ROTATOR CUFF INJURY
A rotator cuff injury is a damage to any of the tendons of the four rotator muscles of the shoulder.
- A rotator cuff is a group of four muscles that come together as tendons to surround the shoulder, stabilize the shoulder joint and allow lifting and rotation of the arms.
- Every time the shoulder is moved, you are using the rotator cuff to stabilize and help move the joint.
- This damage can cause significant pain and disability with a decreased range of motion and use of the shoulder joint. This means that many daily activities, like combing the hair or getting dressed may be painful
- The four rotator cuff muscles include the supraspinatus, infraspinatus, subscapularis, and teres minor.
- Most injury or tear occurs in the supraspinatus tendon, but other parts of the rotator cuff may also be involved.
- A rotator cuff injury is one of the common conditions affecting the shoulder.
- There are two types of tear: a partial tear and a complete or full-thickness tear.
- A partial tear occurs when the tendon that protects the top of the shoulder is damaged or frayed but it’s not completely severed.
- A complete tear goes all the way through the tendon or separates all of the tendons from the bone
- Without treatment, rotator cuff injury can lead to permanent loss of motion or weakness and may result in progressive degeneration of the shoulder joint.
CAUSES
Rotator cuff injury can be caused by:
- An acute injury such as falling on an outstretched arm, lifting an object that is too heavy with a jerking motion.
- Lack of blood supply to the rotator cuff. As we age, the blood supply in our rotator cuff tendons lessens.
- Bone spurs that may develop as we age.
- Repetitive stress such as repeating the same shoulder motions again and again.
Certain factors that may increase the risk of getting a tear:
- Aging, people over 40 are at greater risk
- Certain sports that involve repetitive arm motion such as baseball, tennis, rowing, and weightlifting.
- Occupations that involve overhead work such as carpentry, painting.
- A family history.
SYMPTOMS
- Difficulty sleeping on the affected shoulder
- Pain in the shoulder, especially at night.
- Dull ache deep in the shoulder
- Difficulty reaching full range of motion such as combing hair or reaching behind the back
- Progressive weakness of the shoulder
DIAGNOSIS AND TREATMENT
To make a diagnosis, the doctor will perform a physical exam. During the physical exam, the doctor press on different parts of the shoulder as well as move your arm into different positions. The doctor will test the strength of the muscles around your shoulder and arm. The doctor may question you about physical activities at the workplace, this will help him determine if there is an increased risk for a degenerative condition.
Imaging scan such as X-ray can help visualize bone spur. A bone spur can rub against the rotator cuff tendon causing pain and inflammation.
Ultrasounds and MRI scan can help to visualize the muscles and tendons and the structures of the shoulder in great details.
TREATMENT
Mild cases can be treated with rest, ice and physical therapy. If these treatments do not work, the doctor can recommend:
- A steroid injection into your shoulder joint, especially if the pain is interfering with sleep, exercise, or daily activities.
- Physical therapy
- Surgery such as arthroscopic tendon repair, open tendon repair, tendon transfer, or shoulder replacement.