💥My Doctor Says...(附中文) “First Episode: Hole in my rotator cuff” - 🤔 One of the common myth my patients like to tell me is they underwent several tests at the doctor. And the doctor said, ‘ there is a hole in your rotator cuff’. The doctor gave a steroid injection and tell them to go home and rest. Have you had any kind of experience like that? - 👨🏻‍⚕️ The shoulder joint is encapsulated with muscles, tendons and ligaments. Stability of the shoulder joint comes primarily from the rotator cuff. During any dynamic overhead movement the rotator cuff works in co-contraction to prevent excessive intra-articular translation within the ball-and-socket space. Repetitive use of the tendon will cause it to tear slightly. Just like myofibril micro-tear after weight training - 🧠 The term ‘a hole in your rotator cuff’ often scare patients and put them in a mind-boggling state. The job is left to the physio to address both mental and physical reassurance. Find the moderate loading through rehab exercises can save you from a steroid injection. Having a hole 🕳 in the rotator cuff is not equivalent to complete disuse of the shoulder - Thanks to @adammeakins for inspiring ———————————————— 💥我的醫師說... “第一集：肩膀破了一個洞” - 🤔 很常聽到病人說，我去找醫師照了一個什麼，醫師說我旋轉肌破了一個洞，然後打了一針，可是到現在都還沒有好。 不知道你是不是也有類似的經驗呢？ - 👨🏻‍⚕️ 肩關節是由肌肉、韌帶、滑囊等軟組織保護著，其中最重要的肌肉為四條旋轉肌：棘上肌、棘下肌、肩胛下肌、小圓肌，在肩關節做出過頭推舉的動作時旋轉肌會透過共同收縮，來維持肩關節的穩定性。訓練量增加、動作錯誤等等則會增加旋轉肌的耗損，就等同一週內多次訓練同一部位，導致肌纖維的微撕裂一樣。因此旋轉肌或肌腱，也終會有耗損的一天 - 🧠 那會好嗎？那個洞會補起來嗎？當然會。那一定需要打針才會好嗎？那不一定。我個人不反對病人找醫師打針，兩種情況：一，急性發生，真的很痛；二，做了物理治療，很久都沒有好。恢復狀況當然跟訓練量、訓練種類、年齡有關，不過很常是因為病人根本沒有執行治療性運動，只希望打針就會好，做電療就會好 - 📌 給予「破洞」 🕳 的肌腱適當的負重訓練，才是治本之道。如果狀況不太嚴重，便去打針，有點本末倒置。就如破洞的地墊不代表就不能用，破洞的肩膀不代表就要停止訓練 - #jamesthephysio signing out