ROTATOR CUFF IN­JURIES

Road Today - - Guest Column: Health - RT

By far the most com­mon shoul­der com­plaint that I see in my clinic among pro­fes­sional truck driv­ers are in­juries to the rotator cuff.

The rotator cuff is es­sen­tially a group of mus­cles and ten­dons that sur­round the shoul­der joint. It func­tions to sta­bi­lize the joint by keep­ing it firmly with in the socket dur­ing shoul­der move­ment.

Rotator cuff in­juries or tears may oc­cur from a sin­gle in­jury or due to repet­i­tive strain. Oc­cu­pa­tions and sports which re­quire a lot of over­head move­ments are more likely to in­jure the rotator cuff. Jobs such as painters, elec­tri­cians and car­pen­ters are at higher risk for rotator cuff in­juries In my clinic I of­ten treat rotator cuff in­juries in flat bed­ders due to the phys­i­cal de­mands of the job. Trap­ping and se­cur­ing loads are usu­ally the cause of the in­jury. In ad­di­tion, rotator cuff in­juries can oc­cur due to slips and falls. Just last week I treated a driver that slipped and fell of the deck of his trailer and tore one of the mus­cles of his rotator cuff.

Repet­i­tive strain in­juries to the rotator cuff are also com­mon. Oc­cu­pa­tions which re­quire repet­i­tive move­ments such as fac­tory work­ers are at higher risk. Along the same lines, sports such as ten­nis and base­ball may also in­crease your risk. All of these ac­tiv­i­ties lead to the pro­gres­sive de­gen­er­a­tion of the rotator cuff struc­ture.

The signs and symp­toms of a rotator cuff in­jury vary from per­son to per­son. How­ever, most peo­ple will ex­pe­ri­ence a dull ache deep with in the shoul­der. The pain as­so­ci­ated with the in­jury can also be very sharp and in­tense if there is a sig­nif­i­cant tear. Another com­mon symp­tom is wors­en­ing shoul­der pain when sleep­ing on the in­jured shoul­der. Many pa­tients have dif­fi­culty sleep­ing due to shoul­der pain. In more se­vere rotator cuff in­juries, mus­cle weak­ness and de­creased abil­ity to move the shoul­der will be ex­pe­ri­enced. It is rec­om­mended that you seek med­i­cal at­ten­tion if you ex­pe­ri­ence shoul­der pain that lasts more than a few weeks or you lose the abil­ity to move your shoul­der in cer­tain ranges of mo­tion.

Your doc­tor will be able to di­ag­nose a rotator cuff in­jury by tak­ing a de­tailed med­i­cal his­tory and per­form­ing a phys­i­cal ex­am­i­na­tion of the in­jured shoul­der. If nec­es­sary, your doc­tor will rec­om­mend so­phis­ti­cated imag­ing tests such as ul­tra­sound, x-ray and MRI to bet­ter vi­su­al­ize the in­jury site.

De­pend­ing on the lo­ca­tion and sever­ity of the in­jury, your doc­tor will rec­om­mend the best form of treat­ment for you. Con­ser­va­tive treat­ment such as rest, ice and anti-in­flam­ma­tory med­i­ca­tions are usu­ally the first course of treat­ment. Mild rotator cuff in­juries tend to re­spond well to this type of treat­ment. If con­ser­va­tive treat­ments are not suc­cess­ful, steroid in­jec­tions such as cor­ti­sone may be rec­om­mended to fur­ther re­duce pain and in­flam­ma­tion. Phys­i­cal ther­apy may also be rec­om­mended to help re­store strength and flex­i­bil­ity to the in­jured shoul­der. If all other forms of treat­ment fail, surgery may be nec­es­sary. Cur­rently, there are sev­eral dif­fer­ent op­tions avail­able for rotator cuff in­juries which in­clude arthro­scopic ten­don re­pair and open ten­don re­pair. Again, de­pend­ing on the na­ture of the in­jury, your sur­geon will be able to ad­vise you as to what the best op­tions for surgery are for you

As I al­ways say, pre­ven­tion is the best treat­ment.

For my pa­tients that drive flat bed, I al­ways rec­om­mend that they do a light warm up be­fore they load or un­load. To do this, sim­ply walk around your truck a few times to in­crease blood flow and then do some sim­ple shoul­der and arm stretches. The worst thing you can do af­ter driv­ing for sev­eral hours is to jump out of your cab and be­gin to do phys­i­cal work. The rea­son for this is that mus­cles that have been sta­tion­ary for an ex­tended pe­riod of time will tend to be more tight and less pli­able which in turn in­creases the chance of rotator cuff in­jury. Another good tip is to take breaks while work­ing. This will give your mus­cles a chance to re­cover and re­duce repet­i­tive strain.

Keep these sim­ple tips in mind and you will be well on your way to pain free shoul­ders.

Un­til next month, drive safely.

Dr Christo­pher H. Singh Chi­ro­prac­tor, runs Trans Canada Chi­ro­prac­tic at 230 Truck Stop in Wood­stock, Ont. He can be reached at 519-421-2024 E.mail: chris_s­ingh@sym­pa­tico.ca

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