Asked in Muscular SystemRotator Cuff
When do you return to work after rotator cuff surgery?
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Asked in Workers Compensation, Rotator Cuff
What is workmans comp settlement scale for rotator cuff surgery?
Asked in Muscular System
What are the best rotator cuff exercises?
Asked in Muscular System
What exercises are good for a rotator cuff injury?
How long will you be off of work after rotator cuff repair?
Asked in Workers Compensation, Rotator Cuff
How much money does workmans comp pay if you have rotator cuff surgery?
My injury is cosidered log term and I have to have surgery on my shoulder. I am trying to find out what a good settlement is for this injury. I can't seem to get any straight answers. I have been out of work since Jan. and it is going to be six months after surgery before I can even consider going back to work. So I will be out of work for about 13 months. I am really concerned that I will not be able to do heavy equipment operating again. I have torn the rotor cuff in my shoulder. I would appreciate any input anyone has to help me feel alittle better about my workmen's compensation suit. Thank you for your time and help... Dwren56@yahoo.com
Asked in Health, Muscular System, Rotator Cuff
What should you do if your rotator cuff was broken at work and you had surgery 6 weeks ago and you're still in a lot of pain and your hand is swollen and shows fluid?
I'm thinking you need to see your doctor about this. Any medical question of this type is best answered by a medical professional. This can be a very serious condition, and you should definitely seek medical attention right away. Swelling in the hand can be caused by damage to the blood supply of the hand or by nerves that lead to the hand. Either one of these conditions could be due to the surgery or may have been caused by the initial injury that resulted in the rotator cuff surgery. In some cases, a condition such as RSD can be the culprit for swelling in the hand following an injury to the extremity.
Asked in Chiropractic
How do you treat pain in the shoulder's rotating cup?
Rotator cuff pain is treated in many different ways, depending on the severity of the injury. The rotator cuff is the group of muscles that attach to the shoulder blade and the humerus head, and when they contract they cause shoulder rotation and abduction. Most rotator cuff injuries are actually injuries to the tendon part of the muscle group, just proximal to the insertion point on the humerus. This part of the tendon often gets torn or irritated as it passes under the acromion process of the shoulder blade. Treatment should be directed at reducing tightness and tenderness in the bellies of the rotator cuff muscles, reducing the inflammation in the tendon, and then increasing strength in the muscles. If the tear in the tendon is substantial, the conservative treatment above may not work, and surgical re-attachment or repair might be indicated. Keith E. Biggs, DC
Asked in Surgery and Hospitalization
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Rotator cuff repair?
Definition Rotator cuff repair is a type of surgery to repair a torn tendon in the shoulder. The procedure can be done with a large ("open") incision or with shoulder arthroscopy, which uses small button-hole sized incisions. Description The rotator cuff is a group of muscles and tendons that form a cuff over the shoulder joint. These muscles and tendons hold the arm in its "ball and socket" joint and help the shoulder to rotate and move. The role of the tendons is to hold the powerful shoulder muscles to the shoulder and arm bones. The tendons can be torn from overuse or injury. Your surgeon will first check your shoulder with a small camera (arthroscope) to look at the tear and determine if it can be fixed. The arthroscope is inserted into the shoulder through a small poke-hole. The camera is connected to a video monitor. The surgeon looks around the entire joint to check the cartilage, tendons, and ligaments of your shoulder. After evaluating the shoulder joint, the surgeon places the camera in the space above the rotator cuff tendons, called the subacromial space. The surgeon can check the area above the rotator cuff, clean out the inflamed or damaged tissue, and remove a bone spur (subacromial spur). If a tear is going to be fixed, the surgeon may perform the surgery with a larger, open incision. Other surgeons can use the arthroscope and 1 to 3 additional small poke-holes or smaller incisions to perform the surgery. The additional small incisions allow the surgeon to insert other instruments to repair damaged tissue. The goal is to attach the tendon back to the bone where it tore off. The tendon is attached with sutures. Small rivets (called suture anchors) are often used to help attach the tendon to the bone. The suture anchors can be made of metal or material that dissolves over time, and do not need to be removed. Sutures are attached to the anchors, which tie the tendon back to the bone. At the end of the surgery, the incisions are closed, and a dressing is applied. If arthroscopy was performed, most surgeons take pictures of the procedure from the video monitor to show you what was found and what was done. Why the Procedure Is Performed Reasons rotator cuff repair may be done include: You have shoulder pain when you rest or at night, and it has not improved with exercises over 6 - 12 months. You have a large or complete rotator cuff tear. You are active and use your shoulder for sports or work. You have a lot of weakness and are unable to do everyday activities. Surgery is a good choice in a person whose tear was caused by a recent injury. It is also a good choice when the tendons of the rotator cuff were not already frayed from chronic rotator cuff problems. Some patients with a partial tear may choose not to have surgery, using rest and exercise instead. The best candidates for this approach are those who have only a partial tear and do not place a lot of demand on their shoulder. Shoulder pain will improve with this approach. However, any weakness will not improve, the tear become larger over time, and you may be limited in the sports or other act ivies you can do. Risks The risks for any anesthesia are: Allergic reactions to medications Problems breathing The risks for any surgery are: Bleeding Infection Nerve damage After the Procedure Recovery can take anywhere from 3 - 6 months, depending on the size of the tear and other factors. You may have to wear a sling for 4 - 6 weeks after surgery. Pain is usually managed with medications. You will be wearing a sling when you leave the hospital. Some patients also wear a shoulder immobilizer. This keeps your shoulder from moving. How long you wear the sling or immobilizer will depend on the type of surgery you had. Physical therapy may help you to regain the motion and strength of your shoulder. The length of therapy will depend on the repair that was performed. See also: Shoulder surgery - discharge Using your shoulder after surgery Outlook (Prognosis) Surgery to repair a torn rotator cuff is usually very successful at relieving pain in the shoulder. The procedure may not always return strength to the shoulder. Rotator cuff repair can require a long recovery period, especially if the tear was large. When you can return to work or play sports will depend on the surgery that was performed, but it will usually take several months to resume your regular activities. Some rotator cuff tears may not fully heal. Stiffness, weakness, and chronic pain may still be present. These poorer results are more likely when the following are present: The rotator cuff was already frayed or weak before the injury. Larger tears After-surgery exercise and instructions are not followed Older patients (over age 65) Smoking References Elkousy HA, Edwards TB. Shoulder: Development of skills for shoulder surgery. In: DeLee JC, Drez D Jr, Miller MD, eds. DeLee and Drez's Orthopaedic Sports Medicine. 3rd ed. Philadelphia, Pa: Saunders Elsevier; 2009:chap 17, section Q. Miller RH II, Dlabach JA. Shoulder and elbow injuries. In: Canale ST, Beatty JH, eds. Campbell's Operative Orthopaedics. 11th ed. Philadelphia, Pa: Mosby Elsevier; 2007:chap 44. Seida JC, LeBlanc C, Schouten JR, Mousavi SS, Hartling L, Vandermeer B, Tjosvold L, Sheps DM. Systematic review: nonoperative and operative treatments for rotator cuff tears. Ann Intern Med. 2010 Aug 17;153(4):246-55. Reviewed By Review Date: 06/30/2011 Linda J. Vorvick, MD, Medical Director, MEDEX Northwest Division of Physician Assistant Studies, University of Washington, School of Medicine; and C. Benjamin Ma, MD, Assistant Professor, Chief, Sports Medicine and Shoulder Service, UCSF Dept of Orthopaedic Surgery. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.
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Rotator cuff problems?
Definition The rotator cuff is a group of muscles and tendons that attach to the bones of the shoulder joint, allowing the shoulder to move and keeping it stable. Rotator cuff tendinitis refers to irritation of these tendons and inflammation of the bursa (a normally smooth layer) lining these tendons. A rotator cuff tear occurs when one of the tendons is torn from overuse or injury. Alternative Names Swimmer's shoulder; Pitcher's shoulder; Shoulder impingement syndrome; Tennis shoulder; Tendinitis - rotator cuff; Rotator cuff tendinitis; Shoulder overuse syndrome Causes, incidence, and risk factors The shoulder joint is a ball and socket type joint where the top part of the arm bone (humerus) forms a joint with the shoulder blade (scapula). The rotator cuff holds the head of the humerus into the scapula and controls movement of the shoulder joint. The tendons of the rotator cuff pass underneath a bony area on their way to attaching the top part of the arm bone. When these tendons become inflamed, they can become more frayed over this area during shoulder movements. Sometimes, a bone spur may narrow the space even more. This problem is called rotator cuff tendinitis, or impingement syndrome, and may be due to: Keeping the arm in the same position for long periods of time, such as doing computer work or hairstyling Sleeping on the same arm each night Playing sports requiring the arm to be moved over the head repeatedly as in tennis, baseball (particularly pitching), swimming, and lifting weights over the head. Working with the arm overhead for many hours or days (such as painters and carpenters) Poor control or coordination of your shoulder and shoulder blade muscles Poor posture over many years and the usual fraying of the tendons that occurs with age may also lead to rotator cuff tendinitis. Rotator cuff tears may occur in two ways: A sudden or acute tear may happen when you fall onto your arm while it is stretched out, or after a sudden, jerking motion when trying to lift something heavy. A chronic tear of the rotator cuff tendon occurs slowly over time. It is more likely in those with chronic tendinitis or impingement syndrome. At some point, the tendon wears down and tears. There are two types of rotator cuff tears: A partial tear is when a tear does not completely sever the attachments to the bone. A complete or full thickness tear refers to a through and through tear. It may be as small as a pinpoint or all of the muscle tendon. Complete tears have detachment of the tendon from the attachment site and would not heal very well. Symptoms TENDINITIS OR IMPINGEMENT SYNDROME Early on, pain occurs with overhead activities and lifting your arm to the side. Activities include brushing hair, reaching for objects on shelves, or playing an overhead sport. Pain is more likely in the front of the shoulder and may radiate to the side of the arm. However, this pain always stops before the elbow. If the pain travels beyond the arm to the elbow and hand, this may indicate a pinched nerve. There may also be pain with lowering the shoulder from a raised position. At first, this pain may be mild and occur only with certain movements of the arm. Over time, pain may be present at rest or at night, especially when lying on the affected shoulder. You may have weakness and loss of motion when raising the arm above your head. Your shoulder can feel stiff with lifting or movement. It may become more difficult to place the arm behind your back. ROTATOR CUFF TEARS The pain with a sudden tear after a fall or injury is usually intense. Weakness of the shoulder and arm is often present, along with a snapping sensation of movement. Symptoms of a chronic rotator cuff tear include a gradual worsening of pain, weakness, and stiffness or loss of motion. The exact point when a rotator cuff tear begins in someone with chronic shoulder tendinitis may or may not be noticed. Most people with rotator cuff tendon tears have pain at night. Pain that is worse at night may wake you up. During the day, the pain is more tolerable and hurts with certain movements. Over time, the symptoms become much worse and are not relived by medicines, rest, or exercise. Signs and tests A physical examination may reveal tenderness over the shoulder. Pain may occur when the shoulder is raised overhead. There is usually weakness of the shoulder when it is placed in certain positions. X-rays of the shoulder may show a bone spur. They can be done in your doctor's office. If your doctor feels you may have a rotator cuff tear, you may have one or more of the following tests: An ultrasound test uses sound waves to create an image of the shoulder joint. It can often show a tear in the rotator cuff. MRI of the shoulder may show swelling or a tear in the rotator cuff. Sometimes, a special imaging test called arthrography is needed to diagnose a rotator cuff tear. Your doctor will inject contrast material into your shoulder joint. Then either an x-ray, CT scan, or MRI scan are used to take a picture of it. Contrast is usually used when your doctor suspects a small rotator cuff tear. Treatment TENDINITIS OR IMPINGEMENT SYNDROME Treatment involves resting the shoulder and avoiding activities that cause pain. It may involve: Ice packs applied 20 minutes at a time, 3 - 4 times a day to the shoulder Taking drugs like ibuprofen and naproxen to help reduce swelling and pain Avoiding or reducing activities that cause or worsen your symptoms to worsen For more information about managing your symptoms at home and returning to sports or other activities, see Rotator cuff - self-care. You should start physical therapy to learn exercises to stretch and strengthen the muscles of your rotator cuff. If the pain persists or if therapy is not possible because of severe pain, a steroid injection may reduce pain and swelling in the injured tendons, to allow effective therapy. With rest and exercise, symptoms often improve or go away. However, this may take weeks or months to occur. Arthroscopic surgery can remove inflamed tissue and part of the bone that lies over the rotator cuff. Removing the bone may relieve the pressure on the tendons. ROTATOR CUFF TEARS Someone with a partial rotator cuff tear who does not normally place a lot of demand on the shoulder can try rest and exercise. If the rotator cuff has had a complete tear, or if the symptoms persist despite conservative therapy, surgery to repair the tendon may be needed. Most of the time, arthroscopic surgery can be used. Some large tears require open surgery to repair the torn tendon. Expectations (prognosis) Many people recover full function after a combination of medications, physical therapy, and steroid injections after an episode of rotator cuff tendinitis. Some may need to change or reduce the amount of time they play certain sports to remain pain-free. People with tears of their rotator cuff tend to do well, although their outcome is strongly dependent upon the size of the tear and how long the tear has been present, as well as their age and pre-injury level of function. Calling your health care provider Call for an appointment with your health care provider if persistent shoulder pain occurs. Also call if symptoms do not improve with treatment. Prevention Avoid repetitive overhead movements. Develop shoulder strength in opposing muscle groups. See also: Rotator cuff - self-care References Burbank KM, Stevenson JH, Czarnecki GR, Dorfman J. Chronic shoulder pain: part II. Treatment. Am Fam Physician. 2008;77(4):493-497. Burbank KM, Stevenson JH, Czarnecki GR, Dorfman J. Chronic shoulder pain: part I. Evaluation and diagnosis. Am Fam Physician. 2008;77(4):453-460. Greiwe RM, Ahmad CS. Management of the throwing shoulder: cuff, labrum and internal impingement. Orthop Clin North Am. 2010 Jul;41(3):309-23. Matsen III FA, Fehringer EV, Lippitt SB, Wirth MA, Rockwood Jr. CA. Rotator cuff. In: Rockwood CA Jr, Matsen FA III, Wirth MA, Lippitt SB, eds. The Shoulder. 4th ed. Philadelphia, Pa: Saunders Elsevier; 2009:chap 17. Seida JC, LeBlanc C, Schouten JR, Mousavi SS, Hartling L, Vandermeer B, Tjosvold L, Sheps DM. Systematic review: nonoperative and operative treatments for rotator cuff tears. Ann Intern Med. 2010 Aug 17;153(4):246-55. Reviewed By Review Date: 07/06/2011 C. Benjamin Ma, MD, Assistant Professor, Chief, Sports Medicine and Shoulder Service, UCSF Department of Orthopaedic Surgery. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.
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Rotator cuff exercises?
Alternate Names Shoulder exercises Your Shoulder Joint The rotator cuff is a group of muscles and tendons that attach to the bones of the shoulder joint, allowing the shoulder to move and keeping it stable. The tendons of the rotator cuff pass underneath a bony area on their way to attaching the top of the arm bone. These tendons join together to form a cuff that surrounds the shoulder joint. This provides the stability of the joint and allows movement of the arm bone on the shoulder bone. Injury to these tendons may result in: Rotator cuff tendinitis, when irritation and swelling of these tendons is present A rotator cuff tear, when one of the tendons is torn due to overuse or injury. See also: Rotator cuff problems These injuries often lead to pain, weakness, and stiffness when you use your shoulder. A key part in your recovery is starting exercises to make the muscles and tendons in your joint stronger and more flexible. Your doctor may refer you to a physical therapist to treat your rotator cuff. A physical therapist is trained to help improve your ability to do the activities you want. Muscle Strengthening and Stretching Many muscles surround your shoulder and lower back. When all of these muscles are working together well, they serve to stabilize your shoulder joint. When your shoulder is stabilized, there is less strain on your shoulder joint and muscles when you are active. Before treating you, a doctor or therapist will evaluate your body mechanics. The therapist may: Watch how your shoulder moves as you perform activities, including your shoulder joint and your shoulder blade Observe your spine and posture as you stand or sit Check the range of motion of your shoulder joint and spine. Test different muscles for weakness or stiffness Check to see which movements seem to cause or worsen your pain After testing and examining you, your physical therapist or doctor will know which muscles are too weak or too tight. You will then start a program to stretch out your muscles and make them stronger. The goal is to teach you proper techniques for using your shoulder with everyday activities, at work, or during sports activities. Exercises can help you heal from an injury and avoid re-injury. See Rotator cuff - self care to learn how to take care of your shoulder and avoid placing extra stress on it. If you just had surgery to repair your rotator cuff, see also: Shoulder surgery - discharge Using your shoulder after surgery Exercises for Your Shoulder The goal is for you to function as well as possible with little or no pain. To do this, your physical therapist will treat your shoulder pain, help you strengthen and stretch the muscles around your shoulder, and teach you proper techniques to move your shoulder, for either everyday tasks or sports activities. Before doing exercises, have your doctor or physical therapist make sure you are doing them properly. If you have pain during or after an exercise, the way you are doing the exercise may need to be changed. Most exercises for your shoulder work to either strengthen (make stronger) or stretch the muscles and tendons of your shoulder joint. Exercises to stretch your shoulder include: Stretching the back of your shoulder (posterior stretching) Hand up your back stretch (anterior shoulder stretch) Anterior shoulder stretch - towel Pendulum exercise Wall stretches Exercises to strengthen your shoulder: Internal rotation exercise - with band External rotation exercise - with band Isometric shoulder exercises Wall push-ups Shoulder blade (scapular) retraction - no tubing Shoulder blade (scapular) retraction - tubing Arm reach Reviewed By Review Date: 07/06/2011 C. Benjamin Ma, MD, Assistant Professor, Chief, Sports Medicine and Shoulder Service, UCSF Department of Orthopaedic Surgery. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.
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Asked in How To
How to Exercise to Strengthen Your Rotator Cuff?
Exercise is good, but improper form--specifically, lifting weights while moving in a way that is unnatural for your body--can be dangerous, especially if you're prone to a rotator cuff injury. People who bodybuild, swim or play sports that require repetitive overhead arm movements are more likely to develop this injury, which can take anywhere from two to six months to heal. That's a long time to be out of the game. Here's what you need to know about your rotator cuff--and how you can exercise to avoid this painful injury. Your Rotator Cuff: Why it Matters To lift, move and push objects, we depend on the movements of our arms. The rotator cuff, a series of muscles and tendons gathered around the humerus, helps us do that by enabling our arms to move freely. Without it, we wouldn't be able to lift boxes, rotate our arms, or do anything that involves the free movement of our upper arms. Normally, these tendons and muscles work together and enable the arm to do repetitive moving tasks. When the rotator cuff is overused, however, such as lifting weights repeatedly above your head with movements that are unnatural for your arms, the muscles and tendons can wear down, eventually leading to a tear. If any part of the rotator cuff is injured, you'll notice it. You may have significant trouble lifting or rotating your arm and notice significant front shoulder pain, which may travel down to your arm. Most people who experience a rotator cuff injury get it from years of overuse. Although these injuries can occur after direct trauma to the arm, people who weightlift or swim often report experiencing these injuries. The injury may build up over time, and eventually escalate into a tear that can severely weaken your arm. Avoiding Rotator Cuff Injuries with Exercise Although exercise may cause some injuries, exercise can also help prevent them. Proper stretching, using correct form, and doing exercises that strengthen the muscles and tendons of the cuff can help decrease your risk, while making it stronger--and that means you can lift or push more weights. Here are the most crucial exercises for strengthening this key area: 1. Dumbbell raise: Lying on your stomach on a flat bench, hold a dumbbell in your left hand. Your left hand should be dangling off the bench, with your other arm securely on the bench. Slowly lift the weight while bending your elbow at a 90 degree angle. Stop when your elbow is parallel to your shoulder. Hold it for a few seconds before slowly releasing it to the starting position. 2. Cable rotation: Using a cable machine, move the pulley until it is parallel to your elbow, then grasp the handlebar. Standing parallel to the bar, take your hand, keep your elbow close to your body, and pull it towards your chest by rotating your shoulder. Rotate the shoulder back to the starting position and repeat for 12 repetitions. Switch sides when the repetitions are finished. 3. Dumbbell rotations: Using light dumbbells, hold both dumbbells in front of your lower stomach. Your palms should be facing your body. Slowly bend your arms into a 90 degree angle and pull the weights up until the weights are level with your shoulders. Lower the weight and repeat for ten repetitions. Continue to do these exercises regularly as part of your workout program, being careful to use proper form. Doing so will gradually increase the strength of your rotator cuff, allowing you to lift heavier weights and avoid shoulder injuries.
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