How to prevent and treat rotator cuff injury

How to prevent and treat rotator cuff injury

The shoulder joint has the greatest range of motion of all the joints in the body, which means it is the most unstable and more prone to injury.

In daily life, I believe many people have experienced shoulder pain. Of course, most people may first think of the well-known "periarthritis of the shoulder" when they experience shoulder pain. However, after a period of conservative treatment, the effect is often not ideal. Some even become more and more painful, and in severe cases, it may affect sleep.

In fact, shoulder pain may not only be caused by frozen shoulder. In many cases, it is due to rotator cuff injury. This issue of Xinhua Rehabilitation Science will bring you how to prevent and treat rotator cuff injury.

What is a rotator cuff injury?

First, let us understand what the rotator cuff is.

The rotator cuff is made up of four muscles: the supraspinatus, infraspinatus, teres minor and subscapularis. The tendons of these four muscles wrap around the shoulder like a sleeve.

Rotator cuff injury refers to damage to the tendons of these four muscles, causing shoulder pain and limited range of motion.

How to Identify a Rotator Cuff Injury

1. Magnetic resonance imaging (MRI) of the shoulder joint.

2. Special physical examination of shoulder joint:

①Empty can test

The shoulder joint is abducted 90° and horizontally adducted 30°, with the thumb pointing downward. The examiner presses the upper limb downward forcefully, and the patient resists. Weakness and pain compared with the contralateral side indicate rotator cuff disease or supraspinatus tendon injury or tear.

② Drop arm test

The examiner abducts the patient's shoulder joint to more than 90° and asks the patient to maintain the shoulder abduction position of 90-120°. If the patient is unable to fall and feels pain, the test is positive. This test has a high specificity for supraspinatus tendon injury and is generally seen in patients with complete supraspinatus tendon tear.

③External rotation resistance test

The patient's shoulder joint is in the adducted position, the elbow is flexed 90 degrees, and the elbow is at the side of the body and clamped. The patient is asked to rotate both shoulders externally against resistance, so that the hands are away from the side of the body. If shoulder pain occurs, it is positive, indicating injury to the infraspinatus and teres minor tendons.

④ Hawkins sign

The patient's shoulder is flexed 90° in adduction, the elbow is flexed 90°, the forearm is kept horizontal, and the examiner pushes the forearm downward to internally rotate the shoulder joint. If shoulder pain occurs, it is positive, indicating acromion impingement. Generally, it is necessary to combine MRI examination of the shoulder joint to confirm the diagnosis.

Treatment of Rotator Cuff Injury

Conservative treatment: MRI shows that the injury to the rotator cuff muscles is relatively mild. Oral nonsteroidal anti-inflammatory drugs or subacromial injections can be used for treatment. Rehabilitation therapy can also be performed to help relieve the symptoms. Pay attention to resting the affected side to avoid aggravation.

Surgical treatment: If MRI reveals that the rotator cuff muscle injury is partially torn and severe or there is a trend of persistent worsening of symptoms, arthroscopic rotator cuff repair may be performed.

How to prevent rotator cuff injuries

Pay attention to keeping your shoulders warm, especially when you go to sleep late at night, take care to protect your shoulders.

Always warm up before exercising. Stretch your shoulder joints appropriately at the end of the exercise.

Be sure to pay attention to any discomfort in your shoulders when exercising or working.

Once symptoms such as pain or other discomfort occur, you should stop the activity immediately and see a doctor.

How to recover after rotator cuff injury surgery

(The following must be carried out under strict compliance with doctor's orders)

1. Pendulum motion

The affected limb hangs naturally, with the shoulder joint as the apex for movement in all directions. The body is bent forward, and the affected limb is swung, first in the front-to-back direction, then in the left-to-right direction if there is no pain, and finally in the clockwise circular motion, gradually increasing the range of motion, but not exceeding 90°.

2. Passive forward flexion exercise

Lie on your back with the operated shoulder abducted 30°~45°. Hold the operated upper arm with the healthy hand. Use the healthy hand to lead the affected side to do passive flexion. Do this 5-10 times a day. Avoid pain during training and do not use too large an amplitude.

3. Wall climbing training

Face the wall, place the forefoot of the operated side against the wall, and move the fingers slowly and alternately from low to high, 10 to 20 times back and forth each time, 5 to 10 times a day.

4. Active forward bend exercise

The patient should lie in supine position with the shoulder joint on the operated side abducted at 30°-45°. The operated side should actively perform flexion exercises 5-10 times a day, gradually increasing the range of motion and avoiding causing obvious pain during exercise.

To achieve the best rehabilitation effect after surgery, you need to strictly follow professional rehabilitation prescriptions, carefully carry out rehabilitation training at each stage, proceed step by step, pay attention to safety during rehabilitation training, and avoid re-injury.

The popular science content of this platform has been funded by the China Association for Science and Technology's Science Popularization Department's 2022 National Science Literacy Action Project "National Society Science Popularization Capacity Improvement Project-Rehabilitation Science Popularization Service Capacity Improvement Action Plan"