Rotator cuff injury may include tendinitis, strain, or tear of the rotator cuff. The rotator cuff is made up of muscles and 4 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
Rotator cuff injury is more common in people 40 years and older. Other factors that increase your chance of a rotator cuff injury include:
Heavy liftingAbnormalities of the shoulder, or in rotator cuff anatomy or functionActivities that involve repetitive overhead arm motion such as throwingWeakened shoulder muscles from inactivity or previous injury
Rotator cuff injury may cause: 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
You will be asked about your symptoms and medical history. A physical exam will be done, paying particular attention to 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.
Nonsurgical approaches may include: Rest to help the shoulder heal; an arm sling may be advised to help rest the shoulder areaNonsteroidal anti-inflammatory drugs (NSAIDs) to control the pain and/or inflammationTopical pain relievers, such as creams or patches, that are applied to the skinCorticosteroid injections to help reduce pain and inflammationInjection of platelet rich plasma (PRP) to promote healingIce to help relieve pain and inflammationPhysical therapy to help strengthen and increase motion in the shoulder area
Acromioplasty is 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, larger tears in the tendons or muscles can be sutured.
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 2 to 6 months or longer.
To help reduce your chance a rotator cuff injury:
Avoid overhead repetitive motion.Limit duration of work that involves: Moving hands above shouldersUsing shoulder in extreme outward rotationVibrating tools
Avoid heavy lifting.Exercise regularly to strengthen the muscles around the shoulder joint.
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Last reviewed August 2015 by Warren A. Bodine, DO, CAQSM
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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