Rotator cuff blood flow

by Nathan Wei, MD, FACP, FACR

Nathan Wei is a nationally known board-certified rheumatologist and author of the Second Opinion Arthritis Treatment Kit. It's available exclusively at this website... not available in stores.

Click here: Second Opinion Arthritis Treatment Kit

Blood flow plays an important role in rotator cuff injury- both the development as well as treatment.

The muscles of the shoulder called the rotator cuff, are located between the arm bone and the top of the shoulder called the acromion. This arrangement of muscle lying between bone leads to the condition of impingement syndrome.

Impingement syndrome is a common condition of the shoulder seen in older adults. This condition is closely related to shoulder bursitis and rotator cuff tendinitis. These conditions may occur alone or in combination. There is a poor supply of blood to the rotator cuff muscles and tendons. That is one reason rotator cuff injuries are slow to heal after injury.

When an injury to the rotator cuff muscle occurs, it responds by swelling. However, because the rotator cuff muscle is surrounded by bone, when it swells a number of untoward events occur. The pressure within the muscle increases which results in compression and loss of blood flow in the capillaries. When the blood flow is diminished the muscle tissue begins to fray. Pain is aggravated by reaching up behind the back and reaching up overhead. As the process continues night pain becomes more of an issue.

Minor pain or injury involving the rotator cuff may require RICE therapy:

• rest or reduced activity
• ice or cold packs applied to the shoulder
• compression of the shoulder, such as with ace bandages
• elevation.

Non-steroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen and naproxen, may be used to reduce inflammation and discomfort. In some cases, a corticosteroid, such as triamcinolone, may be injected into the shoulder. Physical therapy helps to increase the strength of the tendons and muscles. Ultrasound may be used to warm the muscles and improve blood flow. Therapists may use massage to stretch the tissue and bring heat to the injury, which increases blood flow. If one has a rotator cuff injury, a major goal will be to improve blood flow to that area by performing passive range of motion (ROM) exercises.

An aerobic exercise program will help improve the blood flow to the tendon and bursa. Increased blood flow helps with healing. Smokers should quit smoking so that more oxygen will reach the injured tendon. All of these modalities can help the shoulder heal faster and better.

This lack of blood flow explains why ultrasound guided needle tenotomy followed by platelet-rich plasma is now the procedure of choice for healing rotator cuff tendinopathy and partial rotator cuff tears. The tenotomy and PRP stimulate blood flow and provide essential growth factors needed for healing.

For more information about rotator cuff tendonitis, visit our sister site:
Tendonitis provides reliable, accurate, and useful information on tendonitis treatment written by a board-certified rheumatologist. Learn more about how to get tendonitis relief using the most up-to-date methods.

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