Word: shoulders
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...phases. Ball throwing and racquet sports become uncomfortable but you can still manage to play - it's the pain later on, especially at night, that first brings the patients in. Overhead activities like putting up books or stacking dishes on a high shelf give the same hard-to-pinpoint shoulder and upper-arm pain. Cuff patients start avoiding movements that make them exert force at a distance from their bodies; fanning a blanket out over a bed, putting a child in a car seat, opening a window. There are, of course, some devoted athletes, who first complain, as Mr. Rumsfeld...
...have what Donald Rumsfeld has? A lot of folks do. Tearing and what's called "maceration" of the rotator cuff are the most common causes of chronic shoulder pain in adult Americans. I find them and other shoulder problems fascinating; this strangely tendon-wrapped joint has kept my professional interest level amazingly high for the 22 years that I've been doing orthopedics. So when, in the middle of doing an arthroscopic rotator cuff repair this morning, my trusty assistant Dave told me about Don Rumsfeld's repair, I knew I had to get the plain truth...
...shoulder is set up differently than any other joint. Whereas your hip can be likened to a ball in a socket (a cantaloupe in a bowler hat seems more apt) your shoulder, bone-wise is like a basketball on a tea-saucer. It has very little mechanical stability by virtue of its bony architecture. In other words, it would be always dislocated were it not for the soft tissues that surround it. Your shoulder moves more widely and in more different ways than any other joint in the body, yet it's very strong. The design feature that enables these...
...during the last presidential election) the cuff gets into trouble primarily because it doesn't have enough room; it gets rubbed on, abraded, sanded down, weakened and eventually torn by the undersurface of the bone ( the acromion) that you feel when you put your hand on top of your shoulder. This mechanism, called "impingement," is the initial culprit in most cases. It's probably not "the old high school football injury" coming back to plague you in your old age. Even folks who say their cuff was torn in a recent injury probably had a cuff that was already weakened...
...five years. Karzai's burdens are compounded by his isolation. He rarely leaves his compound, although he says he recently slipped out of the palace in an unmarked car to press the flesh in Kabul. For all his ebullience, he can't help sounding weary from having to shoulder so much of the responsibility, and the blame, for Afghanistan's turbulent rebirth. "Our expectations were too high. My own expectations were too high," he says. "We came, we thought the neighbors were going to be good with us, that terrorism was gone, that everybody was cooperating, that the little politics...