Tendenitis and bursitis result from rubbing the rotator cuff muscles against the acromion. This is called the impingement syndrome and can be just inflammation in the early stages or the muscles may begin to breakdown as the problem progresses.
Treatment for rotator cuff tendenitis, bursitis and impingement syndrome is rest, careful strengthening exercises with the arm below the shoulder level, anti-inflammatory medications, cortisone shots or surgery.
The rotator cuff muscles are usually torn in younger patients due to a single violent episode of applying too much force to the muscles, such as lifting too heavy an object or falling on the arm. In older patients a rotator cuff tear may result from too much heavy lifting or may result from the muscles rubbing against the overlying acromion. The main symptoms are weakness and pain. Diagnosis may require a Magnetic Scan (MRI), or an Arthrogram (injecting dye in to the shoulder before x-rays).
Treatment for Rotator Cuff Tears:
Treatment is surgery to repair the cuff. We usually do this as an outpatient. Some cuff tears are so large or so old that they can not be repaired. Rehabilitation is long and requires a lot of work by the patient. Often one needs to use a Physical Therapist.
When a shoulder joint’s surface becomes too badly damaged by arthritis or trauma, we have to replace the joint with artificial joint made of metal (stainless steel or a special chrome/molybdenum alloy) and plastic (ultra-high molecular weight polyethylene). Prosthetic replacement is occasionally used for fractures also. The results of shoulder replacement are very good and should last for many years.
Treatment for Unstable Shoulder:
After the first 1 or 2 episodes of dislocation, we usually treat the shoulder with rest, a sling and then exercises to strengthen the muscles. However because there are ligaments torn, often the shoulder continues to slip out of place. If this occurs frequently it begins to interfere with the patients life, and may even lead to arthritis if let go too long. We feel that an unstable shoulder needs to be surgically repaired.