• Adam R Whatley Osteopath

Shoulder Rotator Cuff Tear

SHOULDER ROTATOR CUFF TEAR

The rotator cuff is a group of 4 important muscles that connect the arm bone to the shoulder ball at the ball and socket. The rotator cuff allows for dynamic mobility at the shoulder, allowing for high amounts of mobility, whilst at the same time allowing for stability of the joint. The tendons run under part of the shoulder blade, at the top of the shoulder, and this where they are very vulnerable to being pinched and damaged. over time repeated pinching can lead to tearing of the rotator cuff muscles and/or tendons, resulting in pain and weakness. A tear may result suddenly from traumatic trauma or develop gradually over a period of time. When suffering from a rotator cuff tear, you may find it very difficult to lift or rotate the arm. The pain is also very common at night, often radiating down the arm.

Causes


  • Traumatic ​injury, like a fall for example.

  • Overuse or repetitive activity.

  • Poor posture.

  • Age related degenerative changes due to poor blood supply to an area of the cuff.

  • Impingment (either from bursitis or bone spurs).


Symptoms

  1. Pain at rest and at night, particularly if lying on the affected shoulder.

  2. Pain when lifting and lowering your arm or with specific movements.

  3. Weakness when lifting or rotating your arm.

  4. Cackling or grinding sensation when moving your shoulder in certain positions.


Treatment

  • Painkillers and anti-inflammatory medications only provide short term relief.

  • Osteopathic Treatment and physical rehabilitation aims to keep your shoulder mobile and strong, with further aims to reduce pain and weakness.

  • If conservative treatment fails then you may be offered a Cortisone steroid injection into the area to help reduce inflammation and control the pain. However, it should be noted that these in most cases only offer short term relief and I’m not a solution long-term. Furthermore, It is advisable to avoid repeated steroid injections in the presence of a tendon tear, as this has been shown to further damage the tendon.

  • Platelet rich plasma (PRP) Treatment - a natural non-surgical treatment aiming to restore function and reduce pain.

  • Surgery is required may be required if the tear follows a bad tearing injury. Or, when pain and weakness has not responded to conservative management and rehabilitation. It is important to note that surgery requires a long period of rehabilitation following.

- REGENERATIVE MEDICINE. PLATELET RICH PLASMA (PRP) TREATMENT:

Platelet-rich plasma (PRP) is a very popular ortho-biologic treatment use in regenerative medicine. Ortho-biologics are substances that occur naturally in the human body. When extracted, concentrated and injected back into the body, these substances activate the body’s own healing mechanisms. PRP treatment is performed by taking a small sample of the patient’s blood, extracting the platelets are then further contacting them before they are used to speed up healing and recovery.


PRP injections are very commonly used to facilitate the body’s self-healing mechanisms, and the clinical outcomes are very good. Furthermore, it is completely natural and associated with minimal downtime.

PRP has been shown in scientific research to be highly effective for treating rotator cuff tears, without the risks and expense of surgery.


Most patients here at Dynamic Osteopaths & Regenerative Medicine report minimal discomfort associated with the injection. Also, go on to report significant improvement that occurs in the subsequent weeks. A recent study compared PRP treatment to corticosteroid injections for a rotator cuff tear. Results showed that, at 3 months following treatment, the PRP patients had a significant reduction in pain and improvement in mobility than patients treated with corticosteroid injections. Furthermore, less that 5% of the PRP patients in this study progressed to surgery for their rotator cuff after one year, compared to almost half of the corticosteroid group.



Further studies:


PLEASE FOLLOW THIS LINK HERE FOR FURTHER SPECIFIC INFORMATION ON PRP TREATMENT

Exercises for rotator cuff tear

It is important that the stabilising muscles are working to their best ability during rehabilitation of the shoulder. The shoulder joint relies heavily on dynamic synergistic control while moving and if this is out, there shoulder biomechanics will be affected and the rotator cuff is susceptible to damage So, it is important to do some corrective stabilisation and strengthening exercises under the guidance of your osteopath, such as:

  • Rear scapular (shoulder blade) control

  • Rotator cuff strengthening

  • Postural control

Further specific exercises (below) can be adopted when tolerated

  • Therapy ball can be used to strengthen the core muscles

  • Rear shoulder strengthening (when tolerated)

  • Preventive exercise

PLEASE FOLLOW LINK HERE FOR SPECIFIC SHOULDER REHABILITATION FOLLOWING ROTATOR CUFF DISC INJURY

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