Rotator Cuff Injury
The rotator cuff (not rotary cuff nor rotator cup) is a group of muscles and tendons that surround the shoulder joint. They play a vital role in holding the upper arm bone (humerus) in the socket of the shoulder (glenoid fossa of the scapula). Rotator cuff injury can occur as a result of trauma, such as a motor vehicle accident or fall. Rotator cuff injuries also occur due to degeneration, especially in people who repeatedly perform overhead motions in their sports or occupation. People very susceptible to rotator cuff injury include painters, carpenters, baseball players, and tennis players, however, injuries to the casual landscaper, frequent traveler, or do-it-yourselfer are common. The risk of developing a rotator cuff injury has been found to increase over the age of 40.
Your physician my order an x-ray or an MRI. X-rays are helpful in identifying bone abnormalities such as spurs and fractures. MRIs are helpful for identifying the soft tissue of the shoulder including the size and location of a tear.
Symptoms and Causes of Rotator Cuff Injury
The most common symptoms of a rotator cuff tendon tear are described as:
- Shoulder pain at rest and at night, particularly when lying on the injured shoulder
- Arm weakness
- Crackling sensation, also known as crepitus, when performing particular shoulder movements
- Difficulty with activities of daily living such as combing your hair and washing behind your back
Tears that happen suddenly, especially from falls on an outstretched arm or lifting something too heavy, will cause intense pain. You may experience a snapping sensation, weakness in the upper arm, or the loss of being able to raise your arm overhead. Seek medical attention with your physician for these situations immediately.
Most rotator cuff tears occur due to degenerative conditions, especially in your dominant arm. There are multiple factors that can contribute to degenerative/chronic rotator cuff tears.
- Repetitive stress: Overuse and repetitive movements places significant stress on the rotator cuff muscles and tendons. Sports injuries such as baseball, tennis, rowing, and weightlifting put you at risk for overuse tears. Many jobs or routine chores can also increase the likelihood of overuse tears, as well.
- Lack of blood supply: Rotator cuff tendon tears can occur as we get older due to a reduction in blood supply. Lacking a good blood supply, the body’s natural ability to repair damage is reduced.
- Bone spurs: The formation of bone overgrowth frequently occurs on the underside of the acromion bone as we age. When you lift your arm, the spur rubs on the rotator cuff tendon. This creates a condition called shoulder impingement, and over time, this increases the likelihood of a rotator cuff tear.
Ignoring your pain can lead to permanent joint stiffness and further progression of degeneration in the shoulder joint. While resting your shoulder is important for healing, keeping the shoulder immobile for an extended period of time can result in adhesive capsulitis, also known as frozen shoulder.
Can Therapy Heal My Shoulder?
It is reported that in about 80% of patients, non-surgical treatment can relieve pain and improve function in the shoulder. Non-surgical treatment options include:
- Activity modification
- Non-steroidal anti-inflammatory medication (NSAIDs)
- Strengthening exercises and physical or occupational therapy
- Steroid injection
The advantages of non-surgical treatment is that you avoid the major risks of any surgery, such as infection, permanent stiffness, anesthesia complication, and a lengthy recovery time. Disadvantages may be that the tear can increase in size over time and activities may be limited.
If surgery has been scheduled, we recommend you discuss the benefits of a prehab program with your physician. We treat both pre- and post-surgical cases of rotator cuff injury. Shoulder conditions are treated at Synergy Health and Wellness by our Doctors of Physical Therapy and Occupational Therapist. We utilize a program of manual therapy, postural training, kinesiotaping, therapeutic exercise, pain management, and patient education, in order to help you achieve your greatest results. Contact us today to learn how we can help you with your rotator cuff injury.