Rotator Cuff Impingement/Tears*

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Rotator Cuff Impingement/Tears* Empty Rotator Cuff Impingement/Tears*

Post  Stingray on Mon Aug 10, 2009 11:41 pm

I have an impingement in my rotator cuff and I had a cortisone shot for it on Friday. Hope it helps.

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Post  Hummingbird on Sat Aug 22, 2009 5:56 pm

Your rotator cuff is made up of the muscles and tendons in your shoulder. These muscles and tendons connect your upper arm bone with your shoulder blade. They also help hold the ball of your upper arm bone firmly in your shoulder socket. The combination results in the greatest range of motion of any joint in your body.

A rotator cuff injury includes any type of irritation or damage to your rotator cuff muscles or tendons. Causes of a rotator cuff injury may include falling, lifting and repetitive arm activities — especially those done overhead, such as throwing a baseball or placing items on overhead shelves.

Most of the time, a rotator cuff injury heal on its own with self-care measures or exercise therapy.

Rotator cuff injury symptoms may include:

* Pain and tenderness in your shoulder, especially when reaching overhead, reaching behind your back, lifting, pulling or sleeping on the affected side
* Shoulder weakness
* Loss of shoulder range of motion
* Inclination to keep your shoulder inactive

The most common symptom is pain. You may experience it when you reach up to comb your hair, bend your arm back to put on a jacket or carry something heavy. Lying on the affected shoulder also can be painful. If you have a severe injury, such as a large tear, you may experience continuous pain and muscle weakness.

When to see a doctor
You should see your doctor if:

* You're experiencing severe shoulder pain
* You're unable to use your arm
* You have shoulder pain that's lasted more than a week

Four major muscles (subscapularis, supraspinatus, infraspinatus and teres minor) and their tendons connect your upper arm bone (humerus) with your shoulder blade (scapula). A rotator cuff injury, which is fairly common, involves any type of irritation or damage to your rotator cuff muscles or tendons, including:

* Tendinitis. Tendons in your rotator cuff can become inflamed due to overuse or overload, especially if you're an athlete who performs a lot of overhead activities, such as in tennis or racquetball.
* Bursitis. The fluid-filled sac (bursa) between your shoulder joint and rotator cuff tendons can become irritated and inflamed.
* Strain or tear. Left untreated, tendinitis can weaken a tendon and lead to chronic tendon degeneration or to a tendon tear. Stress from overuse also can cause a shoulder tendon or muscle to tear.

Common causes of rotator cuff injuries include:

* Normal wear and tear. Increasingly after age 40, normal wear and tear on your rotator cuff can cause a breakdown of fibrous protein (collagen) in the cuff's tendons and muscles. This makes them more prone to degeneration and injury. With age, you may also develop calcium deposits within the cuff or arthritic bone spurs that can pinch or irritate your rotator cuff.
* Poor posture. When you slouch your neck and shoulders forward, the space where the rotator cuff muscles reside can become smaller. This can allow a muscle or tendon to become pinched under your shoulder bones (including your collarbone), especially during overhead activities, such as throwing.
* Falling. Using your arm to break a fall or falling on your arm can bruise or tear a rotator cuff tendon or muscle.
* Lifting or pulling. Lifting an object that's too heavy or doing so improperly — especially overhead — can strain or tear your tendons or muscles. Likewise, pulling something, such as a high-poundage archery bow, may cause an injury.
* Repetitive stress. Repetitive overhead movement of your arms can stress your rotator cuff muscles and tendons, causing inflammation and eventually tearing. This occurs often in athletes, especially baseball pitchers, swimmers and tennis players. It's also common among people in the building trades, such as painters and carpenters.

The following factors may increase your risk of having a rotator cuff injury:

* Age. As you get older, your risk of a rotator cuff injury increases. Rotator cuff tears are most common in people older than 40.
* Being an athlete. Athletes who regularly use repetitive motions, such as baseball pitchers, archers and tennis players, have a greater risk of having a rotator cuff injury.
* Working in the construction trades. Carpenters and painters, who also use repetitive motions, have an increased risk of injury.
* Having poor posture. Poor posture can allow a muscle or tendon to become pinched under your shoulder bones.
* Having weak shoulder muscles. This risk factor can be decreased or eliminated with shoulder-strengthening exercises.

Preparing for your appointment
You'll start by seeing your family doctor or a general practitioner. If your injury is severe and requires surgery, however, you'll likely be referred to an orthopedic surgeon.

What to expect from your doctor
Your doctor is likely to ask you a number of questions. Being ready to answer them may reserve time to go over any points you want to spend more time on. Your doctor may ask:

* Where is the pain located?
* Does your job or hobby aggravate your shoulder pain?
* When did you first begin experiencing shoulder pain?
* Have you experienced any symptoms in addition to shoulder pain?
* How severe is your pain?
* What movements and activities aggravate and relieve your shoulder pain?
* Do you have any weakness or numbness in your arm?

What you can do in the meantime
In the days before your appointment, you can make yourself more comfortable by:

* Resting your shoulder. Avoid movements that aggravate it and give you more pain.
* Applying cold packs to reduce pain and inflammation.
* Taking pain medications, if necessary. Over-the-counter nonsteroidal anti-inflammatory drugs (NSAIDs), such as aspirin, ibuprofen (Advil, Motrin, others) and naproxen (Aleve), may help reduce pain. Acetaminophen (Tylenol, others) also may help relieve pain.

If your injury appears to be severe or your doctor can't determine the cause of your pain through physical examination, he or she may recommend diagnostic imaging tests to better delineate your shoulder joint, muscles and tendons. These may include:

* X-rays
* A magnetic resonance imaging (MRI) scan
* An ultrasound scan

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Post  Hummingbird on Sat Aug 22, 2009 6:00 pm

Cortisone shots are injections that may help relieve pain and inflammation in a specific area of your body. Cortisone shots are most commonly given in joints, such as your ankle, elbow, hip, knee, shoulder, spine and wrist, as well as the small joints in the hands and feet. Joint injections are commonly referred to as cortisone shots, but what medication or combination of medications is injected varies. Cortisone shots typically include a corticosteroid medication and a local anesthetic. Cortisone shots are typically given in a doctor's office. The results you can expect from cortisone shots depend on the reason for your treatment.

Cortisone shots may be part of treatment for a number of diseases and conditions, including:

* Baker's cyst
* Bursitis
* Carpal tunnel syndrome
* De Quervain's tenosynovitis
* Frozen shoulder
* Gout
* Hip (trochanteric) bursitis
* Juvenile rheumatoid arthritis
* Lupus
* Morton's neuroma
* Myofascial pain syndrome
* Osteoarthritis
* Plantar fasciitis
* Pseudogout
* Psoriatic arthritis
* Reactive arthritis
* Rheumatoid arthritis
* Rotator cuff injury
* Sarcoidosis
* Tendonitis
* Tennis elbow

Cortisone shots carry a risk of complications, such as:

* Death of nearby bone (osteonecrosis)
* Joint infection
* Nerve damage
* Skin thinning around injection site
* Temporary flare of pain and inflammation in the joint
* Tendon weakening or rupture
* Thinning of nearby bone (osteoporosis)
* Whitening or lightening of the skin around injection site

Limits on the number of cortisone shots
There's some concern that repeated use of cortisone shots may cause deterioration of the cartilage within a joint. For this reason, doctors typically limit the number of cortisone shots in a joint. The limit varies depending on the joint and the reason for treatment. In general, people with osteoarthritis or other noninflammatory conditions may be limited to four cortisone shots per joint. People with rheumatoid arthritis may be limited to one cortisone shot per joint per month.

Cortisone shots don't require any preparation. However, if you're allergic to any corticosteroids or other medications, tell your doctor. Allergic reactions to the injected medication are possible.

During the cortisone shot
Your doctor may ask you to remove clothing in order to access your joint. You may be asked to change into a gown. You'll then be positioned in a way that allows your doctor to most easily insert the needle.

The area around the injection site is cleaned. Your doctor may also apply an anesthetic spray to numb the area where the needle will be inserted.

The needle is then inserted into the injection site. If you're receiving a cortisone shot in a joint, the doctor inserts the needle inside the joint. You'll likely feel some pressure when the needle is inserted. Let your doctor know if you're uncomfortable.

The medication is then released into the injection site. What medication you receive is up to your doctor. Typically, cortisone shots include a corticosteroid medication to relieve pain and inflammation over time, and an anesthetic to provide immediate pain relief.

After the cortisone shot
After your cortisone shot you can go about your day. You may have some mild pain or stiffness at the injection site. Your doctor may ask that you:

* Protect the injection area for a day or two. For instance, if you received a cortisone shot in your shoulder, avoid heavy lifting. If you received a cortisone shot in your knee, stay off your feet when you can.
* Apply ice to the injection site as needed to relieve pain.
* Watch for signs of infection, including increasing pain, redness and swelling that last more than 48 hours.

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Post  Hummingbird on Wed Nov 18, 2009 3:42 pm

Well the shot has definitely wore off!!! I am STILL waiting for an appt with a neurosurgeon!!!

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