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.

 

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.

Cupping Therapy

What exactly is cupping in the context of massage?

A treatment for cupping that is therapeutic includes warming and placing cups, usually made of glass, on the skin. In the process of warming the air in the cup, a vacuum is created, and when it is applied to the skin tissues are drawn to the cup. This promotes healing, increases blood flow, and also reduces the tension in connective tissue. It is similar to deep tissue massage, which can help reduce pain and to break down scar tissue. Cupping is commonly applied to areas of pain, such as the back, neck, and shoulders. The cups can cause temporary soreness or bruise dependent on the strength of suction created by vacuum as well as the degree of internal stagnation. This would indicate that the treatment has eliminated stagnation and toxins, according to TCM. The cups are removed by lifting one edge and allowing air to enter and breaking the seal and vacuum.

What exactly is cupping therapy??
TCM believes that stagnation in blood or qi is what is the cause of the disease. Cupping stimulates the local circulation of blood and qi around the area of treatment. This helps to relieve the swelling, tension, and discomfort. It draws impurities to the surface and removes toxic substances. According to Western science, cupping improves the flow of blood and relaxes connective tissue. Cupping stimulates tissue relaxation and better cell-to-cell communication. The work of U.S. physiologist and acupuncturist Helene Langevin has documented cell-level changes using an ultrasound camera. She has proven the effects of cupping, acupuncture, and massage relax tissue and reducing markers of inflammation. Inflammatory cytokines (chemical messengers) are reduced, while the cytokines that aid in healing and relaxation are increased.

What are the benefits of cupping?

The advantages of cupping include local pain relief and relaxing muscles. Cupping helps improve overall health by removing the blockages in energy that TCM practitioners consider to be obstacles in the flow of energy or Qi. In the case of athletes, cupping may assist in increasing the flow of blood to a specific muscle region or help reduce discomfort. Cupping was used by a variety of athletes during the Rio Olympics 2016. This can be seen in circular markings on some members of the U.S. swim team members.

How long will the cupping of bumps require?

The bruises that result from cupping last from a few days to a couple of weeks. According to TCM practitioner Casco, it is expected that after several weeks of repeated cupping treatments the bruises will reduce as the stagnation is eliminated. This is an indication of a successful cupping protocol.

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