Rotator cuff is the name given to four muscles and their tendons, which keep your arms in your shoulder sockets, allowing you to lift your arms and do day-to-day stuff like combing your hair, cutting vegetables etc.

The shoulder joint is a very important joint of the body and this is why any tear that happens in the rotator cuff can be devastating.

Causes

Tears can happen in rotator cuff due to a number of factors like injury and degeneration due to age. Tears that happen due to an injury to the shoulder are called acute. Degenerative tears are tears that happen due to degeneration of the tendon over time.

Common causes of degeneration are lack of proper blood circulation, which impedes the rotator cuff s ability to repair itself. Repetitive stress is another cause where we stress the tendon by repeating the same shoulder motions again and again while playing games like tennis, cricket etc. and doing jobs that require us to extend our arms upwards a lot. Lifting heavy objects can also lead to tears.

Symptoms

Chronic shoulder and arm pain are good reasons for you to see your doctor. If you suffer from pain in your shoulder at rest, while sleeping on the affected shoulder or pain while lifting and lowering your arm, then there is no time to wait.

The doctor will do a physical examination by moving your arm in different directions. He may follow it up with X-rays and MRI to check how big the tear is in your rotator cuff.

Treatment

Once confirmed that you indeed have a rotator cuff tear, your doctor will start the treatment. The goal of any treatment is to reduce pain and make your shoulder joint work properly again.

Nonsurgical Treatments: 

Nonsurgical treatments include rest, using of a sling to protect the shoulder and modifying your daily activities. This means you may not be able to do activities that cause shoulder pain. Your doctor can also prescribe pain and anti-inflammatory medicines. Strengthening and physical therapy bring up the rear of this type of treatment.

What you must remember is that nonsurgical treatment relieves pain and improves function in the shoulder, but does not improve shoulder strength. The size of your tear may also increase over time.

Surgery: 

Surgery, which attaches the rotator cuff to your bone, is done if you suffer from continuous pain and symptoms over a year or so. If you have a large tear, conservative treatments will not work and surgery will have to be resorted to. 

If you have been suffering from chronic shoulder or arm pain, waiting and watching is definitely not an option. You must visit an orthopedic surgeon at the earliest. Remember, if treatment is not started soon enough, your rotator cuff tear will get larger and will require only surgery.

Rotator Cuff Tears: What Are My Options?

Carpal tunnel syndrome is a condition that causes numbness or tingling in the hands and arms besides other symptoms. Carpal tunnel is basically a narrow passage on the palm side of the wrist. This condition is caused when a nerve in the carpel tunnel is compressed. Since this median nerve runs up through the hands to the forearm, it affects the arms as well. Not only does it cause nerve pain, but also results in limited functionality of the thumb.

To prevent this syndrome, one needs to understand its causes. We have discussed some of the primary causes below:

Issues with the thyroid hormone: Hypothyroidism, an imbalance or lack of thyroid hormones in the body, can create problems that lead to issues with the overall musculoskeletal system. An over-active pituitary gland can also cause issues that affect mobility and motor skills. This can lead to or exacerbate the carpal tunnel syndrome.
Arthritis: Arthritis causes swelling and inflammation of joints and tendons, which tend to increase the symptoms of carpal tunnel. Eventually, arthritis can also lead to compression of the median nerve and other structures in the wrist, thereby leading to carpal tunnel syndrome.
Pregnancy or menopause: During pregnancy as well as menopause, women experience tingling or numbness in their hands, which is believed to be caused by carpal tunnel. Experts say that when a fluid called oedema builds up in the tissues around the wrists and other parts of the body, it puts a pressure on the median nerve, leading to pain.
Work pressure: Experts believe that behaviours can increase the risk of carpal tunnel. The other instances which cause this syndrome include physical labour, using mechanical tools and repeated stress to the wrist. However, various studies suggest that there isn t any direct association between using a computer and carpal tunnel syndrome. It may just cause different forms of hand pain.
Imbalance of body fluids: Fluid retention in the body increases the pressure within the carpal tunnel, which irritates the median nerve. This is common during pregnancy and menopause as discussed earlier.
Obesity: One of the significant risk factors for this syndrome is being obese. So be careful about gaining excess weight.
Other conditions: Certain conditions like hormonal imbalance, diabetes and kidney failure may increase the chances of carpal tunnel syndrome. It also occurs in people who usually have narrow carpel tunnels. In some cases, it is inherited and is passed from one generation to the next.
Inflammatory conditions: Illnesses that end up in inflammation, such as rheumatoid arthritis, can affect the lining around the tendons in the wrist and put pressure on the median nerve.
Fractures: A fracture in the wrist can cause narrowing of the carpal tunnel and irritate the nerve. 

Carpal Tunnel Syndrome - Most Common Causes

Fractures are simply a break in a bone. They can be caused due to injury, (traumatic fractures) or a pre-existing condition like osteoporosis that causes weakening of bones (pathologic fractures). There are many ways to classify fractures. All fractures fall into the major categories of simple and compound fractures. Simple fractures are fractures where bones remain inside the skin and don t jut out. They are also called closed fractures.

Compound fractures, also called open fractures, are broken bones that penetrate through the skin. These types expose the bone and deep tissues to the environment. Compound fractures are more serious of the two. The healing here may be affected due to deep infections for which antibiotics need to be used. There are many different sub types of fractures and we re only going to skim through them here.

Comminuted fractures: Severe fractures in which a bone breaks into several smaller pieces.
Avulsion fractures: A small piece of bone is completely torn off from the main bone due to fierce pulling off a part of the body.
Other types of fractures are characterised by the many different angles the bone breaks into like transverse, oblique and spiral fractures.

Diagnosis
When a bone is broken there are symptoms like swelling that doesn t subside on its own and pain. In such a case it s imperative that one goes to a doctor for a diagnosis. Doctors can usually recognise most fractures by examining the injury and taking an X-ray. The X-ray also provides a clear idea about the type of fracture and the degree of displacement of the bone. And, it s important that the patient doesn t wait too long before approaching a doctor. This is because bones begin to heal very quickly after a fracture and the bone tissue will heal using any tissue available. This can lead to a misalignment of broken pieces of bone and cause disability and loss of function.

There are cases when X-ray may not show a fracture. This is especially common in fractures in the hip and wrist in older people. For diagnosing these, doctors will get some other tests done such as a computed tomography (CT) scan, magnetic resonance imaging (MRI), or a bone scan.

Treatments
Fractures have to be treated by doctors. The doctors set the fractured bones in their proper place and hold them there so that they can heal. Setting a bone is called "reduction." Reduction without surgery is called "closed reduction." But if the fracture is serious, it s going to require surgery with bone repositioning, called open reduction.

In extreme cases, pins, plates, screws, rods, or glue are used to hold the fractured bones in place, inside the body. Once the bone abutment has been treated, the bone is immobilised to allow the broken pieces to heal. In most cases, the fractured part is set in a rigid cast. The fractured ends of the bone can be fixed into place using metal pins connected to an external frame. This is removed after the bone has healed.

Fractures - How To Diagnose Them?

You must have had an ankle sprain or at least heard of it   it is an injury to the ligaments surrounding and connecting the bones of the leg to the foot. The injury occurs when you accidentally turn or twist the ankle in an awkward way. This can tear or stretch the ligaments that hold together the joint and bones of your ankle.

What Could Possible Lead to a Sprained Ankle? 
A sprain occurs when the ankle joint is forced out of its normal position as a result of the following  

  Awkwardly placing the foot while stepping up and down, jumping or running
  Stepping on an irregular surface
  During a sport or any sort of rigorous physical activity
  An injury while exercising
  Wearing inappropriate footwear

Symptoms of a Sprained Ankle-
A sprained ankle causes pain, swelling, and limited range of motion. You are likely to experience the following symptoms you sprain your ankle  

  Tenderness
  Bruising
  Stiffness
  Discolouration of skin
  Instability in the ankle
  Limping
  A popping sound or sensation at the time of the injury
  Inability to put pressure on the injured ankle

The symptoms of an ankle sprain are usually self-diagnosable and treatable at home. Nevertheless, you never know how severe the sprain could be. Therefore, consider seeing a doctor when you are having problems with your foot or ankle. A specialist can determine whether the injury is just a sprain or something more serious, with the help of X-ray and MRI.

What is the Treatment for Ankle Sprain?
The line of treatment depends on the type of sprain your ankle sustains. Treatment options include  

  RICE   Many people resort to simple home remedies such as RICE and cold compress to treat a sprained ankle. RICE refers to Rest, Ice, Compression, and Elevation. It is a first-aid cure for strains and sprains.
  Cold Compress    Helps reduce inflammation and dulls pain sensation
  Medications   If you visit an orthopaedic, he/she will prescribe the NSAIDs to ease pain and reduce inflammation and fever
  Braces and Splints   These are applied to aid in stabilizing and protecting the injured joint and its movement
  Elastic Bandage   Stretchy bandages are used to wrap strains and sprains. These provide compression and support during recovery.

Apart from medications and devices, the doctor may also recommend stretching, physiotherapy, and massage. Mild physical movement and exercise will help relax your muscles and restore flexibility and muscle strength.

An ankle sprain cannot be prevented; it can happen anytime. What you can do is consult a specialist and seek treatment to get back to your daily activities.

Know More About Ankle Sprain!

Bones and muscles, together known as the musculoskeletal system, are responsible for all bodily movements. The bones and muscles move in unison, as they are connected by what are known as tendons, which are thin fibrous tissue. These tendons are prone to damage and inflammation known as tendinitis (this can cause inflammation in any organ). It can occur in any bone/joint but most common in areas which are prone for repetitive use including the wrists, arms, elbows, shoulder, knees, and ankles. 

Read on to understand how it happens and how it can be managed.

Causes: Depending on the onset, tendinitis can be acute or chronic. Though it can occur in any individual, the risk increases with age, as bones lose their elasticity and can tear.

Acute is caused by a sudden injury like a fall or accident or infections
Chronic is caused by repetitive movements, poor posture, poor stretching, overuse, etc. Some common movements include carpentry, painting, golfing, tennis, gardening, lawn mowing, badminton, etc.
Symptoms: As with any inflammation, the symptoms of tendinitis would include swelling, pain, redness, and warmth. There is also a reduced range of motion of the affected joint, producing what is known as adhesive capsulitis.

Prevention: Tendinitis is preventable to some extent by avoiding repetitive work and overuse of the joint. Those who are used to a lazy week and an active weekend should definitely watch out. Sudden, excessive stress can cause tendinitis. The tendons should be subjected to limited stress and activity. With any kind of activity, if there is even a slight hint of pain or any issue, get it checked with the doctor. Continuing to do the same activity will only make it worse. Symptoms to watch for include fever, swollen and painful joints, and limited movement of the affected joint.

Management: If identified and arrested in the early stages, tendinitis can be managed conservatively. Progressive measures of treatment would include the following.

As soon as there is discomfort identified, rest the joint and stop any activity, which you think could have caused the problem. Usually, this should help the condition to subside on its own. Ice and heat therapy can also help.
If it is the ankle or the knee, keep it elevated.
Pain killers may be taken if the pain cannot be tolerated or is affecting daily routine.
After the initial week, mild exercises to strengthen the tendon can be started.
Steroid injections may be required in cases where the joint pain and swelling is significant.
As a last resort, if the above measures do not work, surgery may be recommended. This will again be followed by rest, medications, and physical therapy.

Tendinitis - Ways It Can Be Managed!

From marathon runners to footballers, amongst athletes, 'pulling a hamstring' is the most common type of injury. The hamstring is a group of four muscles at the back of your thigh. When one of these muscles gets overloaded or begins to tear, it is known as a hamstring injury. While a hamstring injury is painful, it does not indicate the end of an athlete's career.

Minor hamstring injuries may heal by themselves. In cases where one of the muscles is torn, surgery is required to repair and reattach the muscles. Recovery time depends on the severity of the injury. Stretching and exercising the muscles of the leg are the most important parts of rehabilitation. The healing of a hamstring injury can be divided into four stages.

1. Acute phase: The first five days after a hamstring injury is known as the acute phase of rehabilitation. The aim of treatment at this phase is to reduce inflammation and keep the other muscles from atrophy. For minor hamstring injuries resting the leg, using ice packs and keeping the leg elevated can accelerate the healing process. Once the pain and swelling has decreased, patients can use a cane or crutch to exercise the leg.

2. Subacute phase: From the fifth day to the 3rd week after the injury, the focus of the treatment shifts from minimizing swelling to strengthening the leg and increasing the range of possible motions. At this time, an athlete can resume cardiovascular training. Swimming and other forms of aquatic training are said to be especially beneficial to the treatment of hamstring injuries.

3. Remodeling phase: The remodeling phase continues upto 6 weeks after the injury. Strengthening the leg is the focus of this stage of treatment. Using ankle weights can be beneficial towards strengthening the leg muscles. It is important to be careful about the weight being used and to gradually increase this weight to avoid an added injury.

4. Functional stage: This stage can last upto 6 months until the athlete can regain full function of his or her leg. As the athlete's gait gets back to normal, they may start jogging and short sprints. Gradually, more sport specific exercises may be added to the workout.

There is no fixed time when an athlete can return to active sports after a hamstring injury. While players with minor injuries may return to the field after 3 weeks, athletes with muscles tears may take upto 6 months to recover completely. Hamstring injuries tend to reoccur and hence before they can get back to active sports, an athlete must pass an isometric strength test and flexibility test. This ensures that there are no subtle after effects of the injury that can increase the risk of a repeat injury.

Hamstring Injury Recovery and Return to Sports

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