Posts Tagged ‘rotator cuff’

Predicting Sports Injuries Before They Happen

Imagine if you could tell when you were about to tear a rotator cuff well before it happened.

That’s what researchers at Washington University in St. Louis hope to be able to do for athletes, and possibly prevent sports injuries.

They have developed algorithms to identify weak spots in tendons, muscles, and bones prone to tearing or breaking.

The technology may one day help pinpoint minor strains and tiny injuries in the body’s tissues long before bigger problems occur.

“Tendons are constantly stretching as muscles pull on them, and bones also bend or compress as we carry out everyday activities,” said senior investigator Stavros Thomopoulos, PhD, Professor of Orthopaedic Surgery at Washington University.

Small cracks or tears can result from these loads and lead to major injuries.

Understanding how these tears and cracks develop over time therefore is important for diagnosing and tracking injuries.”

Visualizing Weak Spots

The researchers have developed a way to visualize and even predict spots where tissues are weakened.

To accomplish this, they stretched tissues and tracked what happened as their shapes changed or became distorted.

The new, more powerful algorithm allowed them to find the places where the tears were beginning to form and to track them as they extended.

They believe the algorithms can be used to measure the pressures and forces that act on the body and cause tissues such as muscles and tendons to crack or tear.

Predicting Rotator Cuff Tears

“If you have a small tear in the rotator cuff, when the tendon stretches, that crack may get bigger,” said Thomopoulos.

Eventually, they hope to predict problems in tendons and muscles as in the rotator cuff.

“If you have a perfectly normal rotator cuff, you can image it in a way to see how the tendon performs moving up and down.

If the tendon is normal, then the strains on it will be normal.

If you have a weak spot in the rotator cuff, the strains in that local area that may be starting to degenerate would probably be higher,” he said.

Those higher strains could predict problems.

This could also help them learn why some surgeries to repair rotator cuff injuries ultimately fail.

Their goal is to increase the odds that the tissue in the shoulder will heal following surgery, and they believe the new algorithms could help them get closer to that goal.

They also want to use the algorithms to prevent additional injuries following surgery to repair knees, shoulders, and other tissues.

So far, they have only used the algorithms in the laboratory on materials, such as plastic wrap, and in animal models.

How soon the new algorithms could be used in patients depends on getting better images of the body’s tissues, they said.

The researchers reported their results online on August 27, 2014 in the Journal of the Royal Society Interface.

Rotator Cuff Care: You May Only Need Physical Therapy

Most patients with rotator cuff injuries respond well to physical therapy and don’t need surgery, according to new research into repairing shoulders.

Every year, about 200,000 Americans undergo shoulder surgery related to repairing the rotator cuff, a set of four small muscles in the shoulder that helps to lift and rotate the arm.Tennis serve

Treatments to repair the rotator cuff include anti-inflammatory agents, steroid injections, surgery, physical therapy, or a combination of the above.

The best option may simply be physical therapy, says John E. Kuhn, MD, Chief of Shoulder Surgery at Vanderbilt University Medical Center.

After surgery “it usually takes people about four months before they can even think to get back to any kind of labor-type work and it usually takes a year to get a full recovery,” says Kuhn, who is the director of the Moon Shoulder Group, a network of doctors researching the best options for repairing shoulders.

“We found exercise programs were effective at treating rotator cuff disease and we consolidated them into one physical therapy program,” says Kuhn.

The program focuses on range of motion, flexibility, and strengthening.

The therapy program doesn’t necessarily heal the rotator cuff, but it does take the pain away, he says.

Kuhn led a new study of 452 rotator cuff tear patients and found the exercise program helped 85% avoid surgery.

The study appeared in the May issue of the Journal of Shoulder and Elbow Surgery.

The effect lasted for 2 years, and only 2% of the patients opted for surgery.

The study also suggests that pain may be a less suitable indication for surgery than weakness or loss of function.

The entire rotator cuff home exercise program is available for free online.

Kuhn suggests you talk to your physician before starting it.

When to see your doctor

Here are some indications you may need to see your doctor for a rotator cuff problem, says Jeffrey H. Yormak, MD, a board-certified orthopaedic surgeon with Somers Orthopaedic Surgery & Sports Medicine Group:

• Pain in the front of your shoulder that radiates down the side of your arm.

• Weakness in your arm and difficulty with routine activities.

• Difficulty with routine activities, including combing your hair or reaching behind your back.

“If you’ve injured your shoulder or experience chronic, lasting shoulder and arm pain, it’s best to see an orthopedic surgeon,” Yormak says.

“Only then can you receive a definitive diagnosis and begin treatment.

Early diagnosis and treatment of a rotator cuff tear may stop symptoms, such as loss of strength and motion, from setting in.”

Swimming, the Near-Perfect Exercise – Except for the Shoulders

I can’t think of a better way to beat the heat of a hot summer day than a dip in a pool or the ocean.

I even deigned to dive through the waves at Atlantic Beach in East Hampton last Saturday.

The water was warm enough and I was hot enough.

A cool way to stay cool.

Swimming is probably the most nearly perfect form of exercise.

And you don’t have to put in thousands of hours in the pool like Olympic champion Michael Phelps to get a good workout.

• It’s non-weight-bearing and so imposes no stress on the bones and joints.

Even people with bad backs can exercise in the water without fear of injury.

• It exercises and strengthens the upper and lower body.

• It’s an exercise in which it’s easy to reach your training range (which exercises your heart) and maintain it.

• It’s an effective weight-control exercise.

An hour of vigorous swimming burns about as many calories as running 6 miles in an hour.

• It’s a form of meditation.

It calms your nerves in addition to providing a good workout.

• It’s a good exercise for people with exercise-induced bronchospasm.

People with this condition are unable to warm and moisten the air to the lungs when they breathe hard.

Although swimming isn’t considered a sport that leads to injuries, serious swimmers often have problems with their shoulders.

The most common injury is referred to as “swimmer’s shoulder” and can affect up to 70% of competitive swimmers.

Swimmer’s shoulder is basically a rotator cuff sports injury.

The rotator cuff muscles, which hold the head of the shoulder in the joint, are not meant to be overstressed with the arm at an angle above parallel to the ground.

All swimming strokes (except the breaststroke) place the arm in this over-the-head position and stress these muscles as the arm is pulled through the water.

The small rotator cuff muscles become stretched, allowing the head to slip around in the shallow socket.

As it slips, it catches the bicep tendons, pinching them and causing pain.

If you feel shoulder pain after swimming, rest for several weeks and then modify your training program by using a kickboard or doing the breaststroke to maintain conditioning.

Combine this with a shoulder-strengthening program using light weights.

Here are some more tips on how to minimize the risk of a shoulder injury from John Cavanaugh, PT, a physical therapist at Hospital for Special Surgery in New York City:

• Do not attempt to swim if you are too tired, too cold, or overheated.

• Make sure to warm up properly.

• Focus on swimming technique. Poor technique can leave you more prone to injury.

• Engage in a general exercise program on land to develop muscle strength, endurance, balance, and flexibility. This includes strengthening the core abdominal muscles.

• Do not swim vigorously if you have a fever, upper respiratory infection, or ear infection.

• If you are training for a triathlon, note that the swim is completely different from pool swimming.

Generally, in open water, you can’t see where you’re going and there are people all around you.

Be aware of the bodies and avoid them as much as you can.