Shoulder Rotator Cuff Disorders
As the shoulder is one of the most complex and used joints in the body, it’s susceptible to a number of common injuries. Shoulder rotator cuff disorders are particularly common and consist of three main conditions including subacromial impingement, rotator cuff tears and calcific tendonitis. Below, you’ll discover more about each type of disorder and its characteristics.
Whenever you lift up your arm, the humeral head, or upper arm bone, is pushed underneath the acromion (roof of the shoulder). If the rotator cuff is impacted by overuse, or a minor tear is present, the humeral head won’t move correctly, causing it to shift closer to the acromion. It is this impingement which leads to the pain felt within the shoulder.
Subacromial impingement is also referred to as subacromial pain syndrome and bursitis.
Rotator cuff tears
The rotator cuff is the formation of muscles and tendons that surround the joint of the shoulder, keeping the head of the upper arm bone within the socket of the shoulder which is very shallow. The rotator cuff is highly susceptible to injury, with tears being particularly common. If a tear does occur, not only can it become extremely painful, but it can also cause problems with weakness of the arm.
Tears can vary in severity, with minor, partial thickness tears to full thickness tears. Patients who experience a minor tear may not even feel any symptoms and these tend to be the most common types of tears experienced. However, interestingly, smaller tears can be much more painful than larger ones. So, the amount of pain experienced isn’t necessarily a sign of the severity of the tear.
In order to diagnose a rotator cuff tear, an MRI scan or ultrasound scan will need to be carried out.
Occasionally, calcium can develop within the tendon of the rotator cuff, leading to a painful condition called calcific tendonitis. This can potentially place additional pressure onto the tendon, while also causing a chemical irritation.
This condition can be very painful, and its cause isn’t actually known. However, it is known to sometimes disappear on its own without the need for treatment and it’s more commonly experienced by those aged 30 to 60 years old. In some cases, the build-up of calcium can affect the movement of the rotator cuff, leading to Subacromial Impingement.
Rotator cuff causes and symptoms
All of the rotator cuff conditions above can occur at any age, for a variety of reasons. Most commonly, you’ll experience a rotator cuff disorder due to injury or overuse of the shoulder. For patients over 40, the condition is often caused by a fall onto the arm, while overuse injuries are common in athletes.
The main symptom with any shoulder injury is pain. You’ll typically experience pain around the injury site, as well as throughout the arm when it’s moved. It is also common for the pain to become worse during the night which can greatly impact your sleep. You may also notice reduced movement within the shoulder or arm, along with clicking noises when the shoulder is moved.
Golfers and Tennis Elbow
Even those who haven’t experienced the conditions themselves are generally aware of the term’s golfers and tennis elbow. However, many are unaware of how the two conditions differ. Both conditions relate to an injury of the tendon which attaches the muscles of the forearm to the elbow bone. However, it’s the location of the injury which separates the two.
Tennis elbow, medically referred to as lateral epicondylitis, occurs in the tendons which are attached to the outer part of the elbow. These are responsible for straightening the fingers, along with extending the wrist backwards.
Golfers elbow, medically referred to as medical epicondylitis, occurs in the tendons which are located on the inner side of the elbow. These tendons are responsible for contracting the fingers and flexing the wrist.
You don’t need to be a tennis player or a golfer to experience these conditions. They are most commonly caused by repetitive strain. So, any job or activities you partake in which place strain onto the tendons can also cause these conditions.
Symptoms for both conditions are similar, it’s largely the location of the symptoms which differ. Golfers elbow will result in symptoms being experienced on the inside of the elbow, while tennis elbow symptoms will appear on the outside. These symptoms include:
The pain will either radiate from the inside or outside of the elbow. With both conditions, you’ll also experience pain as you attempt to twist or grip things. The only symptom to really differ is with golfer’s elbow you can also experience numbness within the little or ring fingers.
The effects experienced with golfers and tennis elbow can range from inflammation, through to partial or full tears of the tendon attachments. They also tend to occur gradually, with symptoms worsening over time.
There is a range of biological treatment options available at our Regenext Clinic, which helps t0 avoid surgery and we would be delighted to discuss which would be the most appropriate for you. Please click on the Get in Touch button and our friendly and responsive team will be delighted to chat.
Gluteal Tendon Tears
Found on the hip’s outer surface in the buttock, the gluteus muscles are used to aid in the rotation of the hip, leg separation and pelvic stability. These muscles consist of gluteus maximus, gluteus medius and gluteus minimus. Tears within the gluteus medius tendon are particularly common in athletes and runners and they can vary in severity.
What causes a gluteal tendon tear?
There are numerous reasons a gluteal tendon tear can develop:
- A sudden increase in activity
- Degeneration due to age
A tear can either be full or partial and, although it isn’t a serious injury, it can potentially impact your quality of life.
The symptoms you’ll typically experience include weakness or pain within the affected side of the hip. If the tear is severe, it can also cause the pain to spread up through the buttock and you may have trouble lifting your leg over to the side.
There is a range of biological treatment options available at our Regenext Clinic, which helps avoid surgery and we would be delighted to discuss which would be the most appropriate for you.
Medial Collateral Ligament Sprains and Tears
Situated on the inner side of the knee, the medial collateral ligament joins the medial tibial condyle and the medial femoral condyle. Consisting of a tough, flat band of connective fibrous tissue, it’s one of the major ligaments responsible for the stability of the knee joint.
The job of the ligament is to prevent against valgus (outward) force, caused when the foot is pointed outwards, out of correlation with the knee. If the force of the motion is too strong, the ligament can’t support it, which causes it to become overstretched. An example of this would be falling in an awkward position onto the foot. However, its most common cause is when the knee is hit with a blunt force at speed, usually football or rugby tackle.
If you have issues with incoordination, or if there’s muscle weakness within the knee, this increases the likelihood of developing a tear or sprain within the ligament. The symptoms produced will depend upon the severity of the tear or stretch, and when it occurs you may actually hear it snap.
Understanding the different grades of MCL tears
MCL tears and sprains are diagnosed based on different grades.
Grade I sprains are considered the mildest injury, resulting in the ligament being slightly stretched. There is no tearing of the ligament, and you may not experience any pain or swelling. However, if a mild sprain does occur, it can potentially increase the chance of suffering a further injury in the future.
Grade II sprains are a moderate injury, resulting in a partial tear. This causes bruising and swelling, and the joint will typically be quite painful. It’s possible some instability may occur.
Grade III sprains are the most severe, resulting in a full ligament tear. This causes the knee to become swollen, and some bleeding underneath the skin may be present. This causes the joint to become unstable, making it difficult to put weight onto it.
The treatment provided for medial collateral ligament sprains and tears will depend upon the grade of the injury, as well as whether any additional injuries have occurred.
There is a range of biological and conservative brace treatment options available at our Regenext Clinic and we would be delighted to discuss which would be the most appropriate for you. Please click on the Get in Touch button and our friendly and responsive team will be delighted to chat.
Achilles Tendon Tears and Tendonitis
Achilles tendon tears and tendonitis can prove particularly painful. It is common in those who regularly play recreational sports and the severity of the injury can vary dramatically.
Understanding Achilles tendon rupture
The Achilles tendon is located on the rear at the back of the lower leg, used to connect the calf muscles to the heel bone. it’s It is responsible for helping you to go onto your tiptoes, point the foot down towards the floor, as well as to walk properly. If it is overstretched, the tendon can partially or completely tear.
When a tear does occur, it’s not uncommon to hear a popping sound before experiencing pain within the lower leg and ankle. Depending upon how severe the rupture is, both surgical and non-surgical treatments can be used to treat it.
Understanding Achilles tendonitis
Where there isn’t a tear, patients may be experiencing Achilles tendinitis. This is where the tendon becomes inflamed due to overuse or injury. Some of the main causes of this condition include:
- Failing to warm up before exercise
- Doing too much physical activity too soon
- Repetitive vigorous physical activity
- Overuse of high heels
- Poorly fitting footwear
- Increasing age
Patients experiencing Achilles tendinitis will typically feel pain within the back of the heel; usually after running or walking. There may be some swelling, and the calf muscles could feel tighter. In some cases, the skin of the heel may also feel warm.
Peroneal Tendonitis and Ankle Tears
Typically caused by an acute injury, or through overuse of the ankle, peroneal tendonitis can cause swelling, tenderness and pain within the tendon. Patients will typically experience the most pain when attempting to move the foot inwards and down towards the floor. The pain is usually present in the outer aspect of the ankle.
The condition won’t show up on an X-ray; it can only be detected using an MRI scan or Ultrasound scan.
What are the peroneal tendons?
There are two main peroneal tendons, located on the outer leg. They are used to connect the foot to the calf and play an important role in your ability to turn the foot.
Both peroneal tendons are found at the back of the fibula, stacked on top of each other. They have a close relationship, which can cause potential issues if they begin to rub against one another.
Most commonly, the tendons can develop inflammation if they do rub together, referred to as tendonitis.
Understanding peroneal tendon tears
In rare cases, peroneal tears can develop. They typically affect the peroneus brevis tendon, caused by either blood supply issues, or when the tendon becomes stuck between the bone and the second tendon.
Patients experiencing pain within the heel may be suffering from a condition called with plantar fasciitis. This occurs when the thick tissue which connects the toes to the heel bone underneath the foot, becomes inflamed. A stabbing pain is typically felt, usually first thing in the morning after getting out of bed, or after a period of inactivity.
Runners are at an increased risk of developing the condition, though it can also be caused by ill-fitting footwear and obesity.
Understanding plantar fasciitis
The plantar fascia is used to absorb the shock within the foot, providing adequate support for the foot’s natural arch. If it is placed under significant stress, it can begin to tear. Over time, if the fascia is continuously torn or stretched, it will become inflamed.
If the condition is ignored, patients will likely see an increase in pain, making it difficult for them to carry out normal activities. In order to minimise the pain, it’s common for patients to start walking differently. However, this can lead to further issues and problems in the back, hip, knee and feet.
There is a range of biological therapies and splints available at our Regenext Clinic and we would be delighted to discuss which would be the most appropriate for you. Please click on the Get in Touch button and our friendly and responsive team will be delighted to chat.