What Are the Different Types of Rotator Cuff Injuries?

The rotator cuff is a general term for tendon tissue covering the anterior, superior, and posterior subscapularis muscles, superior ganglia, infraganglia, and small round muscles. Located under the acromion and deltoid muscle, it is closely connected to the joint capsule. The function of the rotator cuff is to pull the humeral head toward the glenoid during abduction of the upper arm, and maintain the normal fulcrum joint of the humeral head and glenoid. The rotator cuff injury will weaken or even lose this function, which seriously affects the upper limb abduction function. The disease often occurs in repetitive exercises that require extreme abduction of the shoulder joints (such as baseball, freestyle, backstroke, and butterfly strokes, weightlifting, racket sports).

Basic Information

English name: rotatorcuffinjury
Visiting department: orthopedics

Multiple groups: Over 40 years of age
Common causes: Trauma, insufficient blood supply, chronic impact injury to the shoulder
Common symptoms: pain

Causes of rotator cuff injury

Trauma

It is the main cause of the rotator cuff injury in young people. When they fall, their hands are abducted to the ground or they are holding heavy objects, and the shoulder joints are abducted abruptly and lifted or sprained.

2. Insufficient blood supply

Causes rotator cuff tissue degeneration. When the humerus is rotated internally or externally in a neutral position, this dangerous area of the rotator cuff is most susceptible to compression by the humeral head, squeezing blood vessels, making the area relatively ischemic, and causing tendon degeneration. Clinically, rotator cuff rupture mostly occurs in this area.

3. Chronic impact injury to the shoulder

The rotator cuff tissue of middle-aged and elderly patients is degraded due to long-term impact and wear under the acromion. The disease often occurs in repetitive exercises that require extreme abduction of the shoulder joint (such as baseball, backstroke and butterfly stroke, weightlifting, racket exercise). When the upper limbs are extended forward, the humerus head strikes the acromion and coracoid ligament forward, causing injury to the superior ganglia muscle. Chronic stimulation can cause acromion bursitis, aseptic inflammation, and tendon invasion. Acute violent injury can cause the rotation zone to break.

Clinical manifestations of rotator cuff injury

This disease is more common in patients over 40 years of age, especially heavy manual workers. The shoulder was asymptomatic before the injury, and there was a temporary pain in the shoulder after the injury. The pain aggravated the next day, lasting 4 to 7 days. The patient cannot use the affected shoulder automatically. When the upper arm is straightened and the shoulder joint is rotated and abducted, the tenderness between the large nodule and the acromion is obvious. When the rotator cuff is completely broken, it will seriously affect the abduction function of the shoulder joint due to the loss of its stabilization effect on the humeral head. When the rotator cuff is partially torn, the patient can still abduct the upper arm, but there is a pain arc of 60 ° to 120 °.

Rotator cuff injury check

1. X-ray inspection

It is helpful to judge the shape of acromion and to change the bone structure of the shoulder joint. In some patients with rotator cuff injury, there was obvious bone hyperplasia in the anterior and lateral margins of the acromion and the large nodules.

2. Magnetic resonance (MRI) examination

It can help determine the damage site and severity of tendon injury, especially magnetic resonance imaging (MRA) can clearly show a partial tear of the rotator cuff, which is of high value for diagnosis.

Diagnosis of rotator cuff injury

Diagnosis can be made based on clinical manifestations and related examinations.

Differential diagnosis of rotator cuff injury

Frozen shoulder

Frozen shoulders are also known as periarthritis, adhesive shoulder arthritis, and fifty shoulders. They are caused by soft tissue lesions around the shoulder joint and cause shoulder joint pain and movement dysfunction. Occurs in patients over 40 years old, with more women than men (3: 1). It is characterized by gradual aggravation of shoulder pain and impaired mobility of the shoulder joint, with limited active and passive movements.

2. Acromion bursitis

Mainly manifested as pain and tenderness under the acromion, and can be radiated to the deltoid muscle, with severe swelling in severe cases. Long-term disease can cause local muscle atrophy, and shoulder joints cannot do abduction and external rotation.

3. Biceps biceps tendinitis

The onset was slow and gradually worsened. The pain and tenderness were mainly in the humeral nodular sulcus, and the local pain of the elbow flexion of the biceps resistance increased. There is also dysfunction and muscle atrophy over time.

Rotator cuff injury treatment

Conservative treatment

The injured tendon should be fully rested and strengthen the exercise of the shoulder muscles on the healthy side. Patients should avoid pushing and using pulling instead. Topical can be treated with topical drugs such as plasters. For severe pain, non-steroidal anti-inflammatory painkillers can be taken orally.

2. Surgical treatment

If the injury is severe, the rotator cuff is completely torn, or if conservative treatment is not effective for 3 to 6 months, surgical treatment is required.

With the development of arthroscopic technology, the surgical treatment of rotator cuff injuries is now mostly minimally invasive under arthroscopy, with better results. Partial huge tear or poor condition, small incision can be opened to repair the injured rotator cuff.

Rotator cuff injury prevention

1. Vitamin supplements are good for tendonitis healing, especially don't do actions that cause joint sprains. If there is no ice pack, you can use frozen vegetable bags instead. Bandages are best wrapped around the injured area with sports bandages.

2. Be fully prepared before exercise, especially for athletes.