Below are links to articles posted in August, 2018
Rotator Cuff Tendinitis is a leading cause of shoulder pain among athletes and middle-aged individuals. But, anyone can develop this disorder.
Our shoulders are the most flexible joints in our body. And, it’s easy to take these joints for granted until we start to feel pain. This guide will help you understand how the shoulder works and how rotator cuff tendinitis can develop.
Understanding Your Shoulder
Three main bones make up your shoulder. Your upper arm bone, known as the humerus, connects with the scapula (or shoulder blade) and the clavicle (or collarbone). These bones are connected by a series of muscles and tendons at the shoulder joint. This ball-and-socket joint is also known as the rotator cuff.
At the rotator cuff, four main tendons merge over the top of the humerus. They connect with muscles as well as the shoulder bones. This structure keeps the shoulder stabilized and prevents the humerus from popping out of the joint. In addition, lubricating sacs, called the bursae, help the rotator cuff tendons to glide during movement.
The rotator cuff controls the flexibility and movement of the shoulder. As the name suggests, it allows the shoulder and arm to rotate up and down, from front to back, and in or out.
Although your shoulder joint is reinforced by tendons, muscles, and ligaments, certain movements and activities can cause injury.
What is Rotator Cuff Tendinitis?
Sometimes referred to as shoulder impingement or impingement syndrome, this condition involves the tendons of the shoulder joint. When these tendons are damaged or irritated, it causes inflammation, which then results in pain and swelling.
Rotator cuff tendinitis usually develops gradually as a result of repeated irritation to the area. It occurs in athletes who engage in repetitive overhead movements like throwing, swimming, or playing tennis. In addition, as we get older, our muscles and tendons are more prone to injury. Those with occupations that require repetitive lifting or other overhead activities (like painting) are also at risk. In addition, a trauma to the area, like falling, can injure the shoulder tendons.
Symptoms of Rotator Cuff Tendinitis
Symptoms of this condition usually start with dull pain or swelling in the front and top of the shoulder. You may also experience pain in the outer part of the upper arm. This pain may worsen when you lift your arm or attempt to reach behind you.
Other symptoms include:
- Decreased range of motion in the arm and shoulder
- Sudden pain while reaching, lifting, or performing overhead activities
- Pain while pushing, pulling, or lying on your side
- Difficulty sleeping because of shoulder pain
- Muscle weakness
- A clicking sound in the shoulder when raising your arm
- Trouble with daily activities such as putting on a shirt or brushing your hair
Treating Rotator Cuff Tendinitis
A proper diagnosis of tendinitis is needed to rule out other causes like a bone fracture or arthritis. Your doctor can diagnose your shoulder pain by discussing symptoms and completing a physical exam.
In some cases, the doctor may order imaging tests such as x-rays or MRIs to view the damage to your shoulder joint and soft tissues.
Most of the time, this condition only requires conservative treatments. Resting and icing the area may help with the pain and swelling. It is important not to return to stressful overhead activities until your tendons and muscles have had a chance to heal.
Pain management can also include using anti-inflammatory medications (or NSAIDs). Over-the-counter medications like aspirin or ibuprofen can help to reduce pain and swelling.
A physical therapist can perform strengthening exercises to stabilize the area and improve your range of motion. In addition, a physical therapist will suggest ways you can change your habits and prevent further irritation of the shoulder joint.
In more severe cases, a steroid injection may be used to reduce inflammation.
If these conservative approaches fail to provide relief after several months, surgery may be the next option. Surgery is usually recommended when there is a tear in one of the rotator cuff tendons.
In many cases, surgery involves a shoulder arthroscopy. During this procedure, the orthopedic surgeon makes a small incision in the shoulder and inserts a tiny camera. The camera allows the surgeon to assess the affected area and shave off small parts of bone, giving the cuff tendon more space. This prevents further irritation and pinching of the tendon. This procedure also allows the surgeon to remove damaged tissue and repair minor tendon tears.
When a tendon has a major tear, open surgery may be necessary. The surgeon will create more space for the damaged tendon by trimming the tendon and cutting out a small piece of the humerus. Then the surgeon reattaches the tendon to the humerus with stitches or tacks.
Preventing Rotator Cuff Tendinitis
There are a few things you can do to decrease shoulder strain and thus reduce your risk of developing rotator cuff tendinitis. These things include:
- Use lighter weights during strength training.
- Lift heavy objects below the shoulder level.
- Lift heavy objects close to your body.
- Avoid push-ups, bench presses, and shoulder press exercises if painful.
- Maintain a good posture.
- Swim with a sidestroke or breaststroke.
Seeking Treatment for your Shoulder Pain
If resting or over-the-counter medications aren’t relieving your shoulder pain, consulting with a doctor is the next logical step. Our shoulder experts at Orthopedic & Laser Spine Surgery want to help you pinpoint the source of your pain and provide you with the most appropriate treatment.
Our dedicated team offers a comprehensive program using only the latest technology and treatments. If surgery is an option for you, then we specialize in minimally invasive techniques that will make your recovery period shorter. Schedule a consultation now to receive an accurate diagnosis or a valued second opinion!
Do you ever notice a pop or snap in your hip? Certain movements may cause the sound or sensation as a hip tendon or muscle slides over the bone. This condition is commonly known as snapping hip syndrome (SHS). It can also be referred to as dancer’s hip or as coxa saltans.
In many cases, SHS is not a cause for concern. Often painless, it’s more of a nuisance than anything else.
There are certain times, however, when getting treatment will help ease any pain and prevent more serious complications.
So why does the hip snap? The hip’s anatomy is a great place to start taking a look.
Understanding the Hip
As one of the largest joints in the body, the hip joint is an important weight-bearing structure. It allows you to walk, jump, run, and perform various lower body movements. When healthy, it is one of the most flexible joints in the body.
The top of your thigh bone fits into a cup-shaped socket in the pelvis. This ball-and-socket joint uses ligaments to keep everything in place. Above the ligaments, tendons attach muscles in the buttocks, thighs, and pelvis to the bones. A very slippery liquid, known as synovial fluid, protects the bones and helps the joints to flex.
These layers of protection make your hip one of the most durable, stable joints in the body. Unfortunately, even with all its protection, the hip may suffer injury.
What Causes the Hip to “Snap”?
When tendons or muscles slide over the bony knobs of the hip, snapping occurs. This can affect various areas of the hip. These areas include:
Outside of the Hip
Known as external snapping hip syndrome, this occurs when a tendon or muscle slides over the bony knob on top of the thigh bone. This bony mass, known as the greater trochanter, can either catch on the iliotibial band or on the gluteus maximus muscle.
This is typically caused by muscle tension in the iliotibial band or gluteus maximus. You may notice the snapping when climbing stairs, running, or carrying heavy loads like shopping bags. Some may feel a sudden, sharp pain outside the hip.
Inside the Hip
Referred to as internal snapping hip syndrome, this involves the sliding of tendons or muscles over bony structures at the front of the hip joint. The two common hip flexors involved are the iliopsoas tendon connecting to the iliopsoas muscle and the quadriceps muscle known as the rectus femoris.
You may notice internal snapping when getting up from a chair, running, or rotating the legs away from the body. Sometimes this condition causes sudden pain, deep inside the groin area.
Injury to Hip Cartilage
When the cartilage protecting the hip socket tears or gets injured, snapping may occur. This is usually due to a sudden trauma like falling or chronic conditions like hip arthritis. Damaged cartilage usually causes pain and the hip joint to lock up.
Symptoms of snapping hip syndrome can range from mild irritation to dehabiliting pain. Common symptoms include:
- Popping or snapping in any area of the hip when rotating, lifting, lowering, or swinging the leg.
- Leg weakness when making forward or sideways movements.
- Swelling or tightness in the side, front, or back of the hip.
- Problems walking, running, exercising, or getting up from a chair.
- Feeling like the hip will detach from the socket.
- Locking up of the hip when performing certain movements.
Risk Factors for Snapping Hip Syndrome
Just about anyone can develop this condition, but there are certain factors that make snapping hip syndrome more likely. These include:
- Athletes and others who regularly recruit extreme range of motion in the hips, such as ballet dancers, those who practice martial arts, and football players.
- Young athletes who are going through growth spurts.
- Those with arthritis or other chronic conditions that affect the hips.
- People who are recovering from knee or hip surgeries.
- Those with jobs that involve frequent bending at the hips.
- People who dramatically increase their activity level or exercise routines.
Treatment for Snapping Hip Syndrome
For many, a snapping hip isn’t much cause for concern. Others may experience pain because of this condition, making treatment a necessity. Pain occurs when the snapping tendon or muscle becomes inflamed or injured, usually over time. In addition, the snapping can irritate a fluid-filled structure that helps to lubricate the bone and soft tissue. The inflammation of this structure, known as hip bursitis, can be quite painful.
In many cases, conservative treatments can help to reduce pain. These include:
- Resting the Area: Athletes and others with this condition can take a short break from the motions that cause the irritation. This helps the muscles, tendons, and other structures to recover.
- Anti-Inflammatory Medicine: Over-the-counter aspirin or ibuprofen can relieve pain and reduce swelling in the affected areas.
- Physical Therapy: A physical therapist can stretch and massage the area, helping to relieve any muscle tension. In addition, your therapist can suggest modifications to your everyday activities that allow your hip to rest.
- Corticosteroid Injection: If the pain prevents you from engaging in your daily activities, a physician may prescribe a steroid injection to reduce the inflammation.
These treatments have an excellent chance of improving your condition. If you’re still not experiencing relief, however, then other options are still available.
Surgical Treatments for Snapping Hip Syndrome
In rare cases, a surgical treatment may be the best answer to resolve your pain. After a full medical evaluation and diagnostic imaging, an orthopedic surgeon may recommend one of the following procedures:
- Iliopsoas Tendon (IT) Release: Typically used for internal snapping hip syndrome, a surgeon makes strategic cuts in the IT band to reduce tension and lengthen it. This should decrease (or even stop) the snapping.
- Hip Arthroscopy: The surgeon inserts a tiny camera into your hip joint to find and remove loose pieces of cartilage that have become caught in the ball-and-socket joint.
- Acetabular Labrum Repair: If imaging tests determine a tear in the ring of cartilage on the outside rim of the hip joint (labrum), then your surgeon can use a tiny camera and instruments to repair the damage.
In many cases, these minimally invasive procedures will eliminate the snapping and pain caused by this condition.
When Surgery is Necessary…
Although snapping hip syndrome rarely requires surgery, consulting with a qualified orthopedic surgeon can provide solutions to help ease your pain and get your life back on track.
Our experts at Orthopedic & Laser Spine Surgery believe that you can return to a pain-free life. Our team is ready to meet with you, review any previous MRIs or imaging results, and determine the best course of action for your pain. From nagging pain to sports medicine issues, we will help you pinpoint the source of your hip pain and find the best solutions.
Calling the Orthopedic & Laser Spine Surgery clinic may be the next step in getting your life back. Our surgeons are leaders in their fields, with decades of experience in helping others. Don’t hesitate to call or schedule an appointment today!