Definition

The rotator cuff is a group of muscles and tendons that surround and attach the bones of the shoulder joint, keeping it stabilized. Above the rotator cuff, there is a sac of tissue called bursa that shields the rotator cuff as it comes into contact with bones around the shoulder. When the rotator cuff is damaged or injured, it leads to inflammation of the bursa which in turn can cause pain in the shoulder and loss of motion.

Rotator cuff injuries most often occur in individuals who are constantly active and go through repetitive movements in their jobs or during participation in contact sports. Examples include carpenters, swimmers, football players, baseball players, tennis players and others.  

Treatment options for rotator cuff injuries typically involve taking anti-inflammatory medications and injections and going to physical therapy to improve flexibility and strengthen muscles surrounding the shoulder joint.  Surgical repairs, transfer of alternative tendons or joint replacement are also options to be considered if the injury is more severe.  

 

Symptoms

Common signs and symptoms of rotator cuff injuries include:

  • Pain in the affected shoulder
  • Weakness and tenderness in the shoulder
  • Swelling in the tendons of the rotator cuff
  • Snapping or crackling sound in the shoulder joint
  • Limited arm movement
  • Feeling of instability
  • Sleep disturbances

Symptoms may worsen in certain positions such as reaching backwards with the arm ( brushing the hair, fastening a seat belt, or picking up heavy objects) as well as during participation in overhead activities such as throwing or pitching a baseball and playing tennis.

 

 

Causes

Rotator cuff injuries may be a result of either an extensive injury to the shoulder such as from repetitive movement (heavy lifting, involvement in contact sports, construction work, falling on the shoulder) or due to aging and deterioration of the tendon tissue. The development of bone spurs in the bones around the shoulder may irritate or damage the tendon, in turn causing pain and loss of motion in the shoulder joint.

 

Risk factors

A few factors that can increase the risk of having a rotator cuff injury include the following:

·         Being of older age (most common in individuals over the age of 40)

·         Participating in certain sports (baseball, tennis, swimming, archery)

·         Being involved in construction work (carpentry, house painting)

·         Having a family history of rotator cuff injuries

 

Complications

Left untreated, possible complications that can arise from a rotator cuff injury include the following:

·         Permanent hardening or weakness of the shoulder joint

·         Progressive degeneration of the shoulder joint

 

Treatment

 Treatment for  a rotator cuff injury depends on age of the individual, their health, how severe the injury is, and how long ago the injury occurred. Treatment options may include:

  • Taking anti-inflammatory medications and injections to provide pain relief and decrease inflammation
  • Resting the joint as much as possible (wearing a sling if necessary)
  • Icing the shoulder two to three times a day
  • Performing range of motion exercises at home
  • Going to physical therapy in order to improve mobility and strengthen shoulder muscles
  • Surgery, if necessary: arthroscopic tendon repair, open tendon repair, bone spur removal, tendon transfer and shoulder replacement