Introduction to the Rotator Cuff

According to the American Academy of Orthopaedic Surgeons, every year 2 million people in the United States visit their doctor because of a problem that is related to their rotator cuff. If you have not yet had a rotator cuff issue, consider yourself lucky and knock on wood. Because this injury is so common, you probably know of at least one friend, family member or acquaintance who has suffered from some level of rotator cuff pain. So, what is the deal with the rotator cuff and why does it get injured?

Rotator Cuff Anatomy

The rotator cuff is a collection of muscles and tendons that encompass your ball-and-socket shoulder joint (glenohumeral joint). It helps to control shoulder and arm movement, and stabilize your upper arm bone (the humerus) in your shoulder socket. There are four main muscles that make up the rotator cuff:

• Supraspinatus
• Infraspinatus
• Teres minor
• Subscapularis

Pain and Symptoms

Rotator cuff pain is never humerus (get it?). Pain occurs when an area of the rotator cuff is irritated or damaged. Playing sports, certain occupations, an accident or ageing are a few examples of what may cause rotator cuff pain. It is also possible for a rotator cuff injury to emerge for no apparent reason.

Symptoms of an injured rotator cuff may include:

• Shoulder Pain
• Trouble sleeping or lying down
• Clicking or popping
• Limited shoulder motion
• Shoulder weakness

Rotator cuff pain can cause daily activities to become strenuous. Putting a shirt on over your head or throwing a ball for your dog may become increasingly difficult if shoulder pain is left untreated. A rotator cuff injury may be acute or chronic. If the injury is acute, you will feel immediate pain in your shoulder. The pain will be sharp and intense, and may occur as a result of a single injury such as a fall. A chronic injury to the rotator cuff occurs gradually and over time. Repetitive motions or old age can lead to the degeneration of the tendons in the shoulder. If left untreated, symptoms of a rotator cuff injury can persist for months, and the pain usually becomes worse.

Rotator Cuff Irritation in Athletes

Athletes who are involved in sports that require repetitive overhead use of the arm are at risk of an injury to the rotator cuff. For example, baseball and tennis players make repetitive overhead arm motions while practicing and competing. It may be recommended that these athletes take preventative care to keep their rotator cuffs healthy and injury free. Wrestlers may also suffer from a rotator cuff injury as a result of the continuous strain of grappling, or if they fall on an outstretched arm during a take-down. Preventative actions such as strengthening exercises, proper form, rest, stretching and icing may help to reduce an athlete’s risk of a rotator cuff injury.

Strength and Flexibility

Strengthening the muscles in your shoulders is one way to prevent rotator cuff injuries in your future. Do your best to regularly perform a variety of exercises that strengthen the muscles in the upper arms, the back of the shoulders, around the shoulder blades and in front of the chest. Additionally, tight shoulder muscles do not function properly and may increase the risk of tear. Doing arm stretches or including yoga in your daily routine can help your shoulders stay flexible and contribute to better posture. Speak with your doctor or physical therapist to establish a training plan that works well for you.

Rotator Cuff Diagnosis

If you are suffering from persistent or severe shoulder pain, schedule an appointment with one of our experienced shoulder specialists. When you arrive for your appointment, you can expect your doctor to perform a physical examination and ask you a series of questions about your pain.

If needed, an MRI, MRA and ultrasound are useful adjuncts to a clinical exam for identifying rotator cuff tears or injuries.

Treatment Plan

It is tempting to ignore moderately painful aches in the shoulder and to continue on with your life as usual. However, moderate pain can gradually turn into severe shoulder pain that may adversely affect your daily life. Take control of your pain by seeking professional help. Your doctor will recommend a treatment plan that is best suited for you.

Examples of Rotator Cuff Injury Treatment Options

• Rest
• Cortisone Injection
• Pain Medication
• Physical Therapy
• Surgery

Many rotator cuff injuries can be healed with non-surgical treatment. However, If a patient has a severe rotator cuff injury or if conservative measures to treat the pain fails, surgery may be recommended.