Aruba Sports Medicine

Rotator Cuff Injury

The rotator cuff is a group of muscles and tendons that surrounds the shoulder joint and holds the head of the humerus firmly in the shallow socket of the shoulder joint. A rotator cuff injury can cause a dull ache in the shoulder that gets worse at night.

Rotator cuff injuries are common and increase with age. However, they may occur earlier in people whose jobs require repeated overhead movements.

Causes

Most often, rotator cuff injuries are caused by the progressive wear and tear of the tendon tissue that occurs over time. Repetitive overhead activity or lifting heavy objects for a prolonged period of time can irritate or damage the tendon. The rotator cuff can also be injured in a particular incident during falls or accidents.

Risk Factors

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

  • Age. The risk of rotator cuff injury increases with age. Rotator cuff tears are most common in people over 60 years of age.
  • Some works. Jobs that require repetitive overhead arm movements, such as carpentry or house painting, can damage the rotator cuff over time.
  • Certain sports. Some types of rotator cuff injuries are more common in people who participate in sports such as baseball, tennis, and weightlifting.
  • Family history. There may be a genetic component to rotator cuff injuries, as these injuries tend to occur more frequently in certain families.

 

Treatment

Conservative treatments, such as rest, ice and physical therapy, are sometimes all that is needed to recover from a rotator cuff injury. Today, therapies such as shock waves are highly effective in resolving the injury, and invasive therapies such as percutaneous electrolysis are also therapeutic alternatives before surgery is required.

Therapy

Physical therapy is often one of the first treatments recommended. Exercises that target the specific location of the rotator cuff injury can help restore flexibility and strengthen the shoulder. Physical therapy is also an important part of the recovery process following rotator cuff surgery.

 

Traditional and Natural Medicine, Therapeutic Alternative

Traditional and natural medicine considers man in a holistic way, that is, in his totality and within an ecological aspect. It is based on the idea that poor health or illness comes from an imbalance in man in his total ecological system and not only from the causal agent and pathogenic evolution. To maintain adequate mental and physical health, there must be a biological balance; when this is broken, illness appears.

 

Traditional and natural Chinese medicine is an ancient science, the practice is as old as humanity, the most common related techniques of this science are: acupuncture, moxibustion, cupping, acupressure, therapeutic massages, herbal medicine, laser puncture, electroacupuncture, acupuncture analgesia and pharmacopuncture.

In natural medicine, different diagnoses are made, the main one being lifestyle, as it tells us how to walk, rest, whether or not we do physical exercise, habits and behavior patterns such as: managing stress, feelings, our relationships with others, with nature, all of this gives us an idea of where the patient’s problem lies and with a good physical examination and comprehensive observation it allows us to reach an adequate diagnosis and better treatment.

Acupuncture

Acupuncture (acu from Latin means needle and puncture means to prick), is an Asian therapeutic procedure that consists of applying very fine needles to certain points of the body, stimulating them in order to treat different illnesses, regulating the energy of the meridians, the excesses or gaps of energy, both in the meridian and in the organs, thus promoting their proper functioning. Acupuncture and other related techniques such as moxibustion, cupping, etc. are not only used in China and other Asian countries such as Japan, Vietnam and Mongolia, but were also later spread to Europe (France, Italy, Spain, Switzerland, Germany, Holland, Russia) and to the American continent many years later. Acupuncture is also used in different specialties in Western medicine. the method of anesthesia with acupuncture is used in gynecological, ophthalmological operations, general surgery and in stomatology it acts in the remission of pain, regulates the excitation of the nerves as in neuralgia and paralysis by stimulating them to recover motility, helps the accelerated recovery of inflammatory diseases because it favorably alters the number of leukocytes and reinforces the function of phagocytosis, also regulates the functions of hormone excretion, acts on the immune system because acupuncture is applied for pain, high blood pressure, low back pain, tendonitis, bursitis, osteoarthritis, arthritis and many more diseases.

Contraindications of acupuncture : it should not be applied in patients with cancer and other malignant diseases, but it can be used for side effects such as: lack of sleep and depression; not for infectious contagious diseases, not for skin lesions such as burns, not for pregnancy, not for patients who use drugs, not for hemorrhages, not for very elderly patients or very weak people or for children under seven years of age.

Moxibustion

Moxibustion is a treatment method in traditional Chinese medicine that prevents or treats diseases by applying heat to the indicated acupuncture point using moxa or Artemisia tobacco. It can be applied directly to the skin or indirectly with salt, garlic, ginger, etc.

It is used to treat cold-related illnesses and chronic diseases. It influences the immune system by regulating energy and expelling cold and humidity. It can also be used for acute pain and promotes proper functioning of the digestive system.

Contraindications of moxibustion : do not apply to people with fever above 38 degrees Celsius, severe high blood pressure, children under seven years of age, people with fragile skin (diabetics, patients with skin lesions).

Cupping therapy

Cupping therapy, cupping is another technique of traditional Chinese medicine, it is a therapeutic method inherited from our ancestors, its main objective is to produce local congestion or extract blood with prior suction in the applied skin area.

There are different types of suction cups, made of bamboo, glass and plastic. They can be applied in combination with acupuncture. They can be applied with fire or with a suction pump.

Its action influences the skin, dilates the arteries and veins of the skin, activates blood circulation, raises the temperature of the skin by accelerating the metabolism, reinforces cutaneous respiration and nutrition, influences the muscles, joints and peripheral nerves, and also influences the circulatory system and blood.

Application in conditions such as: bruises, distortion, neuralgia, peripheral paralysis, sciatica, bronchitis, pneumonia, cough, bronchial asthma, kidney and gallbladder lithiasis, etc.

Contraindications : Do not apply to patients with high fever, convulsions, pregnancy, coagulation disorders, body regions with edema and skin conditions.

Shoulder Dislocation. Bankart and Hill Sachs lesions

The shoulder is the most complex and mobile joint in the human body. As a result, it can suffer from a variety of problems. Many of the ailments are caused by inflammation or tearing of the tendon, as well as problems in the rotator cuff or the bone system.

Among the most frequent injuries we can highlight rotator cuff tear, dislocation, frozen shoulder, bursitis, tendonitis and fractures.

Today we want to focus on two of the most common shoulder injuries, especially in sports: the Bankart injury and the Hill Sachs injury.

Bankart lesion involves the rupture of the glenoid labrum which is a fibrous capsule that is located where the head of the humerus sits. It surrounds the base of the shoulder joint and is responsible for giving it greater stability. This usually results from an anterior dislocation of the shoulder, in other words, when the shoulder moves forward, usually due to trauma, the head of the humerus takes the labrum with it, it tears it off.

 

Hill Sachs injury Hill Sachs fracture is a depression of the posterolateral part of the head of the humerus. It is caused by the impaction of the head of the humerus against the glenoid rim. anteroinferior following a traumatic event that causes a dislocation of the shoulder. During shoulder dislocation, the head of the humerus is crushed against the glenoid, depressed, and deformed.

 

Symptoms

Patients suffering from Bankart and Hill Sachs lesions experience acute pain and a feeling of shoulder instability. If the lesion is small it may not cause any symptoms, but we will generally find the following symptoms:

  • Persistent shoulder pain.
  • Instability.
  • The patient describes how he feels that “his shoulder is coming out.”
  • After the first dislocation, it is common for further episodes of shoulder dislocation to occur.

Treatment

Conservative treatment includes anti-inflammatory drugs, rest, cold application and physical therapy. If this is not sufficient, surgery will be necessary. The patient usually wears a sling for the first week, although it may be necessary for longer.

In most cases, physiotherapy is recommended to help with pain and postoperative sequelae. Physiotherapy treatment will be based on:

  • Mobilization of the glenohumeral and scapulothoracic joints mainly in all their ranges of motion.
  • Myofascial Treatment.
  • Therapeutic massage.
  • Analgesic and anti-inflammatory treatment through physical agents such as:
  • Shortwave
  • Ultrasounds
  • Laser
  • Analgesic Currents
  • Exercise to strengthen the rotator cuff, all the stabilizing muscles of the shoulder and the scapula.
  • Scapular control and stabilization exercise.
  • Stretching of the shoulder and upper limb muscles.
  • Proprioception exercise and conditioning for normal activity.