Rotator Cuff Injury
The rotator cuff is a set of four muscles and surrounding tendons that connect the humerus (upper arm bone) to the shoulder joint, allowing the arm to rotate and lift. Tears to the muscles or tendons in the rotator cuff can be partial or complete and can happen as a result of a sudden trauma or fall, or they can develop over time due to overuse.
What is a Rotator Cuff Injury?
The rotator cuff consists of four muscles that connect the bones in the shoulder, namely the humerus (upper arm) and the scapula (shoulder blade). Injury can occur to any one of the four muscles or to multiple muscles simultaneously, and can be the result of an acute injury that occurs suddenly or a chronic condition that repeatedly aggravates the area and causes pain and diminished mobility. When the rotator cuff is injured, it can result in anything from occasional pain and inflammation to a complete tear of the muscle, impeding movement of the arm. Depending on the cause and severity of the injury, treatment may vary widely.
What causes a Rotator Cuff Injury?
Since the rotator cuff is the main set of muscles that control movement of the arm, there are numerous situations that can cause injury to the area. Rotator cuff injuries can occur suddenly, and in this case the injury is considered acute. These are usually the result of a severe force resulting from a fall, lifting a heavy object, or moving the shoulder or arm suddenly in such as a way as to cause a trauma to the muscles. Rotator cuff injuries can also be more chronic in nature, resulting from repetitive or excessive movements that weaken the muscle structure over time, or can be the result of a degeneration of the muscles that can occur as a person ages. Injury to the rotator cuff can also be caused by tendonitis. Rotator cuff injuries are seen more often in men above the age of 40 (although tendonitis is more often seen in women), but can occur in anyone at any age, and injuries to the rotator cuff are more commonly seen in those with professions or hobbies that require repetitive shoulder movements.
What are the symptoms of a Rotator Cuff Injury?
The symptoms of a rotator cuff injury will vary depending on whether the injury is acute or chronic and can vary widely from person to person. Typically, if the injury occurs suddenly, such as with a fall or quick movement, there is a tear or partial tear of the muscle which can sometimes be felt, followed by sudden and severe pain. Limited motion, tenderness, muscle spasm and an inability to raise the arm out to the side may also occur in addition to pain. If the injury is a result of chronic or long term causes, symptoms will occur more gradually. Pain will gradually increase over time and is usually worse at night, possibly enough to interfere with sleep. Weakness will develop along with decreased mobility or the inability to lift the arm out to the side or high up in the air. If the injury results from tendonitis, it will usually result in tenderness or a deep aching sensation felt in the shoulder and the upper arm. Pain will increase over time and will be worse when lifting the arm up to the side.
How is a Rotator Cuff Injury diagnosed?
A rotator cuff injury is diagnosed by a medical professional based on the description of symptoms a patient describes, as well as a physical examination and a complete medical history. A patient will be asked to move the arm and shoulder in a variety of different ways and the doctor will manually feel for tenderness, swelling, or deformity. An evaluation of sensation levels along the arm will also be performed. The patient’s range of motion will be evaluated based on passive and active movement, unless there is any suspicion of a broken bone. Any of a number of tests may be performed to clarify a correct diagnosis, including an x-ray, MRI, ultrasound, arthrogram, drop arm test, or impingement injection test. Some tests will not be performed unless initial treatment is unsuccessful in improving the injury.
When should I seek care for a Rotator Cuff Injury?
Any time you experience severe, worsening or prolonged shoulder pain that has not been previously diagnosed, it is best to consult a medical professional. If you experience an acute injury in which you cannot move your arm or shoulder, or have sudden or extreme pain, you should seek medical attention immediately. Otherwise, if you have pain that gradually worsens or limits your ability to perform everyday tasks, you should seek medical advice so that any underlying injury can be addressed and treated before it causes more severe or permanent damage.
What will the treatment for a Rotator Cuff Injury consist of?
The treatment for a rotator cuff injury will depend in part on the extent of the injury and its cause. In most cases, a patient will be instructed to apply ice to the area periodically during the first two days, rest the arm and shoulder (usually placing the arm in a sling), and take nonsteroidal anti-inflammatory medications to reduce pain and swelling. Heat may be helpful following the two days of ice application. If pain persists, steroid injections may be given in the shoulder joint and physical therapy is recommended. If pain doesn’t subside or an acute tear is determined, surgery may be recommended. Surgery is more likely if the muscle is completely torn, the injury doesn’t improve after six weeks of treatment, or the patient requires constant use of his or her shoulder for work.
Which muscle groups/ joints are commonly affected from a Rotator Cuff Injury?
The rotator cuff consists of a set of muscles and tendons that control movement in the shoulder and arm. When injured, a patient will have pain in the shoulder and upper arm and may have difficulty moving the arm or shoulder, or may lose partial or full range of motion.
What type of results should I expect from the treatment for a Rotator Cuff Injury?
With proper treatment, the rate of success following a rotator cuff injury will depend in part on the extent of the injury and the age of the person, as will the length of time it takes to fully recover. The non-surgical success rate is typically in the neighborhood of 40 – 90%. When surgery is indicated, it is typically very successful in alleviating pain and improving motion and performance, as long as an effective course of physical therapy treatment is followed after the surgical procedure.