|
 ROTATOR
CUFF / LABRAL INJURIES
(July
2008)
Since Ben Townley
just had surgery to repair a rotator cuff / labral
injury to his shoulder, I thought this might be a good
opportunity to explain what they are and the differences
between the two.
WHAT IS A
ROTATOR CUFF INJURY ?
A rotator cuff
injury is a strain or tear in the group of tendons and
muscles that hold your shoulder joint together and help
move your shoulder.
HOW DOES IT
OCCUR ?
A rotator cuff
injury may result from the following:
* using your arm
to break a fall (like we do in racing)
* falling onto
your arm
* lifting a heavy
object
 *
use of the your shoulder in sports with a repetitive
overhead movement, such as swimming, baseball (mainly
pitchers), football, and tennis, which gradually
strains the tendon.
* any type of
manual labor requiring overhead work.
WHAT ARE THE
SYMPTOMS ?
The symptoms of a
torn rotator cuff are:
* arm and shoulder
pain
* shoulder
weakness
* shoulder
tenderness
* loss of shoulder
movement
HOW IS IT
DIAGNOSED ?
An orthopedic
doctor will perform a physical exam and check your
shoulder for pain, tenderness, and loss of motion as you
move your arm in all directions. He/she will ask you
whether your shoulder pain began suddenly or gradually.
An x-ray may be done to rule out fractures and bone
spurs. Based on these results, he/she may order other
tests and procedures including:
* an arthrogram –
an x-ray that is taken after a special dye has been
injected into your shoulder joint to outline its soft
structures.
* MRI (magnetic
resonance imaging) – this creates images of your
shoulder and surrounding structures with sound waves.
* Arthroscopy – a
surgical procedure in which a small instrument is
inserted into your shoulder joint so your doctor can
look directly at your rotator cuff.
WHAT IS THE
TREATMENT ?
A tendon in your
shoulder can be inflamed, partially torn, or completely
torn. What is done to the injury depends on the size of
the tear and how much it hurts. If the tear is a minor,
it can be left to heal by itself if it doesn’t interfere
with your everyday activities. A large tear will need to
be repaired by arthroscopy. This is also used to perform
surgery on a joint, not only for seeing inside the
shoulder. The larger tears can be fixed and stitched
back together.
After surgery, your
treatment plan will consist of physical therapy to help
with ROM (range of motion) and strengthen your shoulder
as it heals. Full recovery depends on what is torn and
how it is treated. The goal of rehabilitation is to
return to racing as soon as it is safely possible.
Strength is the key to returning to racing. Keep in mind
that everyone recovers from an injury at a different
rate.
 WHAT
IS A LABRAL TEAR OF THE SHOULDER ?
The shoulder joint
is a ball and socket joint. The labrum is a lip of
connective tissue where the shoulder ligaments connect
to the edge of the socket that holds the ball of the
upper arm bone (humerus bone) into the socket of the
shoulder blade (scapula).
HOW DOES IT
OCCUR ?
The labrum can be
torn by the same mechanisms as a rotator cuff tear. But
it can also include the following:
* having your arm
jerked away from your body
* direct blow to
the front/back of your shoulder
WHAT ARE THE
SYMPTOMS ?
 The
symptoms of a labral
tear also can be related to the rotator cuff tear as
well. But it can also include the following:
* clicking or
grinding when moving your shoulder
* a sense of the
shoulder “going out of place”
HOW IS IT
DIAGNOSED ?
The same way that
the rotator cuff was examined can also be performed to
check out the labrum as well. Many times labral tears
are finally diagnosed when the arthroscopy is performed
to look inside the painful or symptomatic shoulder.
WHAT IS THE
TREATMENT ?
Large tears usually
need to be fixed in surgery. The tear in the labrum may
be re-attached or trimmed away. If there is scar tissue,
it may be removed as well. Torn ligaments may be
re-attached too. Small labral tears may become painless
by avoiding those activities that make the shoulder feel
uncomfortable.
After surgery, your
treatment plan will consist of physical therapy to help
with ROM (range of motion) and strengthen your shoulder
as it heals. Full recovery depends on what is torn and
how it is treated. The goal of rehabilitation is to
return to racing as soon as it is safely possible.
Strength is the key to returning to racing. Again keep
in mind that everyone recovers from an injury at a
different rate. With a labral repair, the return time
back to racing may be longer than the rotator cuff
repair. If you return too soon, you can worsen the
injury and could lead to permanent damage.Many labral
tears are caused by accidents that cannot be prevented.
It is always important to have good strength and always
use proper form during training and rehabilitation to
ensure a safe and prosper return to racing.
|
Josh Demuth,
2-time National Arenacross Champion, '06 Bookoo Arenacross Champion:
"I had a lot of injuries in my Arenacross career. Without having
someone like Keith on the series to help me and the other riders
out, we might make it through a tough night of racing. He's always
been able to get us right back on the track and in the winner's
circle."
Isaiah Johnson: " I was very fortunate to have someone like
Keith on the Arenacross series when my injury occurred. He even went
to the hospital after the event to check up on me since it was a
very serious injury."
