Vim & Vigor - Winter 2011 - Parrish Medical Center - (Page 56)

Q&A Find relief for rotator cuff tears and tendinitis ASK The ExpErt Doc, My Shoulder Is Killing Me! Rotator cuff problems are relatively common, especially in patients older than 40. The rotator cuff consists of four muscles/tendons that surround the ball-and-socket type shoulder joint, and rotates the shoulder inward, outward, backward and forward. If you have shoulder or neck problems, be evaluated for rotator cuff tears or tendinitis by your primary care physician or orthopedist. Michael J. Magee, M.D., is an orthopedic surgeon with offices in the Parrish Healthcare Center at Port St. John, 5005 Port St. John Parkway (near Grissom Parkway). Call 321-433-2247 for an appointment. Most insurances are accepted. Q How are these conditions diagnosed? Q What are symptoms of rotator cuff tears and tendinitis? By a careful history, physical exam and diagnostic tests. Along with the symptoms listed above, chronic cuff tears can show thinning of the muscle. A regular X-ray is helpful to determine the shape of the acromion and arthritis of the shoulder joint. An MRI or MRI arthrogram can help determine the size, shape and appearance of the chronic cuff tear. X-ray arthrograms may be used to determine cuff tears in patients who won’t tolerate an MRI, and ultrasound may also be used. Common symptoms are pain along the outer part of the shoulder, which commonly goes down the arm, but not usually the forearm. It is often painful to sleep on that shoulder, and overhead activities may be difficult. There will often be pain, sometimes weakness, and numbness or tingling is common. Q What are the treatments for tears and tendinitis/bursitis? The rotator cuff may be pinching the acromion, the bone immediately above the rotator cuff. As the arm moves forward, a prominent acromion may cause mechanical wear on the rotator cuff, predisposing it to failure. As we age, the rotator cuff undergoes compositional changes, making it susceptible to thinning and tearing. Cuff tendinitis and bursitis is an inflammation of the tendon and bursa (a fluid-filled, saclike tissue immediately above the rotator cuff) and is frequently seen after performing extended overhead activities. Q What causes rotator cuff tears and tendinitis? Both nonoperative and operative. It’s usually easier to treat cuff tears in their early stages rather than waiting for them to become chronic, large tears. For certain partial-thickness cuff tears or tendinitis/bursitis, rest, ice, nonsteroidal antiinflammatories (NSAIDs) and therapy often can be very effective. Occasional cortisone injections may be beneficial. For full-thickness cuff tears or persistent tendinitis/bursitis, arthroscopic or open repairs are reliable treatments. Q What about recovery after rotator cuff surgery? Recovery is somewhat dependent on the size and age of the cuff tear, and the repair technique. In general, a patient is treated in a sling for several weeks and then started in physical therapy, which can last as little as four to six weeks or as long as several months. 56 Vim & Vigor • W I N TER 2 011

Table of Contents for the Digital Edition of Vim & Vigor - Winter 2011 - Parrish Medical Center

Vim & Vigor - Winter 2011 - Parrish Medical Center
Contents
Tasty Tips
Opening Thoughts
Community Calendar
Delegation of Authority
Back in Action
Supplementary Knowledge
Keys to Survival
Clearing the Air
Mark Harmon of NCIS fame makes 60 look good
This One’s for the Girls
Life After a Loss
Do Your Diabetes Homework
Healthy Returns
Making Time
Exercise Disguised as Fun
Community Health: Sleep apnea
Foundation Focus: Gifts make a difference
Ask the Expert: Rotator cuff tears and tendinitis

Vim & Vigor - Winter 2011 - Parrish Medical Center