Rotator Cuff Injury

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.