There are two bony protrusions called coracoid and acrominon located on the upper part of the shoulder head and a strong bridge-shaped ligament between them. The muscles that lift the shoulder head sideways with a lever-like movement and move it inwards and outwards are damaged by rubbing against the ligament above during movement. . This condition occurs as pain and limitation of movement in situations that require you to bring your hand over the head.
Symptoms: The most characteristic symptom of this syndrome is pain when the shoulder muscles rub under the belt when lifting the arm to the side, especially between 70 and 110 degrees. When the arm is raised more than 110 degrees, the pain disappears as friction disappears. This condition is seen in the early stages of the disease. However, if a large tear and bleeding has occurred in the muscles due to long-term exposure to this friction, the pain may continue at rest and may wake up from sleep.
Stages of the Disorder:
Stage 1 (Edema and Bleeding Stage): Excessive friction occurs due to overuse in sports such as tennis, swimming and weight lifting. As a result, edema and bleeding develop. At this stage, special movement examinations and local anesthetic injection tests are performed by the Orthopedist to distinguish the disease from other shoulder disorders. If the pain disappears with the injection, the problem is in that area. This stage of impingement syndrome is generally seen between the ages of 20-25.
Rest is given. If there is no mania due to chest diseases, cold can be applied. Anti-inflammatory drugs are prescribed. The arm is partially rested. Movements on the horizontal plane are avoided. Movement is maintained with stretching and strengthening movements in order not to cause frozen shoulder by leaving the shoulder completely immobile. The person, and especially the athlete, is taught which movements can cause friction. Simple measures such as using the monitor at eye level and reducing the inclination on the shoulder with an upright sitting position are beneficial. For example, turning the body sideways towards the court while serving in tennis reduces friction.
Stage 2 (Scabbing and Tendon Hardening) Long-term recurrent bleeding and edema due to friction harden over time, creating a hard tissue resembling a scab in the injury area. This this new thing at once The hard and thick scar tissue causes compression in the friction area. Thus, friction causes the wound, and the newly formed scar causes friction, creating a vicious circle. This stage of compression usually occurs between the ages of 25-40.
The problem is now chronic and does not heal with non-invasive treatment. Tissues and tissues that have thickened with the arthroscopic method, that is, the surgeries performed with a camera by entering two or three 1cm holes and The ceiling causing friction is cleaned. Then, stretching and strengthening exercises are given.
Stage 3 (Bone Protrusions and tendon ruptures) At this stage, bone protrusions in the form of calcification develop on the worn surfaces. The muscle called supraspinatus, which lifts the shoulder head upward, wears out due to friction and ruptures occur. This stage is seen over the age of 40.
The treatment is surgery. Arthroscopic tendon repair and thinning of the bone tissue in the ceiling are performed. Using special techniques, the ends of the broken tendon are stitched to the threads of the screw driven into the shoulder bone by a closed method. By thinning the bone roof thickness, re-wear of the repaired tendon is prevented by friction. In elderly patients, even if the ruptured tendon is stitched, it may be deteriorated enough to rupture again. In such cases, only cleaning surgery or even shoulder prosthesis surgery can be performed in advanced stages.
Read: 0
