Can we prevent shoulder Injuries?

Many scientific studies have shown the way a low-grade inflammation can turn into a silent killer, able to contribute to cardiovascular disease, cancer, Dementia and Diabetes Mellitus (Type 2). It is now proven that chronic, low-grade inflammation can contribute to these conditions and even to degenerative arthritis. 75% of the adult population carry this burden as a health problem.

Harvard University and other institutions are pushing for a fight toward Inflammation not by the mean of anti-inflammatory diets as it is advertised but by having enough sleep, stop smoking, limit your drinking alcohol, manage your weight etc… Let us chose a model like a model in the rotator cuff conditions, very common and affecting almost 4 million people in the United States each year. Most people suffering from this condition can recover with rest and physical therapy however in more serious situation, it can degenerate. A complete tear can unable one from raising the upper extremity away from the body and a surgical repair may become necessary to restore functionality.

Let us define the anatomical boundaries of the rotator cuff: A return to our anatomy book will allow us to understand the function of such apparatus. It is made of four muscles and their tendons joining together to form a cover-like roof around and above the head of the humerus, on the top of the shoulder. This group of muscles allows a control on the shoulder and the arm. The rotator cuff muscles are important stabilizers which function in tandem for a better synchronization of the motion of the shoulder. They cover the head of the humerus (upper arm) for better control. Those muscles act as stabilizers and function as mobilizers of the shoulder with a lever action on the arm.

Rotator cuff tendonitis is an inflammation or an irritation of the tendons and/or the muscles around the shoulder joint, rendering any motion painful and difficult. Occasionally pain and swelling can be manifested at an exquisite area of tenderness in front of the shoulder or on the side enabling the individual to raise the upper extremity. Often a sensation of clicking and popping can suggest an impingement inside the shoulder. This pain is such that it can disrupt the sleep, interfering as well with the function of the extremity. At times it is very difficult to move the arm even in a depending position. Brief, the sensation of pain remains unsupportable.

Diagram of the shoulder, including the location of the rotator cuff


Anatomy of the shoulder: Supraspinatus, Infraspinatus and Teres Minor (Posterior)

The rotator cuff is a group of four (4) muscles that envelop the joint to connect the humerus to the scapula allowing movement of the joint: Supraspinatus-Infraspinatus-Teres Minor and the Subscapularis.

The Teres minor, Supraspinatus and infraspinatus share a common tendon which attach on the intertubercular groove of the humerus. The Supraspinatus is located above the scapular spine on the posterior of the scapula to attach the supraspinous fossa. The Infraspinatus is below the scapular spine and attach to the infraspinous fossa on the scapula. The Teres Minor is found on the lateral border of the scapula. The Subscapularis muscle is a large triangular muscle which fills the subscapular fossa and inserts into the lesser tubercule of the humerus, in front of the capsule of the shoulder joint.