Rotator Cuff Injury

What is Rotator Cuff Injury?

The rotator cuffs a set of four muscles/tendons in the shoulder. The four tendons are - the infraspinatus, the subscapularis, the teres minor, and the supraspinatus. Together these four stabilize our shoulder joints, helping us perform various arm movements. Mainly, it helps us lift and move our arms away from our bodies. The rotator cuff essentially connects the shoulder blade socket with the numerus (the ball of the upper arm bone). Together, they form the ball-and-socket joint that we call the shoulder.

This part of the skeletal system is prone to injuries. In fact, the rotator cuff is constantly prone to degeneration, inflammation, and trauma. That’s why rotator cuff injury is one of the most common sources of shoulder pain. When the four tendons tug away from the arm bone, they tear. These tears can only be confirmed by radiology testing. Treatment varies from individual to individual and depends on how severely damaged the four tendons of the rotator cuff are.

This condition can be caused by repetitive strains or acute injuries. There are two types of tears - incomplete or partial tears and full-thickness or complete tears. With partial tears, the tendons stay somewhat attached to the arm bone. Such patients can experience some mobility and motor functions. But, with complete tears, the tendons rip apart completely from the shoulder bone. Such patients require immediate physiotherapeutic attention.

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The rotator cuffs a set of four muscles/tendons in the shoulder. The four tendons are - the infraspinatus, the subscapularis, the teres minor, and the supraspinatus. Together these four stabilize our shoulder joints, helping us perform various arm movements.

Symptoms of Rotator Cuff Injury

There are no symptoms of sudden tears. Accidents involving the shoulder cause rips to the tendons almost immediately. With degenerative tears, patients experience mild pain that intensifies over time. Pain relievers don’t help, and patients suffer from shoulder weakness all the time. Some other common symptoms of rotator cuff tears include:

  • Partial loss of motion in the arm/shoulder.
  • Persistent pain in the upper arm, especially when lying or resting on the affected arm.
  • Pain when moving the shoulder in certain ways.
  • Snapping, crackling, popping, or clicking sensations and sounds when moving the shoulders.
  • Difficulty in raising the arm.
  • Inability to lift items.

Causes of Rotator Cuff Injury

Severe accidents, such as sports injuries or falls, can cause tears to the rotator cuff. However, the more common cause of these injuries is degeneration. As the tendon wears down over time with age and repeated use, it experiences degenerative tears. That’s why people over 35 are at high risk of experiencing such injuries.

  • Overuse – Constant shoulder movements during physical activities stress the muscles and tendons, causing tears in the rotator cuff. That’s why professionals like carpenters, mechanics, warehouse operators, etc., often pick up this condition. The same applies to recreational and professional athletes.
  • Bone Growth - Abnormal bony growths in the shoulder rub against the tendons, creating unnecessary friction whenever patients lift their arms. This friction eventually causes partial or complete tears.
  • Blood Disease - Blood flow to our shoulder regions decreases and becomes less healthy with age. Without proper blood supply to nourish themselves, the tendons suffer, and they can tear. That’s why people who have family histories of blood or shoulder problems are at high risk. The same applies to smokers and senior citizens.

When to See a Physiotherapist to Fix Rotator Cuff Injury?

Patients must see a licensed physiotherapist or a healthcare provider if they experience these symptoms:

  • Chronic pain in the shoulders/arms.
  • Pain that impacts rest or sleep.
  • Swelling or weakness in the shoulder joints.

A top physiotherapist should be able to -

  • Discover the potential causes of the rotator cuff tears.
  • Understand whether it’s a partial or complete tear.
  • Recommend the best surgical and nonsurgical treatments.
  • Advice on how to lower the risk of worsening the rotator cuff tear.
  • Prepare for potential signs of complications (e.g., frozen shoulder)

Rotator Cuff Injury – Key Risk Factors and Complications 

The risk of picking up this injury/condition increases a lot when you participate in activities that involve sudden, strenuous movements of the shoulder. For example, if you’re taking heavy luggage off of racks after months of physical inactivity, you can damage your rotator cuff. Here are the key risk factors and complication risks –

  • Rotator cuff tears and injuries become worse without treatment.
  • Complete tears make it impossible for patients to move their arms.
  • Without treatment, chronic shoulder pain can lead to adhesive capsulitis or frozen shoulder.
  • Adhesive capsulitis patients lose their range of motion, and their shoulder joints become almost unusable.
  • Tears mostly occur on the patient’s dominant shoulder (left or right side). But having tears in one shoulder amplifies the chances of picking up tears in the opposite shoulder.

How to Prevent Getting Rotator Cuff Injury?

The easiest way to avoid suffering from this injury/condition is always keeping your muscles/tendons flexible via stretching and strengthening exercises. You can cure rotator cuff tears with nonsurgical treatments. You can also prevent picking up such injuries by leading a healthy and calculated life.

Treatments for Rotator Cuff Injury

Treatments vary depending on the patient’s history of physical activities and the types of symptoms they experience in their shoulders.

  • Healthcare providers perform physical exams to check the range of motion, extent of the tear, etc.
  • To confirm diagnoses and locate tendon tears, healthcare providers conduct X-ray tests, MRI scans, and ultrasound tests.
  • Patients can decrease pain and improve their shoulders’ functionally with the help of nonsurgical treatments. Some treatments include: using arm slings, taking anti-inflammatory drugs, steroid injections, and physical therapy.
  • Healthcare providers recommend surgery only for complete tears. For extremely serious tears (e.g., the patient has athletic commitments), doctors may recommend reverse shoulder replacements, tendon transfers, and other complex surgical procedures.

Related Conditions

This condition qualifies as a tendon injury. To be specific, a rotator cuff injury is technically “tendinosis.” In tendinosis, overuse causes tiny tears in the tissues in and around the tendons. Similar conditions include - frozen shoulder, Achilles tendinitis, and Osteoarthritis.

Frequently Asked Questions

1. What are the home remedies for these injuries?
If you have mild pain in the shoulder, apply cold packs. Take organic anti-inflammatory medications, get a lot of rest, and avoid reinjuring the shoulder.
2. What specialists treat this condition?
General practitioners, orthopedic surgeons, rheumatologists, and physiatrists are all qualified to treat this condition. Physical therapists also frequently help patients who suffer from these types of injuries.
3. Do I need surgery?
Surgery is never the first recommendation that doctors make. They only discuss surgery with patients who experience long-standing pain even after months of physical therapy.

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