Are you suffering from tennis elbow or rotator cuff tear? Or is your loved one in severe pain? Let’s dive deep into its symptoms, diagnosis, and reliable treatment in the form of regenerative tendon repair.
What is Rotator Cuff Tear?
Rotator cuff tear is a common form of shoulder pain. It refers to the ripping of muscles and tendons responsible for the rotation of the shoulder joint. The shoulder joint stabilizes your arm and plays a crucial role in the multi-axis motion of your arms. So, any abnormality in its function leads to severe disability.
The tear may involve single or multiple cuff tendons. The patient often presents with a painful and weak shoulder. The pain can be so severe that the patient may be unable to perform routine tasks. Such injuries are typically due to the overuse of muscles and tendons.
It is more common in older people, especially individuals over 80 years. The majority of patients have symptomatic cases. Partial-thickness or full-thickness may increase in size and enhance the number of symptoms. The symptoms aggravate with age, and it is more common among athletes who use their arms and people who work in offices. Frequent use of arms can exacerbate the risk of developing rotator cuff tear or tennis elbow.
Many patients can return to their normal routine activities after getting treated with physical therapy. Certain exercises can help improve the flexibility and strength of muscle groups.
What Are The Common Causes?
Generally, three major factors play a significant role in the development of the rotator cuff tear and tennis elbow.
- Sudden unusual movement of the arm.
- Frequent use of the wrist or arm in repetitive activities like Tennis, Carpenter, etc.
- Aging – as you get old, degenerative abnormalities in tissues are very common.
Common Symptoms
Although signs and symptoms may differ according to the severity of the patient, it also depends on the age. But we will describe some common symptoms.
- Deep pain in the shoulder.
- Mild to extreme arm weakness.
- Severe pain at night during sleeping.
- Difficulty in arm rotation and shoulder pain is common.
- Restricted arm movements.
How Is It Diagnosed?
The best diagnosis approach is to see your doctor or visit a specialist. If you have a sudden arm injury, see a doctor immediately.
During this process, the doctor will physically examine different parts of the arm and shoulder and press them slightly to check the actual points of injury. You can go for other diagnostic tests such as X-rays, MRI, and Ultrasound.
- X-Rays: Show off the actual causes of the pain in your shoulder.
- MRI: Radio Waves and magnetic fields will display the different soft structures of your body parts in detail.
Treatment Process
Various types of treatment are being used, such as ice, physical therapy, and surgery (in severe cases). Depending on the diagnosis, your doctor will suggest the best suitable treatment for your rotator cuff tear. (Hernigou et al., 2014)
Generally, healthcare experts treat rotator cuff tear in three major ways with the help of medicine, therapy, and surgery if needed.
Shoulder Replacement Surgery:
An artificial process is applied in which the ball part of the joint is placed into the shoulder joint. But this happens when a severe injury occurs, and immediate treatment is suggested to avoid further complications. The joint and socket parts are well managed to repair it up to maximum possibility. (GARIBALDI et al., 2021)
Tendon Alternative Surgery:
The doctors perform tendon alternative surgery when the tendon damage is very drastic and needs to be swapped with another tendon. So, a nearby tendon is taken as a replacement for normal function.
Tendon Repair:
The surgeon places an incision and repairs the torn tendon. The tendon is reattached to the bone as a repair therapy.
Arthroscopic Treatment:
The surgeon uses a small camera after a small incision and repairs the tendon to reattach it with bone. (Mishra & Pavelko, 2006)
Prevention Tips
- Exercise and target both the small and large muscles of the shoulder to strengthen the rotator cuff.
- Keep good posture.
- Avoid sleeping on your side with your arm stretched overhead.
- Don’t smoke, as it decreases blood flow to the rotator cuff.
Tennis elbow (lateral epicondylitis)
Tennis elbow refers to a painful condition when elbow tendons are inflamed due to hyperactivity. This occurs primarily due to repetitive movements of the wrist and arm. (Tennis Elbow Symptoms, Causes, and Treatments, n.d.)
As the name indicates, tennis players are more prone to develop this disorder, but other people may also get this condition. Different groups of individuals can be affected by tennis elbow, such as office workers, plumbers, painters, etc. – anyone who uses their wrist and hands frequently.
The pain originates near the tendons of the forearm. It can often get very severe and end up restricting the movements of the elbow joint. Rest, rehabilitative exercises, and pain medications can help manage this condition efficiently.
Evaluation:
The condition may develop in any person irrespective of age but is particularly more common in people above 40.
Common Symptoms
Initially, the pain is mild and slowly spreads. But it can radiate from the outside of the arm and reach the forearm and wrist. Tennis elbow may cause pain when:
- Picking up a cup of tea or coffee.
- Shaking hands with someone.
- Opening the door.
- Lifting weight.
- No significant flexion and extension in the forearm.
What Are the Common Causes?
The tennis elbow doesn’t develop overnight. It takes time to develop after continuous use of elbow tendons repeatedly. Repeated activity put a strain on the elbow muscles and tendons.
Even playing tug of war can produce microscopic strains in muscles and cause pain. The tennis players use the backhand for stroke, which is why it’s also called tennis elbow.
Other Activities That Can Aggravate the Pain:
- Driving (especial Sports cars)
- Painting
- Cooking (cutting vegetables and other ingredients)
- Sports like Squash and Fencing
How Is It Diagnosed?
A detailed examination by a healthcare professional can help diagnose the issue. The doctor may move your elbow and arm to check the severity of the condition and suggest treatment accordingly.
Patient history also plays a crucial role in the final diagnosis. The radial nerves are also examined during this procedure. The other methods include detecting pain by putting pressure on the middle finger, wrist, or hands of the patient. Also, by asking the patient to lift a light of the heavy object.
Common Imaging Tests
- X-Rays
- MRI
Treatment
The Tennis elbow can recover independently, but you may need extra medications to eliminate pain. The best method is to allow your elbow and arm to rest for a few days. And when the pain subsides, try to perform mild exercises that will help the muscles and joints feel more stable. (Lee et al., 2015)
If you are a tennis player, a physiotherapist might suggest physical therapy for effective treatment. It includes numerous physical motions and activities that help you recover soon. If the pain is severe, over-the-counter painkillers can help offer relief.
A surgical option might be recommended if your tennis elbow is of severe type and invasive treatment is needed for complete recovery.
- Injections To Reduce Pain: Doctors inject microneedles in tendons in parts with high strain. (Mishra & Pavelko, 2006)
- Surgery: If you have a chronic condition, the doctor might recommend surgical intervention. Self-healing is usually impossible at that stage, and surgical specialists may have to remove that tendon to avoid complications.
Conclusion
Various types of treatment are being used for rotator cuff tears, such as ice, physical therapy, and surgery (in severe cases). The Tennis elbow can recover independently on its own, but you might need pain medications for relief. Tendon Alternative Surgery is an effective option to treat rotator cuff tears and tennis elbow. Consult your healthcare professional to get medical advice before deciding on a treatment option.
References:
- GARIBALDI, R., ALTOMARE, D., SCONZA, C., KON, E., CASTAGNA, A., MARCACCI, M., MONINA, E., & DI MATTEO, B. (2021). Conservative management vs. surgical repair in degenerative rotator cuff tears: A systematic review and meta-analysis. European Review for Medical and Pharmacological Sciences, 25(2), 609–619. https://doi.org/10.26355/EURREV_202101_24619
- Hernigou, P., Flouzat Lachaniette, C. H., Delambre, J., Zilber, S., Duffiet, P., Chevallier, N., & Rouard, H. (2014). Biologic augmentation of rotator cuff repair with mesenchymal stem cells during arthroscopy improves healing and prevents further tears: A case-controlled study. International Orthopaedics, 38(9), 1811–1818. https://doi.org/10.1007/S00264-014-2391-1
- Lee, S. Y., Kim, W., Lim, C., & Chung, S. G. (2015). Treatment of Lateral Epicondylosis by Using Allogeneic Adipose-Derived Mesenchymal Stem Cells: A Pilot Study. Stem Cells, 33(10), 2995–3005. https://doi.org/10.1002/STEM.2110
- Mishra, A., & Pavelko, T. (2006). Treatment of chronic elbow tendinosis with buffered platelet-rich plasma. American Journal of Sports Medicine, 34(11), 1774–1778. https://doi.org/10.1177/0363546506288850
- Rotator cuff injury – Symptoms and causes – Mayo Clinic. (n.d.). Retrieved December 30, 2021, from https://www.mayoclinic.org/diseases-conditions/rotator-cuff-injury/symptoms-causes/syc-20350225
- Tennis Elbow Symptoms, Causes, and Treatments. (n.d.). Retrieved December 30, 2021, from https://www.webmd.com/fitness-exercise/tennis-elbow-lateral-epicondylitis#1