Rotator cuff tears are an extremely painful type of injury. They are extremely common and they cause debilitating pain and restrict range the range of motion in the shoulder. Not only does a torn rotator cuff cause pain, but it also reduces the amount of strength in the shoulder, which makes simple activities painful and difficult to manage.
The shoulder is made of three separate bones. The upper arm bone, the collarbone, and the shoulder blade. The shoulder itself is a ball-and-socket joint, which is very susceptible to injury, especially if you live an active lifestyle.
The tendons of the rotator cuff cover the head of the upper arm bone and are used to help raise and pivot your arm. Located between the shoulder bone and the rotator cuff is a fluid-filled sack called a bursa to keep the joint lubricated. This is why any rotator cuff injury should be treated by a ShoulderMD.
Description of a Rotator Cuff Tear
A rotator cuff tear involves a tear in one or more of the rotator cuff tendons. In severe cases, the rotator cuff tendon is pulled completely away from the bone attachment. In some cases, the patient’s pain begins as a minor problem, with the rotator cuff fraying slowly over time.
There are different types of rotator cuff tears, including:
This is typically referred to as a partial tear. The tendon is damaged but is not completely severed.
Also known as a complete tear, the tendon is completely separated from the bone. Essentially, there is a hole in the tendon
Causes of Rotator Cuff Tears
There are two primary causes of rotator cuff tears, including injury and degeneration. The most common forms of injury are acute tear and degenerative tear. An acute tear is caused by an injury, usually falling down or lifting something too heavy. Sometimes it is caused by lifting something with a jerking motion. This type of tear is typically caused by another injury, like a dislocated collarbone or shoulder. Degenerative tears wear down the tendon slowly. This can happen normally as we get older, or it can happen as a result of a primary illness. Usually, this type of injury happens in the dominant arm, but it is possible for the same type of injury to developing in the other arm as well. There are some factors that make you more likely to develop a degenerative rotator cuff tear.
Knowing what puts you at a greater risk of developing a rotator cuff tear can help you reduce the likelihood of you developing one. Being over the age of 40, lifting heavy items over the head, and being an athlete place you at greater risk. Also, there are some career trades that are at greater risk, including painters, carpenters, and anyone who works with their hands above their heads frequently.
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The condition results in a urinary opening that does not work well or form in common locations. For males the urethra opens on top of or on the side of the penis, often near the base. For females the urethra forms near the clitoris or even higher, near the stomach. Surgery is required to fix this defect in males and females, with the goal of restoring function and appearance. Epispadias is a rare congenital condition that can affect males and females, though is more common with males.
Understanding the Condition
While it is unknown how this defect is caused, it is characterized by improperly formed pelvic bones. The urethra doesn’t fully form which results in the urinary opening in the wrong place. This condition is often diagnosed at birth. In less extreme cases the condition won’t be detected until later, normally during potty training when the child experiences urine leaks or frequent urinary tract infections. Females will have abnormal clitoris and labia.
Generally, males who suffer this condition will also experience a wider and shorter penis that curves upward. The urethra forms on top or on the side of the penis instead of at the tip and is wider than average. Besides potential cosmetic issues, this condition affects the bladder’s ability to hold urine and boys or girls with this condition will leak urine. The curvature of the penis in males can also cause discomfort as well as hindering sexual relations later in life.
Surgery is the only solution to return bladder continence and achieve a normal appearance. Surgery closes the bladder wall and often also adjusts the pelvic bones. The goal during surgery is also to straighten and elongate the penis to restore a normal appearance. During surgery the surgeon will also move the urinary opening to the correct location. There is more than one method for surgery including rebuilding the penis, or less often completely taking it apart and reassembling it for ideal function and appearance.
Surgery for females is less complicated. For females surgery places the urethra in the correct location and the two parts of the clitoris will be put back together. Early surgery in females can often completely circumvent incontinence problems before they begin.
While surgery can help to restore the look and function of the urethra and penis, problems with incontinence and infertility may persist. The goal of surgery is to restore regular function and appearance but is not always completely successful. Your doctor can further evaluate your child’s specific needs and what kind of surgery to pursue.
While this congenital condition is often apparent at birth, parents who suspect their children are suffering can consult a pediatric urologist for further testing to determine the problem. Oftentimes this condition is associated with other deformities, but sometimes presents on its own. Surgery is necessary to correct function and appearance and to help achieve normal quality of life.