Rotator cuff tear 2010 found no solid evidence that rotator-cuff surgery benefited people more than nonoperative management. Those with pain but reasonably maintained function are suitable for nonoperative management. This includes oral medications that provide pain relief such as anti-inflammatory agents, topical pain relievers such as cold packs, and if warranted, subacromial corticosteroid/local anesthetic injection. An alternative to injection is iontophoresis, a battery-powered patch which "drives" the medication to the target tissue. A sling may be offered for short-term comfort, with the understanding that undesirable shoulder stiffness can develop with prolonged immobilization. Early physical therapy may afford pain relief with modalities (e.g. iontophoresis)
Mucous sheaths of the tendons around the ankle Mucous sheaths of the tendons around the ankle The mucous sheaths of the tendons around the ankle protect tendons in the ankle. All the tendons crossing the ankle-joint are enclosed for part of their length in mucous sheaths which have an almost uniform length of about 8 cm. each. On the front of the ankle the sheath for the Tibialis anterior extends from the upper margin of the transverse crural ligament to the interval between the diverging limbs of the cruciate ligament; those for the Extensor digitorum longus and Extensor hallucis longus reach upward to just above the level of