The Rotator Cuff is a very important part of the functional shoulder. It consist of four muscles: supraspinatus, infraspinatus, teres minor and subscapularis. These group serves as abductors, lateral rotators and medial rotators of the shoulder. They also act as depressors of the humerus. This function keeps the action of deltoid from pulling the head of humerus upward into the subacromial space, which would cause impingement of the cuff.
Impingement is caused when subacromial space, area between the top of the humerus and the bottom of acromion becomes closed off and pinches the ratator cuff. Symptoms include pain, weakness and loss of motion. Movements above the shoulder tend to increase pain. Pain while sleeping is often encountered. Beside the weakness of rotator cuff, impingement can be caused by abnormal acromions.
Impingement syndrome may be classified in three stages.
Stage one is usually associated with an overuse injury by someone who is under the age of 25. The rotator cuff is weakened, but the condition is often reversible.
Stage two usually involves people from the ages of 25 to 40, and the condition is more advanced, with some irreversible tendon damage beginning to arise.
Stage three is the result of years of build up, and often involves tendon rupture or tear. This is seen mostly in patients over the age of 50.
Understanding the impingement syndrome is aided by understanding the physical properties of the tendons, which make up the cuff. The strength and stiffness of tendons, which give them their mechanical advantages, comes from collagen molecules.
Collagen molecules run parallel to each other and derive their characteristic strength from the cross-linkage between them. New collagen has relatively few cross-links, but as it matures, the number of cross-links grows, therefore increasing the strength and stiffness of the fiber. This maturation process begins to level off with age however.
For old patients, the number of stable cross-links being formed drops off considerably, therefore reducing the strength of the tendon. Tendon strength is also affected by the demand placed on it. Compared to young patient which is often reversible because of the properties of the tendons.
Treatment is rather conservative, consisting of rest and ice, followed by a strengthening program and possibly some physical therapy.
An active person who exercises frequently will have much stronger tendons than an inactive person will. Disuse or immobilization of tendons causes them to weaken considerably, as no demands are being placed on them.
Impingement is caused when subacromial space, area between the top of the humerus and the bottom of acromion becomes closed off and pinches the ratator cuff. Symptoms include pain, weakness and loss of motion. Movements above the shoulder tend to increase pain. Pain while sleeping is often encountered. Beside the weakness of rotator cuff, impingement can be caused by abnormal acromions.
Impingement syndrome may be classified in three stages.Stage one is usually associated with an overuse injury by someone who is under the age of 25. The rotator cuff is weakened, but the condition is often reversible.
Stage two usually involves people from the ages of 25 to 40, and the condition is more advanced, with some irreversible tendon damage beginning to arise.
Stage three is the result of years of build up, and often involves tendon rupture or tear. This is seen mostly in patients over the age of 50.
Understanding the impingement syndrome is aided by understanding the physical properties of the tendons, which make up the cuff. The strength and stiffness of tendons, which give them their mechanical advantages, comes from collagen molecules.
Collagen molecules run parallel to each other and derive their characteristic strength from the cross-linkage between them. New collagen has relatively few cross-links, but as it matures, the number of cross-links grows, therefore increasing the strength and stiffness of the fiber. This maturation process begins to level off with age however.For old patients, the number of stable cross-links being formed drops off considerably, therefore reducing the strength of the tendon. Tendon strength is also affected by the demand placed on it. Compared to young patient which is often reversible because of the properties of the tendons.
Treatment is rather conservative, consisting of rest and ice, followed by a strengthening program and possibly some physical therapy.
An active person who exercises frequently will have much stronger tendons than an inactive person will. Disuse or immobilization of tendons causes them to weaken considerably, as no demands are being placed on them.
