I interviewed my dad, Greg Patterson, about shoulders because he enjoys working with shoulder patients and is very interested in them. My dad is a physical therapist at Amedisys Home Health Agency. His answers are in blue, and my response to the answers he gave are below each question.
1. Describe what a rotator cuff tear is:
“It usually comes about through a lifting-type injury, usually an acute tear
comes from someone with an outstretched arm lifting up and in front of the body.
The supraspinatus muscle is the most common to tear along with muscles that
attach in the anterior area of the shoulder.”
My Response: I did not know that many rotator cuff injuries come about
through lifting. I always thought these injuries came about through
overuse.
2. What is the difference between a rotator cuff tear and a strain/sprain of
the rotator cuff?
“A strain or sprain means that the muscles and tendons are still intact, and
a tear means there is a complete or partial rupture of the junction of the
muscle and the tendon or the muscle tears off the bone.”
My Response: I knew the general difference between a strain or sprain and a
tear, but I did not know there were different ways the rotator cuff could be
torn.
3. What categories or types of people are the most susceptible to rotator
cuff injuries?
“Pitchers, swimmers, gymnasts, as well as people that have jobs that require
repetitive and heavy lifting. You see more 40-60 year olds with rotator
cuff problems.”
My Response: I always thought tennis players were at a big risk for
rotator cuff injuries, but I learned that they are more prone to elbow
injuries. I also thought that people older than 60 would be more at risk
than 40-60 year olds.
4. What is the best prevention early in life?
“Using good ergonomics with lifting heavy objects or avoiding repetitive
activities that stress the shoulder/rotator cuff complex. One of the
biggest things is making sure the posterior rotator cuff and the scapular
stabilizing muscles are strong and allow for good, protective
co-contraction.”
My Response: I did not know which areas of the shoulder and back to
strengthen to prevent a rotator cuff tear. I didn’t know that the scapular
stabilizing muscles came into play as well.
5. What are the different treatment options for a rotator cuff tear?
“If it is a full tear, surgery is the only effective way to get return of
good function. Whereas partial tears could recover effectively with
physical therapy, but often still lead to a complete tear later. It
depends on how big the tear is.”
My Response: I always thought that surgery was the only option for
any level of a rotator cuff tear.
6. What kind of exercises are the best for post-surgical rotator cuff
therapy?
“Immediately following surgery you would do passive range of motion to
maintain flexibility about the joint. This would be followed by active
range of motion and strengthening exercises after significant surgical healing
has occurred (typically 6-8 weeks).”
My Response: I didn’t know that there was a period of time when the
patient with the tear had to just do passive range of motion. I always
thought the patients could do active range of motion exercises right away after
surgery.
7. What are the complications patients experience post-surgery?
“They can experience frozen shoulder which is tightness of the muscles in the
shoulder due to immobility. If they are too aggressive early on they can
tear the surgical repair. There is also the possibility of infection.”
My Response: I didn’t know that there were risks on both sides of the
scale for recovery. If a patient doesn’t do enough exercises, they might
get frozen shoulder, and if a patient does too much in terms of exercise too
fast, they might re-tear their rotator cuff.
8. How long does it take for a full recovery after rotator cuff surgery?
“A full recovery, as with any orthopedic injury, is about 6 months for return
to most activities, and with full return to activities at one year.”
My Response: I didn’t know how long the full recovery was for rotator
cuff surgery. I always thought it was 6 months for full recovery.
9. What are some easy exercises people can do to strengthen the muscles to
prevent a tear?
“You can work internal and external rotation in the plane of the
scapula. Reverse rows are a good exercise to work these muscles. You
would not want to do overhead military presses. Tricep strengthening is a
good exercise.”
My Response: I never knew any specific exercises that specifically
targeted the muscles that need strengthening to prevent a rotator cuff
tear. It turns out I knew how to do these exercises, I just didn’t know
that they targeted those muscles.
10. Why do you like working with rotator cuff injury patients?
“They usually recover well and patients are motivated because they want to
enjoy the return of function in their upper extremity and shoulder.”
My Response: I have seen this in the outpatient rehab clinic. The
shoulder patients usually work hard to get back to a normal functioning
level. They also recover well after surgery.
1. Describe what a rotator cuff tear is:
“It usually comes about through a lifting-type injury, usually an acute tear
comes from someone with an outstretched arm lifting up and in front of the body.
The supraspinatus muscle is the most common to tear along with muscles that
attach in the anterior area of the shoulder.”
My Response: I did not know that many rotator cuff injuries come about
through lifting. I always thought these injuries came about through
overuse.
2. What is the difference between a rotator cuff tear and a strain/sprain of
the rotator cuff?
“A strain or sprain means that the muscles and tendons are still intact, and
a tear means there is a complete or partial rupture of the junction of the
muscle and the tendon or the muscle tears off the bone.”
My Response: I knew the general difference between a strain or sprain and a
tear, but I did not know there were different ways the rotator cuff could be
torn.
3. What categories or types of people are the most susceptible to rotator
cuff injuries?
“Pitchers, swimmers, gymnasts, as well as people that have jobs that require
repetitive and heavy lifting. You see more 40-60 year olds with rotator
cuff problems.”
My Response: I always thought tennis players were at a big risk for
rotator cuff injuries, but I learned that they are more prone to elbow
injuries. I also thought that people older than 60 would be more at risk
than 40-60 year olds.
4. What is the best prevention early in life?
“Using good ergonomics with lifting heavy objects or avoiding repetitive
activities that stress the shoulder/rotator cuff complex. One of the
biggest things is making sure the posterior rotator cuff and the scapular
stabilizing muscles are strong and allow for good, protective
co-contraction.”
My Response: I did not know which areas of the shoulder and back to
strengthen to prevent a rotator cuff tear. I didn’t know that the scapular
stabilizing muscles came into play as well.
5. What are the different treatment options for a rotator cuff tear?
“If it is a full tear, surgery is the only effective way to get return of
good function. Whereas partial tears could recover effectively with
physical therapy, but often still lead to a complete tear later. It
depends on how big the tear is.”
My Response: I always thought that surgery was the only option for
any level of a rotator cuff tear.
6. What kind of exercises are the best for post-surgical rotator cuff
therapy?
“Immediately following surgery you would do passive range of motion to
maintain flexibility about the joint. This would be followed by active
range of motion and strengthening exercises after significant surgical healing
has occurred (typically 6-8 weeks).”
My Response: I didn’t know that there was a period of time when the
patient with the tear had to just do passive range of motion. I always
thought the patients could do active range of motion exercises right away after
surgery.
7. What are the complications patients experience post-surgery?
“They can experience frozen shoulder which is tightness of the muscles in the
shoulder due to immobility. If they are too aggressive early on they can
tear the surgical repair. There is also the possibility of infection.”
My Response: I didn’t know that there were risks on both sides of the
scale for recovery. If a patient doesn’t do enough exercises, they might
get frozen shoulder, and if a patient does too much in terms of exercise too
fast, they might re-tear their rotator cuff.
8. How long does it take for a full recovery after rotator cuff surgery?
“A full recovery, as with any orthopedic injury, is about 6 months for return
to most activities, and with full return to activities at one year.”
My Response: I didn’t know how long the full recovery was for rotator
cuff surgery. I always thought it was 6 months for full recovery.
9. What are some easy exercises people can do to strengthen the muscles to
prevent a tear?
“You can work internal and external rotation in the plane of the
scapula. Reverse rows are a good exercise to work these muscles. You
would not want to do overhead military presses. Tricep strengthening is a
good exercise.”
My Response: I never knew any specific exercises that specifically
targeted the muscles that need strengthening to prevent a rotator cuff
tear. It turns out I knew how to do these exercises, I just didn’t know
that they targeted those muscles.
10. Why do you like working with rotator cuff injury patients?
“They usually recover well and patients are motivated because they want to
enjoy the return of function in their upper extremity and shoulder.”
My Response: I have seen this in the outpatient rehab clinic. The
shoulder patients usually work hard to get back to a normal functioning
level. They also recover well after surgery.