Getting my cuff rotated

The rotator cuff is a group of muscles and tendons that surround the shoulder joint. Ok, because you asked, the four muscles involved are called: supraspinatus, infraspinatus, subscapularis, and teres minor (why is it the last one of a series is always named something that looks completely different than the others?)

The rotator cuff muscles work as a unit. They help to stabilise the shoulder joint and also help with shoulder joint movement. These things seem to come in packages of four, as there are also four tendons of the rotator cuff muscles that join together to form one larger tendon, called the rotator cuff tendon (not a very imaginative name if you ask me). This tendon attaches to the head of the bony surface at the top of the upper arm bone, which is called quite sarcastically the humerus. The rotator cuff tendon passes through a space underneath the acromion of the scapula, called the subacromial space (oh come on, was it trainee day at the naming department????).

The main symptoms of rotator cuff injury are sudden pain and painful movement of the shoulder. Pain is worst when you use your arm for activities above your shoulder level. That makes sense to me as getting clothes on and off and blow drying my hair is torture. Pain may also affect sleep, especially  when you sleep on the injured side. Thankfully I sleep on the other side (thanks to left hip bursitis), and my pain is along the bottom of my upper arm. Um, you know where I mean!

Rotator cuff injuries occur most often in those who repeatedly perform overhead motions in their jobs or sports. Examples include painters, carpenters, and people who play baseball or tennis. It can also develop after lifting or pulling something awkwardly, or reaching to get something heavy off a top shelf. Using your arm to break a fall or falling on your arm can do it.  Some people develop bone spurs, an overgrowth of bone, on the top of the shoulder blade that protrudes over the rotator cuff.  Repetitive stress of any kind can cause inflammation and eventual tearing. that doesn't sound to good, and it's not, as it can cause irritation and damage.

The risk of rotator cuff injury also increases with age. 

It's common to recover from a rotator cuff injury with physical therapy exercises that improve flexibility and strength of the muscles surrounding the shoulder joint. Most people exercise the front muscles of the chest, shoulder and upper arm, but it is equally important to strengthen the muscles in the back of the shoulder and around the shoulder blade to optimize shoulder muscle balance.  Severe rotator cuff injuries, involving complete tears of the muscle or tendon, may require surgical repair. Other treatments include: rest, heat or cold depending on stiffness (heat) or inflammation (cold), medicines (ibuprophen for example), ultrasound, massage, and acupuncture.  Cortisone injection is another option, but that's a pretty last resort, before surgery.

 

The problem is the potential for what's called frozen shoulder syndrome, when shoulder movements become painful, stiff and reduced, sometimes completely 'frozen', perhaps due to scar tissue formed in the shoulder.  It most commonly occurs in people aged between 40 and 65 years. It is more common in women. It is more common than average in people who have diabetes and some other conditions, including overactive thyroid disease.  Check, check, no (thankfully). Although either shoulder can be affected it is most commonly the non-dominant shoulder - that is, the left shoulder in a right-handed person.  Interesting.  I wonder if it's because the muscles in the non-dominant shoulder might be a bit weaker and thus more easily injured. One thing it is not is connected in any way with arthritis and no other joints are affected.  Without treatment, symptoms usually go away, but this may take up to 2-3 years!  Yikes, I can't wait that long!

So I am visiting a physiotherapist who performs massage, acupuncture and ultrasound as needed.  I have a few exercises that get tweaked every two weeks or so, and I ice the shoulder after I exercise.  I also take ibuprophen when it is sore, but not on an empty stomach as ibuprophen can cause stomach pain in some people.  I am also having to modify my pilates and yoga classes so that I don't overdo arm and shoulder work, and I have left off swimming for the time being, focussing on walking and biking instead.  It's a slow, painful, frustrating business, but I am seeing modest improvement.

When One Door Closes.....

......you sometimes get smacked in the face.

Just when my hip bursitis was beginning to calm down, I got an ache in my upper left arm.  Putting clothes on over my head was so painful I was wearing everything I had with buttons and zips. That's when I realized I'm not really a cardigan kind of girl.  I only had one shirt and 2 sweaters, and it is winter, so I got pretty bored of my wardrobe before I decided to do something about it.

Hello doctor.  Hello physiotherapist.  Yes, I thought I'd seen the last of you, too.  No offence.  Non taken.

Looks like I did something to my rotator cuff.  And a funny thing about that is - well not really so funny - but I can do practically none of my scoliosis exercises with a rotator cuff injury.  I can't hang, or stretch with my arms overhead, even hanging down.  I can't pull with my arms out, and I certainly can't stretch pecs. 

So I get a new selection of exercises designed to strengthen the upper part my shoulder blades.  Seems my lower blades are extremely strong, from all the hanging and pressing, etc. Interesting. so yet again my scoliosis is impacting on my health and fitness. I can actually feel my back curve is going back to where it was, my hump is a bit larger and when I lie on the ground with my knees bent, I can't feel the floor with one side of my lower back. I never thought I was making much progress with my exercises, but now I know I was.  And I hope it won't take too long to get back there!

Christmas has not helped.  I feel like a fat pig, not having walked much, pilates and yoga classes shut down for a few weeks over the holiday, no swimming because my days and nights are filled with other things. And I am eating, eating, eating.  I wasn't too bad up until Christmas but I have experienced virtually no self-discipline since.  So as soon as my Dad's 80th birthday celebrations are over and my sister leaves town taking all my left-over chocolate and cheezies with her, my life will get back on track.  And hopefully by then, this rotator cuff thing with be better and I can hang again.