Shouldering responsibilities has been used time and again to show how mighty the burden is. Considering how small the joint is and how beautifully and precisely the humerus bone is cuddled on all sides by the rotator cuff, it is one of the creators best designed piece of anatomy. It is to shoulder very complex movements- all within a shallow hollow
A hug for expressions of love, a punch for protection, a throw at the stumps to dismiss the batsman, a well crafted bowling action to impress the crowd, a shrug to show displeasure- it can express as beautifully as a face. But then, you over work it and the restriction of movements is so debilitating and painful and when left alone, permanent
The shoulder joint otherwise called the glenohumeral joint is a ball and socket joint. It is the articulation of the glenoid process of the scapula and the head of the humerus. This union is covered by a capsule which is kind of lax, giving it the needed space for all kinds of movements. There are numerous muscular tendons that are attached all around the joint which imparts stability which is called the rotator cuff. There are air filled sacs in between the rotator cuff and the bone called bursae. They act as shock absorbers
Dislocation is the commonest complication of this joint, considering that the socket is shallow and most of the ball is outside the joint. A forceful landing on the outstretched hand is the commonest cause of dislocation. Anterior dislocation is the commonest. It can be reduced back into its normal place.
Not everyone in their lifetime experiences a shoulder dislocation. But the rotator cuff is going to give some kind of trouble during one’s lifetime for sure. The rotator cuff is a tendinous cuff that attaches muscle to bone and stabilisés every movement of the shoulder joint. The shoulder joint is the most over worked joint , so to say. The rotator cuff is the most valued anatomical structure to maintain with caution. The injuries to the rotator cuff are the most nagging and they fall into 3 categories- Tendinitis is the commonest and is due to overuse. The painter is an example where overuse during work can result in painful movements and restriction of movements. Bursitis is inflammation of the bursae. Though not very common, it is still prevalent
Strains and tears are very common one are caused by overstretching of the muscle due to overwork or an acute injury. They are painful and result in restriction of normal activity. A tear is common to a bowler in cricket. A sudden fall or an accident can cause tears
A strain concerns the common man and this is what I would like to address today. Inflammation of the tendons that make up the rotator cuff causes impingement due to reduction of space between the rotator cuff and the bone. Simple movements become painful and stressful to the common man. Combing the hair, buttoning oneself especially the back buttons, raising up the hand to lift something- every small thing becomes painful. And the pain does not go away- what is worse it the restriction in mobility can become permanent and is called a frozen shoulder.
Sleeping on the same side, sleeping with arms over your head, repeated works employing the same muscles for example lifting the arms over the head often. Sometimes there is no reason whatsoever. Nevertheless rotator cuff tendinitis can be very painful
How do I know that my rotator cuff is strained.
-Pain while raising or lowering the arms
-A clicking sound on moving the shoulder
-Restriction of movement especially buttoning
-Pain and swelling in front of the shoulder
-Pain in the middle of the night
-Kind of weakness in the affected arm
The treatment for a rotator cuff injury or what the common man calls a shoulder pain goes by the pneumonic-RICE, that is rest, ice, compression in the case of inflammation and elevation ( in acutely severe inflammation) also to include exercise for strengthening as the pain subsides. NSAIDs can be used for pain- what we call pain killers. Avoid the activity that causes pain. Apply ice packs thrice a day. Get the help of a therapist to work on stretching and passive movements in order to restore the complete range of movements . Once the pain is controlled, exercises should be started to regain strength.
Very rarely does the treatment go beyond this. Injection of steroids into the rotator cuff and surgeries are done only in extreme cases. They recover very well