially ligamentous
injury in the rotator cuff.
02:21
Here you see the ligament wrapping
around the glenohumeral joint.
02:26
Remember, that the rotator cuff
is very important
for stability of
the shoulder joint.
02:34
How do we treat rotator cuff tears?
Well, vast majority of the time
Physical Therapy and Rehabilitation.
02:40
This can be combined with
nonsteroidals, ice,
range of motion exercises,
and judicious rest.
02:48
Remember,
we don't want a frozen shoulder.
02:50
So we do encourage our patients
to continue moving them.
02:54
Surgery is an option
for some traumatic tears
specifically in younger patients
or in patients that fail
conservative measures.