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Dra. Sofía González
2023-04-19 |
SUBACROMIAL COMPRESSION, SHOULDER IMPINGEMENT & ROTATOR CUFF TENDINITIS
One of the most common physical complaints is shoulder pain. The shoulder is made up of several joints combined with tendons and muscles that allow a great range of movement of the arm. Because the shoulder is made up of so many different structures, it is vulnerable to many different problems. The rotator cuff is a common source of shoulder pain.
DESCRIPTION
The rotator cuff is a common source of shoulder pain. Pain can be the result of the following:
Tendinitis. The rotator cuff tendons can become inflamed or damaged.
Bursitis. The subacromial bursa can become inflamed, causing pain and functional disability.
Pinch. As the arm is raised to shoulder height, the space between the acromion and the cuff narrows. The acromion can rub (or pinch) the tendon and bursa, causing irritation and pain.
NON-SURGICAL TREATMENTS
The goal of treatment is to reduce pain and restore function. When planning treatment, Dr. Eliseo Mora will take into account your age, activity level, and general health.
In most cases, the initial treatment is non-surgical. Although non-surgical treatment may take several weeks or months, many patients gradually improve and resume function.
Rest. Doctors at the Tijuana Knee and Shoulder Clinic may suggest rest and activity modification, such as avoiding overhead activities.
Non-steroidal anti-inflammatory drugs (NSAIDs) . Medications such as ibuprofen, aspirin, and naproxen reduce pain and inflammation.
Physical therapy. A physical therapist will first focus on restoring normal movement in the shoulder. Stretching exercises to improve range of motion are very helpful. If you have trouble holding your hands behind your back, you may have a stiff posterior shoulder capsule (capsule refers to the inner lining of the shoulder, and posterior means the back of the shoulder). A targeted stretch of the posterior capsule can be very effective in relieving shoulder pain.
Once the pain improves, the therapist may start a strengthening program for the rotator cuff muscles.
Injection of Autologous Plasma Rich in Growth Factors. At Clínica de Rodilla y Hombro de Tijuana, we are aware that it is very important to provide the body with the tools to help it regenerate injured anatomical structures, avoiding the use of medications that in the long run term cause deterioration in the infiltrated structures, such as steroid injections.
SURGICAL TREATMENT
When non-surgical treatment does not relieve pain, Dr. Eliseo Mora may order an MRI study of the shoulder to rule out partial or total rupture of the rotator cuff. If this diagnosis is confirmed, it will be necessary to perform surgical reconstruction of the tendon of the rotator cuff and subacromial decompression.
The surgeon may also treat other conditions present in the shoulder at the time of surgery. These can be arthritis between the clavicle and the acromion (acromioclavicular arthritis), inflammation of the biceps tendon (biceps tendonitis).
Source: American Academy of Orthopedic Surgeons. "Shoulder Impingement/Rotator Cuff Tendinitis". OrthoInfo. https://orthoinfo.aaos.org/en/diseases--conditions/shoulder-impingementrotator-cuff-tendinitis/. Accessed April 19, 2023."
