Women and female athletes are disproportionately affected by knee injuries. The anterior cruciate ligament (ACL) rupture that occurs in non-contact sports is the most frequent injury. Women are four to eight times more likely than males to sustain an ACL tear.

“Every year, more female athletes are participating in sports, which results in a higher rate of knee injuries in these athletes,”

The majority of sports medicine doctors, surgeons, and other professionals have expertise in treating female athletes who have joint-related injuries. Additionally, several Women’s Sports Medicine Programs have doctors that specialize in health problems specific to female athletes.

We can assist and teach all athletes how to significantly reduce this risk, even if women have a higher risk of knee injuries. One established technique is to integrate relatively simple injury prevention exercises into normal routines.

The Female Athlete’s Body

The broadening of the hips and the loosening of tendons and ligaments that occur in women’s bodies between adolescence and pregnancy can weaken the core and other muscle groups and lessen neuromuscular control.

If left untreated, knee injuries in female athletes can keep them out of the game for months and potentially result in more serious problems like early osteoarthritis. There are certain specialized care and treatment programs that put the wounded female athlete’s return to play and recovery first.

These modifications may have a major impact on how women move, particularly while performing basic sports movements like jumping and running. For instance, when jumping, women frequently lean more on their quadriceps than their hamstrings, which can throw off the balance of their muscles and aggravate knee pain.

After puberty, women have a propensity to land and jump with their knees bent inward rather than parallel, and this inward placement can result in ACL damage,

Additionally, hormones such as estradiol, progesterone, and relaxin released during the menstrual cycle may affect how loose or stiff a woman’s ligaments are, which may raise her risk of injury. Examining the links between women’s menstrual cycles and knee injuries is a developing field of research.

The Most Common Knee Injuries in Women

 If left untreated, knee injuries in female athletes can keep them out of the game for months and potentially result in more serious problems like early osteoarthritis.

• Anterior cruciate ligament (ACL) damage
• Dislocation of the patella
• Meniscal damage
• Tears in the medial collateral ligament (MCL)

Knee Injury Prevention Exercises

ACL Preventative Training, which includes suggestions specifically for female athletes and has been shown to lower injury risk by up to 50%, consists of strength training, plyometrics, agility, balance, and flexibility training.

Exercises that are good at strengthening the core and glutes and that are simple to incorporate into regular workouts to help prevent knee problems include:

• Simple broad jumps

Simple broad jumps are an incredible method to work on controlling your muscles and perfecting your form for the field, court, or track. Make sure your feet leave the ground and touch it simultaneously as you jump forward, and that your weight stays in your heels as you land.

Additionally, it’s critical to land with your knees parallel and your ankles directly under your knees, avoiding any inward tilting.

• Bridge

Bridge exercises can strengthen the glutes, hips, and core, all of which can help athletes avoid knee injury.

Simple bridge hip lifts are a good place to start; as your strength develops, move on to single-leg and weighted bridges. For more core impact, try balancing with an exercise ball under your feet.

• Squats

Squats are a vital exercise in practically every sport. You can lower your risk of injury by using the appropriate squat form to prevent overextending or putting too much pressure on your knees. Keep your back straight and your knees aligned with your ankles when you squat.

Even if your squat is a little shallow, squat as low as you can while still keeping appropriate form. Hold on to a wall or a bar if you require more stability. As your strength and technique improve, go on to single-leg squats.

Always Consult The Expert

There are various options for ACL reconstruction surgery. It’s important to get an accurate diagnosis and medical treatment as soon as possible so you can get back to your normal routine. You can see Dr. Reetadyuti Mukhopadhyay if you are looking for an ACL Surgeon in Gurgaon. With the use of advanced technology and his expertise, he can treat any form of severe ACL injury.

For a consultation on your case or a second opinion, get in touch with us right away.

During the examination, if you have a shoulder injury, you might hear the terms “shoulder dislocation” and “shoulder subluxation” and question if they are interchangeable. These two shoulder ailments differ slightly from one another yet both affect how the joint works. A shoulder injury Understanding the fundamentals of the joint and the distinction between these two issues can be helpful during your recovery and rehabilitation if you do have a shoulder injury. Shoulder Anatomy To do actions like reach up and catch a ball or take something off a shelf, the shoulder joint is only loosely fastened.

The shoulder dislocates more frequently than other joints of a similar form because of its mobility. Think of your hand like the letter “C,” formed. Imagine now sliding the other hand inside the “C” while balling it into a fist. Similar to the one that lets you move your arm, this synovial ball and socket joint is fundamental. The shoulder is known as the glenohumeral joint in medicine. The ball head of the humerus, the main upper bone in your arm, meets the glenoid fossa, the “C” figure or socket, of your shoulder blade at your shoulder. To retain the ball inside the “C,” a capsule of connective tissue surrounds the joint.

A shoulder can move in any direction and can dislocate in a variety of ways. The ball and socket must remain aligned for the joint to move freely. That alignment can be altered and injuries can result from just a hard blow to the shoulder.

What exactly is a dislocated shoulder?

A shoulder dislocation occurs when the joint’s ball and socket have completely separated. The humerus’ ball portion has completely separated from the glenoid fossa. Because the glenoid fossa, or the socket of the joint, is so shallow, the humerus bone can easily get loose and produce this common injury. The ball part of the humerus pulls out of its socket and is forced towards the front of the body in the majority of anterior dislocations. This is a wound that might develop after a fall. Putting your hands out in front of you to try to halt falling is an instinct. The shoulder joint’s ball bursts out or dislocates as you land, moving towards the front.

What is Shoulder Subluxation?

A form of dislocation called shoulder subluxation occurs when the ball and socket are not completely separated. The joint’s two structures are still in touch, but one of them has moved out of place. Damage to the joint’s supporting structure, such as tears in the muscles or tendons, may make the joint more prone to subluxation. For instance, a shoulder subluxation may occur in a baseball player who injures his rotator cuff. The muscles and connective tissue that make up the rotator cuff hold the joint together. If the muscle tears, the joint’s ball may become sufficiently loose to allow the humerus bone to move while still being contained in the glenoid fossa.

A subluxation typically concerns the mechanical integrity of the shoulder and its supporting structures, whereas a dislocation involves the structures of the shoulder.

How to Recognize an Injury

The two most noticeable signs of these two injuries, pain and arm immobility are comparable despite the significant variances between them. Your natural inclination will be to use your other hand to support the weight of your arm. Along with numbness and tingling in the arm, muscular spasms close to the shoulder, and bruising and swelling around the joint are possible symptoms. However, a dislocated shoulder may appear physically abnormal. The shoulder may square off and appear to be at an abnormal angle because the ball and socket have entirely separated. Frequently, the dislocation may be accompanied by a fracture. You might detect a bump at the top of the shoulder when you have a shoulder subluxation. This is the joint’s ball that is extending beyond the glenoid fossa.

Available Treatment Alternatives

The severity of the connective tissue injury around the joint and whether the humeral ball is entirely displaced both affect how these two injuries should be treated. The shoulder’s supporting structures, including the nerves and blood flow, may suffer damage from a full shoulder dislocation. While forcing the ball back into the socket eases the pain, doing so without enough rest and rehabilitation could lead to more harm. Treatment for shoulder subluxation aims to address mechanical issues, such as a torn rotator cuff, to allow the shoulder to heal. If you suspect a separation or dislocation, the best course of action is to immobilize the shoulder as soon as possible with a splint or sling.

Always Consult The Expert

There are various options for shoulder surgery and treatment. It’s important to get an accurate diagnosis and medical treatment as soon as possible so you can get back to your normal routine. You can see Dr. Reetadyuti Mukhopadhyay, the best orthopedic ACL Surgeon in Gurgaon. With the use of advanced technology and his expertise, he can treat any form of severe shoulder or knee related injury.

For a consultation on your case or a second opinion, get in touch with us right away.

Do you have any weakening or soreness in your shoulders? Do you find it challenging to raise your arm above your head?

One of the most typical causes of shoulder pain is a rotator cuff injury, which may be what you are experiencing.

But how can you tell if you have tendinitis or a tear in your rotator cuff? Let’s examine some of the primary distinctions between these two injuries.

What is A Rotator Cuff?

Your rotator cuff is a collection of muscles and tendons that connects your shoulder blade to the upper arm bone. These muscles control the arm’s inward and outward rotation in addition to lifting the arm.

You quickly realize how much you rely on your rotator cuff when something goes wrong with it, whether you are picking something up off the shelf, getting dressed, or brushing your hair. The discomfort that results from a rotator cuff injury can become crippling.

Why Does the Rotator Cuff Hurt?

There are two typical causes of rotator cuff discomfort.

•  When the tendons become irritated and inflamed, it results in rotator cuff tendonitis. This ailment is also known as bursitis or impingement.

• When one or more of the tendons completely or partially rupture, it causes a rotator cuff injury. A full-thickness rip occurs when the tendon has completely pulled away from the bone, as opposed to a partial tear, where the tendon is only partially removed from the bone.

Both of these injuries may develop due to:

Rotator cuff injuries are frequently sustained while swimming, pitching a baseball, or serving a tennis ball, among other repetitive overhead motions. Carpenters and painters, for example, whose work requires overhead motions, are likewise more vulnerable.

Aging-related degeneration – Over time, the tendons may get damaged due to gradual wear and tear.

Trauma that occurs suddenly, such as falling with the arm extended or taking a direct impact on the shoulder, can cause a rotator cuff tear.

What Signs and Symptoms Indicate a Rotator Cuff Injury?

Similar symptoms can be seen in tendonitis and rotator cuff injuries, however, tendonitis symptoms are typically more severe.

Symptoms of rotator cuff tendonitis include:

• Continual shoulder pain
• When extending an arm overhead, it hurts severely.
• Nighttime discomfort that can be disruptive to sleep
• Swelling
• Stiffness

Those who have a torn rotator cuff might encounter:

• Attempting to raise an arm overhead causes excruciating discomfort
• Pain that causes you to wake up from sleep
• Pain in the shoulder while you are not moving it
• Shoulder affliction
• Crepitus (a grinding or popping sensation) (a grinding or popping sensation)
• Swelling
• Tenderness

How Are Injuries to the Rotator Cuff Treated?

If you have rotator cuff pain, seeing an orthopedic doctor for an accurate diagnosis is the first step to take.

Dr. Reetadyuti Mukhopadhyay Sports & arthroscopic surgeon can suggest some beneficial attentive therapy options first. These may consist of:

• Rest, Ice
• Physical exercise
• medications that are non-steroidal anti-inflammatory
• An arm sling
• Physical exercise

Dr. Reetadyuti Mukhopadhyay might advise surgery to help you return to the hobbies or sports you enjoy if you’ve had a full tear or if nonsurgical treatments don’t work.

So take the first step towards, pain-free life. Book an appointment today!

Every joint of the body is important but if you are an athlete, then the power of the musculoskeletal system gains more importance. But there are some sports that demand more force from some particular joints of the body. Today, we will be discussing some sports that require extra strength from shoulder joints.

Joints present in the shoulder- know their functions

The shoulder joint is a unique ball and socket due to its allowed range of motion and especially when it’s too fragile to move due to a smaller socket than the upper arm bone. Basically, it is formed by the attachment of the humerus and the scapula. Many ligaments and tissues engulf this joint to provide stability. But when we segregate the complete shoulder joint, then 4 distinct joints can be found in the shoulder that co-relate and co-depends on this single joint. These are the following:

• Sternoclavicular joint

This joint consists of the medial aspect of the clavicle (collarbone), the sternum manubrium (breastbone), and the articular disc. The disc acts as a protection and fractures before the joint gets dislocated. It facilitates many movements like axial rotation, protraction/retraction, and elevation/depression.

• Scapulothoracic joint

It is the anterior articulation between the thorax and scapula. This joint allows various movements like up/down rotation, elevation/depression, and protraction/retraction.

• Aromioclavicular joint

It is responsible to keep up the connection between the scapula and collarbone while suspending the upper portion of the shoulder.  This joint allows rotation in 3 different planes and those are- up/down, internal/external, and anterior/posterior. Moreover, this joint is the only joint that can help in making the interaction between the scapula & posterior thorax.

• Glenohumeral joint

This joint holds the responsibility to keep the upper portion of the shoulder attached to the shoulder joint. Rotator cuff muscles play an important role in keeping this joint intact as it is too fragile to perform stable movements. It’s a structural weakness that makes it prone to dislocation. As it is the most flexible point, it helps in various movements like internal/external rotation, arms lifting, flexion, and many more.

Sports and the intensity of shoulder power

There are many sports that involve a high risk to the shoulder. Let’s list some of them.

• Baseball & cricketers

Baseball players and cricketers usually have the pressure to hit high and catch the ball by performing repetitive overhead movements. Can you imagine a helicopter shot in a cricket match with an injured shoulder? Obviously, it seems to be impossible. These sports include repetitive overhead movements. Over exhaustion can lead to shoulder instability or shoulder cuff injury.

• Tennis

Tennis is a game that is fully based on your arm and shoulder performance. With shoulder pain, Serena Williams would have not won so many tournaments. Swinging the racquet and hitting the ball is not an easy task. Hitting the racquet continuously for a long duration increases the risk of getting a SLAP tear which can affect the power of your shoulder.

• Swimming

A good swimmer needs to have good coordination arms and legs. When one strokes to swim ahead, then it puts intense force by repetitive overhead movements. Over-performing can lead to acute shoulder pain.

• Volleyball

This game completely depends on your arms and shoulders. Hitting the ball with bare hand to serve and hit it to the other counter. As the shoulder is overused, it can lead to various problems like SLAP tear, acute injuries, etc.

It is the list of some sports that require high shoulder power. But almost every outdoor sport requires the strength of the shoulder. If you are looking for an experienced shoulder specialist in Gurgaon, then you can consult Dr. Reetadyuti Mukhopadhyay. He is trained in treating shoulder problems and sports injury.

If you are an athlete, you would understand the importance of fitness of the entire body.  Moreover, the majority of games put intense pressure on the shoulder joint. It means that as a sportsperson, one needs to especially pay attention to this joint and train it to enhance its endurance. It is the reason that players of sports like volleyball, tennis, etc. are at a higher risk of getting some shoulder injuries.  Today we will be discussing some shoulder strength training for all athletes.

Simple shoulder strength training for all athletes

• T push up for endurance

To perform this exercise, you need to take the posture of a push-up (in sideways). So place one arm on the floor in a lying posture. Then lift the other arm while keeping your feet tilted. A ‘T’ shape will be formed by your shoulder. The weight of the entire body will be shifted to the shoulder that is placed on the ground. Hold this pose for a few seconds and move back to the push-up position. Then, repeat it with the other arm. Perform 4-5 sets daily. This exercise improves the endurance of the shoulder.

• Static Rotator Cuff Contraction

Stand with spine and neck straight. Now raise one hand and bent it towards your other arm. Hold your arm with your other hand and try to press your elbow on your chest to make  90 degrees angle. Hold this position for a few seconds and repeat it with the other arm. Perform this exercise at least 10 times with each arm. This exercise is especially beneficial for rotator cuff muscles.

• External Rotation while lying sideways

Hold a normal weighted dumbbell or bottle filled with water in your left hand. Now lie down on your right side and place a soft towel (rolled) under your left elbow. Place your head on your right hand. Simply flex your left hand to 90 degrees and let the weight rest on your stomach. Please note that you should not bend your wrist in this posture or you may get an injury. While keeping your left humerus (upper arm bone), rotate your left forearm to lift the weight. This exercise can help in preventing rotator cuff injuries like tendonitis.

• Military Press

Stand straight and hold two dumbbells.  Tighten your arms’ muscles and lift the arms. The placement of elbows while lifting the weights should be slightly in your front to give enough space for your rotator cuff to function. Thereafter, hold the dumbells straight up while tightening your abs to avoid arching backward. Hold the posture for a few seconds, and then move your arms hallway back to form your hands perpendicular to your scapula. This exercise works on the frontal deltoids and improves the strength of the shoulder joint.

• Scaption and shrug

Stand straight with some gap between your feet while holding a dumbbell in each hand. Now raise your arms 30 degrees without bending your elbows till they are at your shoulder level. Now, try to shrug your shoulder in an upward direction without changing the posture of your arms and feet. Hold this position for a few seconds, and then lower down your shoulder to relax your body.  This exercise targets deltoids muscles, rotator cuff, Serratus anterior, and the upper traps present in the shoulder. It can be helpful to keep up the shoulder’s health and improve its strength.

If you are an athlete, you must follow the above-listed shoulder exercises. Moreover, these are easy to perform and do not require many apparatuses. For a personal consultation or treatment of sports injury, you can consult Dr. Reetadyuti Mukhopadhyay. He is an experienced sports injury doctor in Gurgaon and has helped many athletes in preventing injuries and curing existing injuries.

The shoulder joint is fragile and is utilized even when we are working on your desk. Hence, everyone needs to focus on their shoulder health to keep them fit to maintain productivity at the workplace. Moreover, poor shoulder health can lead to severe problems and make your shoulder prone to many injuries. Let’s have a discussion on the same so that you can prevent shoulder pain and stay happy.

Shoulder joint- the complex anatomy

It is the largest joint and majorly consists of two bones- humerus and scapula. This ball and socket joint consists of several bones, ligaments, and muscles.

• Important bones present in this joint
• Acromion- the bony structure near the scapula
• Clavicle- the bone that connects with acromion to form acromioclavicular
• Coracoid process- a hook-like structure that originates from the scapula
• Other components
• Ligaments- tissues that join a bone with the other bone

Glenohumeral ligaments

It contains superior, middle, and inferior glenohumeral ligaments and is responsible to attach the humerus to its socket. The prime role of these ligaments to keep the joint intact, prevent dislocation and provide stability.

Coraco-acromial ligament (CAL) & coraco-clavicular ligament (CCL)

CAL connects the coracoid to the acromion & CCL attaches the clavicle coracoid process of the scapula. CCL plays a crucial role in maintaining the integrity of the scapula and clavicle which makes the shoulder square.

Transverse Humera Ligament (THL)

It consists of a tendon that is biceps brachii muscles and runs through the intertubercular sulcus

• Muscles- supporting tissues for stability and smoother movements

Rotator cuff muscles

The prime muscle band present in the shoulder joint with 4 different muscles- supraspinatus, infraspinatus, teres minor, and subscapularis. It is attached to the proximal humerus near the front section

Supraspinatus

It originates from the supraspinatus fossa & helps in lifting the arm (initial 30 degrees) and stabilizing the joint.

Infraspinatus

It originates from the infraspinatus fossa and helps in the external rotation of the humerus.

Teres Minor

It is placed below Infraspinatus and runs from the inferior aspect of the dorsal scapula and helps in external rotation and lifting of the humerus.

Subscapularis

This muscle starts from the subscapular fossa and plays a crucial role and lifting the humerus.

Rhomboid

This muscle is the only muscle that functions in depressing the shoulder and can be subdivided into Rhomboid major and minor. The minor starts from the nuchal ligament and spinous processes of C7-T1 whereas the major originate from the spinous processes of T2-T5

Trapezius

A triangular-shaped muscle starts from the outer aspect of the nuchal line in the occipital, upper thoracic region, and cervical. It is the muscle that is responsible for upliftment and depression of the shoulder depending upon the movement.

Deltoid

It helps in lifting the upper arm bone and has three distinct origins. These are the clavicle, acromion, and spine of the scapula. The functionality of the deltoid muscles differs according to the fibres which are activated for the movement.

How to prevent shoulder injuries?

• Take enough rest

It is important to listen to your body and take some rest whenever you are feeling tired. Moreover, if you are an athlete or dancer, then you need to take care of your joints, as sometimes due to performance pressure, we forget our limits. But resting does not mean restraining yourself from shoulder movements. You should perform mild stretches and warm-up.

• Pay attention to your sleeping posture

If you are suffering from pain in the left shoulder, then you should avoid sleeping on your left shoulder joint. You can sleep on your back or the other shoulder joint. In case, if you are suffering from discomfort due to sleeping on your back, then you can pop out your arm with a pillow.

• Work on endurance

It is important to work on the strength of the joint and for the same you can perform some shoulder exercises and train your body to play for longer on the ground. But this training should be gradual.

• Never miss warm-up

Before starting your game or training, it is important to perform a mild warm-up exercise. It will activate synovial fluid that will work as a lubricant for the joints and improve the grace of the movements.

• Cross-train your body

Some sports require rigorous use of the shoulder joint like volleyball, tennis, etc., and reduce the burden on the shoulder joint, you can cross-train your body. For example, if you are a tennis player, then you can cross-train your body by running or biking. If you are in a profession that requires repetitive overhead movements, then you can urge your senior to assign some activities that do not include overhead movements for a while.

• Pay attention to the technique

It is important to pay attention to the technique of the train as a wrong technique can also lead to injuries. Always perform exercises under the guidance of experts.

So if you are a sportsperson, then you should take the following preventive measures to avoid shoulder injuries while training or playing. Some steps can help you to keep up the shoulder health. Also, try some superfoods to improve joint health. In case, if you are looking for an experienced shoulder specialist in Gurgaon, then consult Dr. Reetadyuti Mukhopadhyay. He is a trusted sports injury doctor and has helped many athletes in preventing or curing injuries with the most effective approach.

Rotator cuff injuries are quite common as it is a delicate group of muscles present in the shoulder joint. The core function of this muscle is to provide support to the joint by keeping the upper arm bone intact in the socket while lifting the arm. They also play a crucial role because the humerus tends to slide easily and this muscle group keeps it in place and helps in lateral as well as medial rotation of the joint. Due to so much responsibility on this muscle group, overuse, overstretching or repetitive movements can result in shoulder injuries (especially rotator cuff). This is the reason why many athletes who indulge in games like tennis or baseball are at a higher risk of getting a rotator cuff injury. Severe injuries can only be treated through surgical method. But don’t worry as these injuries can be prevented to some extend by following some tips. Let’ discuss them.

Simple ways to prevent rotator cuff injuries and keeping the shoulder joint healthy

• Don’t push your limits

Everyone needs to pay heed to their body requirements. The stamina of every person is different and it is not a good idea to exhaust your body. Your body is your closest companion and you should listen to it. If you are feeling that you are tired, then take a break, especially when it comes to the shoulder joint. This joint is much more fragile when compared with other joints and hence don’t go beyond its capacity, otherwise, you may suffer from muscle injuries.

• Maintain your BMI

It is important to stay fit and in shape, as it does exert extra pressure on the joint due to excess body-weight. Moreover, it will help you prevent many other health problems, as you will be consuming a healthy diet with regular exercise.

• Pay attention to flexibility & with the right training method

It is important to maintain the flexibility of the body as it improves the range of motion and even helps in strengthening the tendons & muscles. Hence, one should perform some stretching and warm-up exercise for each joint every day. Also, never forget that the training technique matters a lot when it comes to injuries. Your negligence to the technique can be the prime reason for injuries during performing exercises.

• Abstain from overstretching & follow precautions

There are many situations wherein we try to reach for something by overstretching arms and if this habit continues for long, then it may lead to rotator cuff injuries. Follow these tips to avoid such problems:

• Maintain the posture while sitting as well as standing
• Never try to reach an object that is placed on a high shelve (is beyond your capability). Try to take the help of a ladder or chair.
• Always lift weights while keeping the back straight
• Don’t try to drive or work on the computer for long in the same posture as it may affect our shoulder joint and its muscles.
• The height of your desk should be perfect that aligns well with your arms
• If you are suffering from a shoulder sprain or any other shoulder problem, then try to take enough rest and focus on recovery. Don’t try to hurry up and you can try the RICE method for pacing up the recovery process after an expert’s help.

So these were some simple tips that can help you in preventing a rotator cuff injury as it works on keeping the joint healthy. If you want to consult an experienced shoulder doctor in Gurgaon, then you may book an appointment with Dr. Reetadyuti Mukhopadhyay. He has helped many patients in getting back to their normal life without any shoulder pain.

Our shoulder joint is one of the most powerful joints as it is capable of lifting various objects and moving in multiple different directions. One of the most crucial parts of this joint is the rotator cuff as it helps in keeping the upper arm bone stable in the socket while moving it in different directions.

As this set of muscles is solely responsible to initiate the movement of the arm and maintain integrity, there is a high chance of rotator injuries due to overuse. This is the reason why athletes who are indulged in games like tennis, badminton, etc. are more prone to such injuries. Let’s discuss all the identification methods to check if the reason behind your shoulder pain is rotator cuff injury.

Rotator cuff injury- how it occurs?

A rotator cuff is a combination of 4 distinct tendons that starts from the humerus and runs along in the different segments of the joint to provide complete stability to the shoulder joint. Moreover, these tendons are tightly packed which leads to strength and stability. Whenever the shoulder tries to move beyond its limit, the tendons brushes with the bony structure called acromion or another tendon. This confrontation can lead to problems like rotator cuff injury.

A rotator cuff injury can be further divided into 3 categories:

• Rotator cuff tendonitis:

It occurs when a tendon of the cuff is inflamed due to repetitive or overstretched movements

• Shoulder bursitis:

This shoulder problem develops due to the spreading of the inflammation in the shoulder bursae which is responsible for the lubrication of the cuff tendons

• Rotator Cuff tear

It is related to a tear of the rotator cuff tendon due to trauma or tendon weakness

How to identify shoulder pain as a rotator cuff injury?

• Checking out the symptoms

Experiencing sudden shoulder weakness after injury

After lifting something heavy or getting a hit on the shoulder, the person may suffer from extreme pain and may feel weakness in the affected area.

Check for the origin & intensity of the pain

Try to gently move your arm in different directions and observe the intensity & epicenter of pain. In case of minor injury, the person will experience dull pain. Try performing some overhead movements for this analysis.

Observe if there is an unusual sound

Raise your arm and check whether there is any popping or cracking sound occurring from the shoulder joint as it is an indication of an internal injury.

Pain at night

Usually, rotator cuff injury leads to pain that worsens at night and may even lead to sleepless nights. So check for pain during the nights as well. If you are suffering from consistent pain, there is a high chance that the reason for the pain is rotator cuff injury.

• Evaluating through various physical exams under medical supervision
• Diagnostic tests for clarity on the source of shoulder pain

Your medical expert may suggest you undergo some tests like X-rays to check the cause and other associated things that may play an important role in planning the treatment & rehab plan.

The rotator cuff is one of the most important muscle groups present around the shoulder joint. It is the responsibility of this group to keep the humerus (upper arm bone) intact in the joint while moving the arm. As there is such a major task for this muscle group to handle, it is at high risk of getting injured resulting in rotator cuff tears. In such a situation, one must visit a shoulder specialist and get it treated in time. The treatment approach depends on the severity and type of injury. Let’s discuss the different types of rotator cuff tears and understand this shoulder problem in depth.

Rotator cuff- the anatomy

The rotator cuff comprises 4 different muscle-tendon units. These muscles originate from the shoulder blade and insert onto the arm bone. These muscles are:

• Supraspinatus: This muscle is responsible to facilitate the first 15 degrees of raising the arm and later on the other muscles (deltoid and trapezius) takes over the responsibility of the movement.
• Infraspinatus: This muscle helps in the external rotation of the arm (lateral aspect). It along with the subscapularis also helps in centralizing the shoulder joint.
• Teres Minor: It is located just below the Infraspinatus and helps in the external rotation of the arm (lateral aspect).
• Subscapularis: It is the strongest rotator cuff muscle and contributes to all types of shoulder movements. It connects the arm bone from the front.

The rotator cuff may give way at the following sites

(this classification is only meant for patient awareness)

• Type A: This type of tear involves bone avulsion or tear of the tendon at the insertion site
• Type B: Tendon bulk is involved in the tear
• Type C: This type includes the involvement of the muscles
• Type D: This type of rotator cuff dysfunction is caused due to muscle insufficiency

Type A Rotator Cuff tear

Although tendon or muscle is included in such a shoulder problem, the involvement of bone is also considered while planning the treatment process. Due to fractures, nonunion, or bone insufficiency, this shoulder problem can become more complicated and falls under this category. It can be further classified as A1, A2.

A1 covers acute bony involvement and arthroscopic approach or traditional methods are used to treat such injuries.

A2 indicates tuberosity nonunion that is generally a consequence of the failed treatment of A1 as the displacement of fracture may affect the length of the tendon and affects the functionality of the rotator cuff. For the treatment of such nonunion of proximal upper arm bone fracture, there are many surgical techniques. The selection of the treatment procedure depends on many factors like age, associated risks, etc.

Type B Rotator Cuff tear

This type of rotator cuff tear involves an injury in the tendon and be further divided into 4 grades- B1, B2, B3, and B4. The size of the tear plays a crucial role and the tear pattern is identified with the help of the involved components (muscles) of the rotator cuff. The tear patterns are:

• Type A: Supraspinatus & superior subscapularis tear
• Type B: Supraspinatus & complete subscapularis tear
• Type C: Supraspinatus, superior subscapularis, & infraspinatus tear
• Type D: Supraspinatus & infraspinatus tear
• Type E: supraspinatus, infraspinatus, and teres minor tear

B1 indicates a tear in the lateral section (tendon) of the muscle and B2 refers to a tendon tear that is medial to a lateral tendon (generally torn Supraspinatus connecting to infraspinatus). B3 signifies a Fosbury flop tear wherein prominent tendon flips and causes the gathering of fluids. This tendon further runs throughout the joint medially. B4 means tendon to acromion adhesion and is generally observed in the case of a major contracted rotator cuff tear.

Type C Rotator Cuff tear

This category includes rupture of musculotendinous intersection and can be observed in all 4 muscles present in the rotator cuff. There are different grades and define the intensity of the tear and these are:

• Grade 1: muscular strain without any complications if treated well
• Grade 2: partial tear without any tendon retraction
• Grade 3: complete musculotendinous tear

Type D Rotator Cuff tear

It refers to muscle insufficiency and be divided into many sub-categories. D1 symbolizes muscle atrophy or fatty infiltration due to the muscle weakness and if left untreated, then can affect several tendons at a single time. D2 deals with neurological impairment and develops due to a series of shoulder problems. Sometimes a cyst developing in the body affects the muscular tissue of the shoulder joint and hence it falls in the category of D3.

So these were the types of rotator cuff tear and each condition requires a unique treatment plan. Hence, you should get medical help as soon as possible. If you are looking for an experienced rotator cuff repair surgeon in Gurgaon, then you can book an appointment with Dr. Reetadyuti Mukhopadhyay. He tries his best to heal the shoulder problem as soon as possible by implementing the most effective treatment technique.

The rotator cuff is a ring/cable of tendons that form a cuff over the shoulder joint and helps in keeping the joints in position while moving it. It is the most delicate set of muscle-tendon units of the shoulder joint and hence repetitive movements, direct blow, or overstretching of the arm can lead to an injury to this cuff. Sometimes this injury can lead to a complete or partial rotator cuff tear and need surgical treatment. Let’s discuss on rotator cuff surgery process and things that you should expect after it.

Shoulder Arthroscopy for rotator cuff repair

It is a surgical technique that is used to treat numerous shoulder problems and is considered a better option than the traditional method. In arthroscopy, the surgeon makes small incisions near the shoulder joint and uses an arthroscope to get an inside view of the joint. An arthroscope is a small device that has a small camera attached to a thin pipe. After viewing the anatomy, the surgeon may use screws and sutures to repair the torn tendons and muscles.

What to expect after surgery?

After the surgery, the joint may become a little fragile and will need a well-planned rehabilitation plan for the conditioning of the joint. The duration of this rehab may vary from 4 months to 6 months and will consist of many different phrases.

• Initial 3-6 weeks- keep the joint stable & protected

The focus in the initial period will be to maintain the functionality of the joint with stability.  For this, your medical expert may suggest you wear a sling throughout the day. It will help you to keep the joint protected and limit the movements that will in turn contribute to healing. Initially, the patient may experience some pain and swelling too. To get relief from this situation, you may be advised to follow ice therapy and take medications. Moreover, it is important to take care of your shoulder while sleeping. For this, you may try a shoulder support pillow, that will provide comfort to you and support to your joint. But as each case is unique, hence it is recommended to seek medical advice on sleeping position.

• 6-12 weeks- maintain flexibility with Physical therapy

In this phase, the prime focus is to improve flexibility and the range of motion. Hence, Physical therapy sessions will be conducted that will include active as well as passive exercises. It will also help in reducing swelling and pain. But remember that you will need to avoid lifting extremely heavyweights in this duration.

• 3-6 months- strengthen the muscles and joints

This phrase will include some intense exercises that will help in strengthening the joint and regaining full strength. Performing these exercises in a daily routine can be helpful in making the shoulder stronger.

It is suggested to abstain from driving a car for a long period in the first 12 weeks of the rehabilitation plan. Moreover, if you experience discomfort or anything unusual, then report to your doctor as soon as possible.

If you are looking for an experienced arthroscopic / shoulder surgeon in Gurgaon, then book an appointment with Dr. Reetadyuti Mukhopadhyay. He is proficient in arthroscopy & advanced shoulder surgeries and has helped many patients in getting rid of the pain.