Rotator cuff injury may include tendinitis, strain, or tear of the rotator cuff. The rotator cuff is made up of muscles and four separate tendons that fuse together to surround the shoulder joint.
Rotator Cuff Injury
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Causes of a rotator cuff injury include:
Direct blow to the shoulder areaFalling on an outstretched arm
Chronic degenerative wear and tear on the tendons:
Arthritis may decrease the space for the tendonsChronic instability of the humerus may traumatize the tendons
Repetitive overhead motion of the arm such as in:
SwimmingBaseball (mainly pitching)Tennis
A risk factor is something that increases your chance of getting a disease or condition.
Risk factors for a rotator cuff injury include:
Age: 40 or olderHeavy liftingAbnormalities of the shoulder, or in rotator cuff anatomy or functionActivities that involve repetitive overhead arm motion such as throwing or work relatedWeakened shoulder muscles from inactivity or previous injury
Recurrent, constant pain, particularly when reaching overheadPain at night that prevents you from sleepingShoulder muscle weakness, especially when lifting the armPopping or clicking sounds when the shoulder is movedLimited range of motion in the shoulder joint
The doctor will ask about your symptoms and medical history. A physical exam will be done. The doctor will carefully examine your shoulder. You will be asked to move your shoulder in several directions.
Tests may include: Ultrasound
The treatment will depend on the extent of your injury, level of pain, and amount of immobility. The first step is usually a nonsurgical approach.
Rest—to help the shoulder heal. The doctor may recommend that you wear an arm sling to help rest the shoulder area.Nonsteroidal anti-inflammatory drugs (NSAIDs)—to help control the pain if there is inflammationTopical pain medicines (such as creams or patches) that are applied to the skinCorticosteroid injections—to help reduce swelling and painInjection of platelet rich plasma (PRP) to reduce bleedingIce—to help reduce swelling and pain. Apply ice to shoulder area for 15 minutes, 3 to 4 times a day.Physical therapy—to help strengthen and increase motion in the shoulder area
This involves surgery on the bony structures that impinge the rotator cuff. Surgery can be arthroscopic or open.
A small instrument is inserted into the shoulder and used to remove bone spurs or degenerated portions of the rotator cuff tendons. Lesser tears can be repaired during arthroscopy as well.
This combines arthroscopy with an incision in the shoulder joint. Through the incision, the doctor can suture larger tears in the tendons or muscles.
This is used to repair the injured tendon or muscle in more severe cases. A tissue transfer or a tendon graft can be done during surgery if the tear is too large to be closed together. In the most severe cases, a joint replacement may be necessary.
Depending on the extent of your injury, full recovery can take anywhere from two to six months, and sometimes longer.
If you are diagnosed with a rotator cuff injury, follow your doctor's
To reduce your chances of getting a rotator cuff injury:
Avoid overhead repetitive motionLimit duration of work that involves Moving hands above shouldersUsing shoulder in extreme outward rotationVibrating tools
Avoid heavy liftingExercise regularly to strengthen the muscles around the shoulder joint
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Last reviewed October 2012 by John C. Keel, MD
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.
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