Rotator Cuff Injury

WHAT IS IT?

A rotator cuff is a group of muscles and tendons that surround the shoulder joint, keeping the head of your upper arm bone firmly within the socket of the shoulder.

The pain associated with a rotator cuff injury may begin as a dull ache deep in your shoulder and become more severe. It may disturb your sleep, particularly if you lie on or move the affected shoulder. You may find it difficult to reach above your head or behind your back.
Rotator cuff injuries commonly result from:

• Falling. Using your arm to break a fall or falling on your arm can bruise or tear a rotator cuff tendon or muscle.
• Lifting or pulling. Lifting an object that’s too heavy or doing so improperly can strain or tear your tendons or muscles.
• Repetitive stress. Repetitive overhead movement of your arms can stress your rotator cuff muscles and tendons, causing irritation, inflammation, and tearing.
• Bone spurs. An overgrowth of bone can occur on a part of the collarbone that protrudes over the rotator cuff, irritating and damaging the tendon.

TREATMENT

Conservative care is often all that’s needed to treat an irritated tendon. Other options exist for tears and more severe damage.

Conservative care
Try these steps:

• Rest your shoulder. Avoid painful movements and limit heavy lifting or overhead activity until your shoulder pain subsides.
• Apply ice and heat. Use a cold pack 15 to 20 minutes every three or four hours. When the inflammation and pain have improved, hot packs or a heating pad may relax tight muscles.
• Take pain relievers.

Medication

If conservative treatments don’t help, your doctor might recommend a corticosteroid injection into your shoulder joint. While such shots are often helpful, if administered too frequently they can contribute to weakening of the tendon.

Therapy

Physical therapy can help restore flexibility and strength to your shoulder after a rotator cuff injury. Most people exercise the front muscles of the chest, shoulder and upper arm, but it’s equally important to strengthen the muscles in the back of the shoulder and around the shoulder blade.

Surgery

Options may include:

• Bone spur removal. The excess bone may be removed and the damaged portion of the tendon smoothed.
• Tendon repair or replacement. A torn rotator cuff tendon may be repaired and reattached to the upper arm bone. If the torn tendon is too damaged for reattachment, a nearby tendon may be used as a replacement.
• Shoulder replacement. Severe injuries associated with arthritis of the shoulder may require shoulder replacement surgery.

Excerpt From: The Mayo Clinic. “Mayo Clinic A to Z Health Guide”.