Page 24 - Jan_14

sports medicine

by Dr. John-Erik Bell

My shoulder hurts! could it be my rotator cuff?

W
hetheryour preferred activity is become inflamed and painful when towel for 15 minutes at a time, two to about the diameter of a pen is inserted into
tennis, paddling, rock climbing, it pinches against bone spurs on the three times per day can help minimize the back of the shoulder through a one-
skiing, swimming, golf, or a host of acromion, which is the front part of the inflammation. Over-the-counter anti- quarter-inch incision, which allows the
other athletic pursuits, chances are you shoulder blade. This pinching condition inflammatory medications such as surgeon to look inside the shoulder and

need a healthy shoulder to enjoy them is called impingement syndrome, which ibuprofen or naproxen are very helpful as watch the image on a large high definition
and perform at your best. Some of the involves both bursitis and rotator cuff well, but be sure to check with your doctor monitor. The surgeon can see the bones
most commonly injured structures in the inflammation. Occasionally, calcium to make sure these are safe to take. When and cartilage of the shoulder joint, the
shoulder are the rotator cuff muscles and deposits will form and build up in the the pain is especially bad, the injection biceps tendon, the labrum (a ring-like
tendons.
rotator cuff, which results in a very painful of powerful anti-inflammatories such as cartilaginous stabilizing cushion that
The rotator cuff is a group of four condition known as calcific tendonitis. cortisone into the inflamed bursa can be surrounds the socket), all four tendons of

muscles and tendons responsible for The most severe injury of the rotator cuff extremely helpful. The most important the rotator cuff, the bursa, and any bone
stabilizing the shoulder and providing is when the tendons tear apart. Sometimes part of treatment for rotator cuff problems spurs that may be causing impingement.
the wide range of motion that lets you these tears are partial, but sometimes the is physical therapy. Sometimes this can In most cases, problems with any of these
do lots of important activities like lifting, tears can be very serious and tear away be done as a home exercise program structures may be surgically repaired using
reaching, throwing, pushing, and pulling. from the bone to which they should be that you can do on your own, but often the arthroscope. After surgery, physical
These muscles connect your upper arm to attached.
the supervision of a physical therapist is therapy is needed to restore function to

your shoulder blade and provide strength Fortunately, most rotator cuff needed as well.
the shoulder. The success rate for surgery
in rotational and overhead movements of problems can be treated without surgery. Shoulder therapy focuses on range depends on the severity of the tear that
the arm.
It is important to see your doctor to make of motion, strengthening, and stability. is found, but in most cases patients
The rotator cuff can be hurt either sure that the correct diagnosis is made The motion and stability of the shoulder experience significant relief of pain and
by repetitive motion or a sudden traumatic before starting treatment. Often, this can blade is often overlooked and is very improvement in function after surgery. For

injury. As you get older, the rotator cuff be done with a good examination of the important for successful treatment of more information on rotator cuff injuries
tendons become weaker and are more shoulder and sometimes with x-rays. Your rotator cuff problems. The first phase of and their treatment, visit http://patients.
likely to be damaged. The most common doctor will check your range of motion therapy focuses on regaining lost mobility dartmouth-hitchcock.org/ortho/rotator_
symptoms of a rotator cuff injury are and assess the strength of the rotator cuff. of the shoulder, which sometimes is hard cuff_injuries.html
pain with overhead reaching, pain that If weakness of the rotator cuff is present, to detect, especially external rotation With these recommendations and
interferes with sleep, loss of shoulder that can be a sign of injury to the tendons. (reaching out to the side while facing the help of your doctor, you should be able

mobility and weakness of the arm. These In some cases, an ultrasound or MRI forward) and internal rotation (reaching to return successfully to the activities you
symptoms can make simple everyday might be necessary to look at the rotator behind your waist and high up on your love. We’re here to get you back to your
tasks difficult to complete and can make it cuff more closely than x-rays can.
back). Your rotator cuff is responsible passion, and look forward to seeing you
difficult to get a good night’s sleep.
Most shoulder problems are first for both of these motions. Once range on the court, in the water, on the trails, on
Rotator cuff injuries range from treated with a combination of rest, ice, of motion is restored, the focus turns to the field, or on the mountain soon!
simple tendonitis, bursitis, impingement anti-inflammatory medications, physical strengthening and stability.

syndrome, calcific tendonitis, partial therapy, and sometimes anti-inflammatory If your shoulder does not improve
tears, and complete tears of the tendons. injections when pain is severe. Rest means with these treatments, or if the rotator Dr. John-Erik Bell is an orthopaedic surgeon
Tendonitis is caused by inflammation of avoiding the specific activities that cause cuff is completely torn, then your doctor at Dartmouth-Hitchcock Medical Center
the tendon and is the result of overuse. the shoulder pain, such as repetitive may recommend surgery. Surgery for and specializes in shoulder, elbow, and sports
Inflammation is when the rotator cuff and overhead motions or heavy lifting, but rotator cuff problems is usually done as medicine. He has been practicing at DHMC
for the past eight years, after completing his
nearby tissues are irritated and swollen. you should not completely stop using the an outpatient, which means you don’t shoulder and elbow fellowship at Columbia
Tendonitis is caused by inflammation of shoulder or else you could develop a stiff have to stay in the hospital. In most Presbyterian Hospital in New York. He
the tendon and is the result of overuse. or “frozen” shoulder. Icing the shoulder cases, the rotator cuff can be repaired lives in Hanover and enjoys skiing, cycling,
The rotator cuff is covered by a cushioning with an ice pack or a pack of frozen “arthroscopically,” requiring only small paddleboarding, and spending time with his
tissue called the bursa, which can also
vegetables over your shirt or over a thin
incisions. A fiber-optic magnifying camera
wife and three children.

Perform at
Adventure in Vermont

with the help of Gifford physical therapy

Explore one of New England’s richest landscapes
in beautiful Craftsbury Common, Vermont. Our

classes in flat water canoeing, bicycle touring, and

backcountry climbing will hone your expedition
skills and let you travel the region.

For information, please visit:
www.sterlingcollege.edu/summer

Sterling College
Available in: Randolph 728-7100,

Working Hands.Working Minds.
Sharon 763-8000 and Wilder 295-7333
www.giffordmed.org

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