What is the difference between a rotator cuff tear and a frozen shoulder?
Many of us have hear the terms frozen shoulder and rotator cuff tear (often mispronounced rotor cuff or rotary cup) . The rotator cuff injury is one of the most common injuries of the shoulder. The shoulder is a ball and socket joint with the arm bone, Humerus, meeting the shallow socket of the glenoid fossa. This socket is part of the shoulder blade, scapula. The term rotator cuff refers to the four muscles of the shoulder that help to support the shoulder joint during rest and movement. These muscles are; the supraspinatus, infraspinatus, teres minor, and subscapularis. These 4 muscles attach the shoulder blade to the upper arm bone and keep the head of the humerus in close proximity to the shoulder socket.
Rotator cuff tear
Rotator cuff muscles and tendons can be injured over time, or with a sudden injury such as a fall. In an over use injury, the soft tissue may start to fray, often caused by repeated injuries from tennis or racket ball. A tear can be partial or complete, with the muscle being torn into two pieces. Symptoms of a rotator cuff tear can include shoulder pain, stiffness and weakness. You may have trouble lifting overhead or picking up objects, especially above shoulder height. Getting dressed, washing hair or tucking in a shirt can be difficult or even painful. Sleeping can be limited too due to pain.
Often rest is the best remedy. Once you see your doctor he or she may determine that no surgery is required. If a repeated activity is causing pain such as lifting, grand kids, tennis or swimming then please refrain from those activities for a few months to allow the tear to heal. If in the case of a complete tear and pain limits movement or sleeping too much then surgery may be required. In that case movement is greatly restricted to allow healing to occur. Physical therapy may be advised in either case to fully heal and regain range of motion, ROM.
Pain and stiffness in the shoulder can become or be the result of a frozen shoulder. This is recognized by movement of the shoulder becoming very difficult. Again, the head of the humerus is a ball that fits closely with the socket of the scapulae. As we talked before, muscles and tendons keep the head of the humerus in the shallow socket. Surrounding the shoulder joint is a thick tissue called the capsule. This strong connective tissue can thicken and tighten, making movement difficult and painful. This can be caused by an injury such as a fall or lack of movement over a period of time such as wearing a sling or a brace. This is known as a secondary injury. If in the case of a primary injury, there is no known cause. There are three stages of a frozen shoulder; freezing stage, frozen stage and thawing stage.
Adhesive capsulitis, another form of frozen shoulder is where the connective tissue surrounding the joint becomes inflamed, scarred and tight. Symptoms of adhesive capsulitis are pain, stiffness, tightness and altered function of the arm. Symptoms often occur gradually and worsen over time. They may resolve in 1-2 years.
Treatment for a frozen shoulder can involve physical therapy, rest and pain management. Consult your physician for a referral to physical therapy and possibly in injection or other forms of pain management. Returning to your previous level of activity will take therapy, passive range of motion, PROM and strengthening to help you regain function of your shoulder.
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