The rotator cuff, which is located in the shoulder, is made up of four muscles and tendons that connect the humerus (large bone of the upper arm) to the scapula (shoulder blade): supraspinatus, infraspinatus, teres minor, and subscapularis muscles. Together, the tendons and muscles work to assist with stabilization of the shoulder during movement, as well as rotation of the upper extremity. Injuries to the rotator cuff are caused by repetitive, overhead motions, traumatic injuries and age-related wear and tear. Due to decreased blood supply, rotator cuff injuries may require increased time for healing.
Falls and heavy overhead lifting may cause acute/sudden injury of the rotator cuff. Repetitive overhead movements from activities, such as painting and overhead sports (baseball, swimming, tennis), increase the risk of developing this condition over time. Prolonged heavy lifting and the formation of bone spurs around the shoulder may also irritate and damage the tendon, resulting in injuries to the rotator cuff. Additionally, muscles of the rotator cuff degenerate because they have become worn out from use. Injuries to the rotator cuff as result of the above situations include:
- Rotator Cuff Tear: Injury to the muscles of the rotator cuff occurs because they are weakened by sudden trauma, repetitive motions, and/or age. Identified because of pain and weakness in the arm, a tear is classified as partial or full-thickness.
- Rotator Cuff Tendonitis: A repetitive strain injury, this can also be painful.
- Rotator Cuff Impingement: Due to a narrowing of space during overhead motions, the rotator cuff tendons get stuck between the humerus and another bone, the acromion. Repetitive movements cause inflammation and pain, as the bone continuously rubs against the tendons.
Symptoms of rotator cuff injury may include limited range of motion in the shoulder, pain that worsens as the arm is lifted, weakness and tenderness in the shoulder, pain that radiates down the arm towards the elbow, cracking sounds when moving the arm, and pain when sleeping on the affected shoulder. Diagnosis of a rotator cuff injury is done through physical examination and imaging tests, including X-ray, MRI and ultrasound.
Treatment options for rotator cuff injuries vary, based on the extent of the damage. Conservative, non-surgical options are used to treat partial tears and include rest, pain relieving medications, steroid injections into the shoulder joint, range of motion exercises, and physical therapy. The healing regimen for moderate cases of rotator cuff injuries includes immobilization, anti-inflammatory medications, and cold therapy. More severe rotator cuff injuries, such as full-thickness tears, may require surgery to repair the rotator cuff.