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The tendons at the ends of the rotator cuff muscles can become torn, leading to pain and restricted movement of the arm. A torn rotator cuff can occur following trauma to the shoulder or it can occur through the "wear and tear" on tendons, most commonly the supraspinatus tendon found under the acromion.
Surgery may be done arthroscopically or as open surgery. The impinging structures may be removed in surgery, and the subacromial space may be widened by resection of the distal clavicle and excision of osteophytes on the under-surface of the acromioclavicular joint. [4] Damaged rotator cuff muscles can be surgically repaired.
The supraspinatus muscle performs abduction of the arm, and pulls the head of the humerus medially towards the glenoid cavity. [5] It independently prevents the head of the humerus from slipping inferiorly. [5] The supraspinatus works in cooperation with the deltoid muscle to perform abduction, including when the arm is in an adducted position. [5]
Subacromial bursitis is a condition caused by inflammation of the bursa that separates the superior surface of the supraspinatus tendon (one of the four tendons of the rotator cuff) from the overlying coraco-acromial ligament, acromion, and coracoid (the acromial arch) and from the deep surface of the deltoid muscle. [1]
[5] [6] A strain injury can also damage the supraspinous ligament. [7] The supraspinous ligament creates resistance during midline epidural anaesthetics when the needle is being inserted. This increased resistance needs to be taken into account, and is one of the first subcutaneous tissues. [8]
Suprascapular nerve entrapment syndrome, causing shoulder pain and localized muscular atrophy of the supraspinatus and infraspinatus muscles. This can potentially develop due to suprascapular nerve being entrapped and compressed within the suprascapular canal potential anatomical entrapment sites.
Surgical treatment of SLAP tears has become more common in recent years. The success rate for repairing isolated SLAP tears is reported between 74-94%. [10] While surgery can be performed as a traditional open procedure, an arthroscopic technique [11] is currently favored being less intrusive with low chance of iatrogenic infection. [12]
When treating a person with a spinal cord injury, repairing the damage created by injury is the ultimate goal. By using a variety of treatments, greater improvements are achieved, and, therefore, treatment should not be limited to one method. Furthermore, increasing activity will increase his/her chances of recovery. [1]