While athletes suffer from traumatic forms of the injury, for many others age is to blame for torn rotator cuffs.
It's believed millions of Americans over 60 suffer from one.
Every Year 250,000 people go under the knife for relief, but now there's a surgery-free alternative you can do for free.
Just opening a cupboard was excrutiating for Kay Subhawong.
Kay says, "I couldn't lift this right arm to take plates out of the cupboard."
She has a torn rotator cuff. The small muscles that hold the shoulder joint together have ripped apart.
"That type of rotator cuff tear occurs with aging just like getting wrinkles or gray hair."
Kay thought her only option was an operation.
Kay says, "I was really scared. I am not a fan of surgery."
Dr. John Kuhn says, "It usually takes people about four months before they can even think to get back to any kind of labor type work and it usually takes a year to get a full recovery."
Vanderbilt's Doctor John Kuhn convinced Kay to skip surgery and do these exercises instead.
"And then you have to pull your arm down."
Kuhn is Director of the Moon Shoulder Group, a network of doctors researching the best options for bad shoulders.
Dr. Kuhn: "We found the exercises programs that were found to be effective at treating rotator cuff disease and consolidated them into one physical therapy program."
The program focuses on range of motion, flexibility and strengthening.
Dr. Kuhn: "We do not expect the therapy program to make someone's tendon heal, but it does take their pain away."
After six weeks of exercises Kay still hurt, but after twelve weeks she says, "You know my arm doesn't really hurt."
A new study of 452 rotator cuff tear patients found the exercise program helped 85% avoid surgery.
Dr. Kuhn: "And the effects last for two, up to five years so far."
Kay finished the program about five years ago.
Her shoulder misery is just a bad memory.
Now, she's focusing on making good ones.
Kay says, "I just pulled my suitcase all over Europe a few weeks ago."
Doctor Kuhn says the exercise program has changed the way he practices.
He tells us he's using therapy instead of surgery a lot more than he used to.
The entire shoulder program is available free online at ----> http://www.moonshoulder.com/
The Doctor says you should talk with your physician before starting it.
BACKGROUND: The rotator cuff is made up of tendons and muscles in the shoulder. The tendons and muscles connect the upper arm bone with the shoulder blade and they hold the ball of the upper arm bone in the shoulder socket. The combination means greater range of motion of any joint in the body. A rotator cuff injury can include any type of irradiation or damage to the tendons and muscles. Causes of an injury can include lifting, falling, and repetitive arm activities (usually those that are done overhead like throwing a baseball). About 50 percent of rotator cuff injuries can heal with self-care or exercise therapy. (Source: www.mayoclinic.com).
SYMPTOMS: Rotator cuff injury symptoms can include: shoulder weakness, loss of shoulder range of motion, inclination to keep the shoulder inactive, and pain and tenderness in the shoulder. The most common symptom is pain. A lot of times it is experienced when a person reaches for a comb, for example. Lying on the shoulder can also be painful. (Source: www.mayoclinic.com)
INJURY: The four major muscles, supraspinatus, infraspinatus, teres minor, and subscapularis, and their tendons connect the upper arm bone with the shoulder blade. A rotator cuff injury, which is common, involves any type of damage or irritation to the muscles or tendons, including:
Tendinitis: tendons in the rotator cuff can become inflamed due to overuse, especially if you are an athlete.
Strain or tear: if tendinitis is left untreated, it can weaken a tendon and lead to chronic tendon degeneration or to a tendon tear.
Bursitis: the fluid-filled sac between the shoulder joint and rotator cuff tendons can become inflamed and irritated. (Source: www.mayoclinic.com)
NEW TECHNOLOGY: In the United States, at least ten percent of people over sixty, or close to six million people, will develop a rotator cuff tear. Usually treatment for rotator cuff injuries involves exercise therapy. Other treatments can include surgery, steroid injections, and arthroplasty. Now, the physical therapy program out of Vanderbilt University Medical Center can effectively treat most patients with full-thickness rotator cuff tears and shoulder pain, without the need for surgery. The study included 396 patients ages 18 to 100 who had atraumatic full-thickness tears that were documented by magnetic resonance imaging and no other abnormality. Most patients were assigned to a physical therapy program, which included daily postural exercise, active-assisted motion, active training of scapula muscles, and active range of motion, also with anterior and posterior shoulder stretching. They also performed three weekly rotator cuff and scapula exercises. The patients returned at six and 12 weeks. At this point they could decide that treatment was successful and did not need a follow-up, they had improved but would like to continue therapy, or the non-operative treatment had failed and they need arthroscopic rotator cuff repair. The researchers contacted the patients by phone at one and two years to determine whether they had undergone surgery since their last visit. At six weeks, the data showed that fewer than 10 percent of patients had decided to go forth with the surgery. For patients to whom follow-up data was available at the two year mark, only two percent had the surgery. The finding suggests that pain may be a less suitable indication for rotator cuff repair than is weakness or loss of function. Researchers hope that future studies will identify risk factors that can predict progression to rotator cuff tears and symptom onset, but also which repaired tears are likely to fail. (Source: http://www.medscape.com/viewarticle/737461)
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FOR MORE INFORMATION, PLEASE CONTACT:
John E. Kuhn, MD
Chief of Shoulder Surgery
Vanderbilt University Medical Center