Rotator Cuff Injury

What is a Rotator Cuff?

The rotator cuff is a group of four muscles and their associated tendons in the shoulder that play a crucial role in stabilizing and providing mobility to the shoulder joint. These muscles and tendons work together to allow you to lift and rotate your arm. The four muscles that make up the rotator cuff are:

  1. Supraspinatus: This muscle helps initiate the abduction of the arm (lifting it away from the body) and stabilizes the head of the humerus (the upper arm bone) in the shoulder socket.
  2. Infraspinatus: This muscle is responsible for the external rotation of the arm, which allows you to turn your arm outward.
  3. Teres Minor: The teres minor muscle also contributes to the external rotation of the arm and helps with various arm movements.
  4. Subscapularis: This muscle enables internal rotation of the arm and helps to hold the head of the humerus in the shoulder socket.

The tendons of these muscles connect to the head of the humerus and form a cuff-like structure that encircles the shoulder joint, thus giving rise to the name “rotator cuff.” The rotator cuff is essential for shoulder stability and function, especially during activities that involve overhead arm movements, such as throwing, lifting, and reaching.

Injuries to the rotator cuff are common and can result from overuse, trauma, or age-related wear and tear. Rotator cuff injuries can cause pain, weakness, and limited range of motion in the shoulder and may require medical attention, including therapy or, in some cases, surgical intervention to repair the damaged tendons or muscles.

If you have a question about whether your condition should be treated by one of our hand therapists, call Restored Hope Hand Therapy at (928) 275-2201.

Risk Factors & Causes

Rotator cuff injuries can occur for various reasons, and they are often associated with a combination of factors. The most common causes of rotator cuff injuries include:

  • Overuse: Repetitive overhead arm movements, such as those performed in sports like baseball, tennis, and swimming, or in occupations like painting or construction, can lead to overuse injuries. Over time, the repeated stress on the rotator cuff tendons can cause them to become inflamed or damaged.
  • Trauma: A sudden injury, such as a fall onto the shoulder or a direct blow to the shoulder, can damage the rotator cuff. Traumatic injuries can range from mild strains to severe tears in the tendons.
  • Age-related degeneration: As people get older, the tendons of the rotator cuff can naturally degenerate and weaken. This age-related wear and tear can make the tendons more susceptible to injury, even with minor stress or trauma.
  • Poor posture: Maintaining poor posture, especially when sitting at a desk or using a computer for extended periods, can put excessive stress on the shoulder and contribute to rotator cuff problems.
  • Muscle imbalances: Weakness or imbalances in the muscles surrounding the shoulder can lead to abnormal mechanics and increased strain on the rotator cuff tendons.
  • Inadequate warm-up and stretching: Failing to properly warm up and stretch the shoulder muscles before engaging in physical activities can increase the risk of rotator cuff injuries.
  • Genetic factors: Some individuals may be genetically predisposed to certain shoulder conditions that can increase the likelihood of rotator cuff problems.

Common Symptoms

Common symptoms of a rotator cuff injury can vary depending on the severity and nature of the injury. The most typical symptoms include:

  • Shoulder pain: Pain is the most common and noticeable symptom of a rotator cuff injury. The pain is often located at the front or side of the shoulder and can radiate down the arm. It may be described as a dull ache, a sharp pain, or a constant discomfort. The pain may worsen with specific movements or when lying on the affected shoulder.
  • Weakness: A rotator cuff injury can lead to weakness in the affected shoulder. You may find it difficult to lift or move your arm, especially when performing overhead activities.
  • Reduced range of motion: Limited mobility is a common symptom. You may have difficulty raising your arm, reaching behind your back, or performing other shoulder movements. This limitation in range of motion can be due to pain and muscle weakness.
  • Pain at night: Rotator cuff pain often becomes more pronounced at night, making it difficult to sleep on the affected side.
  • Clicking or popping: Some individuals may experience clicking or popping sounds when moving their shoulder, which can be a sign of a rotator cuff injury.
  • Instability: In some cases, a rotator cuff injury can lead to a feeling of shoulder instability, as if the joint is not properly supported.
  • Gradual onset of symptoms: While traumatic injuries can result in sudden and severe symptoms, rotator cuff injuries can also develop over time, with symptoms starting off mildly and worsening gradually.
Rotator cuff repair after surgery (3D model)

Rotator Cuff Tendinitis or Shoulder Impingement

Rotator cuff tendinitis and shoulder impingement are related shoulder conditions, and they often coexist, but there are some key differences between the two:

Rotator Cuff Tendinitis (Tendonitis):

  • Rotator cuff tendinitis refers to inflammation of the tendons of the rotator cuff muscles. It is often an early stage of rotator cuff injury and can progress to more severe issues if left untreated.
  • It typically involves irritation and inflammation of the tendons due to overuse or repetitive movements, such as those in sports or jobs that involve overhead motions.
  • Common symptoms of rotator cuff tendinitis include shoulder pain, especially when lifting the arm or reaching overhead, and sometimes weakness.
  • Tendinitis is primarily an inflammatory condition, and treatment often includes rest, ice, anti-inflammatory medications, and physical therapy to reduce inflammation and strengthen the shoulder.

Shoulder Impingement:

  • Shoulder impingement, on the other hand, refers to a mechanical issue in which the structures in the shoulder (often the acromion, a bony projection of the shoulder blade) impinge or pinch the rotator cuff tendons as the arm is raised.
  • Impingement can result from anatomical factors, such as the shape of the acromion, or it may be caused by muscular imbalances or poor posture.
  • Common symptoms of shoulder impingement include pain, especially when raising the arm, and reduced range of motion due to the impingement of the tendons as they pass through the subacromial space.
  • Treatment for impingement often involves addressing the underlying cause, which may include physical therapy to improve shoulder mechanics, exercises to strengthen the rotator cuff muscles, and in some cases, modifying activities that exacerbate the condition. Anti-inflammatory measures may also be used to manage associated inflammation.

Non-Surgical Treatment

Nonsurgical treatments for rotator cuff injuries are often the first line of management and can be effective in relieving pain, improving function, and promoting healing. The choice of treatment depends on the severity of the injury, the individual’s symptoms, and the recommendations of a healthcare professional. Some common nonsurgical treatments that we may perform at Restored Hope Hand Therapy for rotator cuff injuries include:

  1. Rest: Giving the injured shoulder adequate rest is essential to allow the damaged tissues to heal. Avoid activities that worsen the pain and strain on the shoulder.
  2. Physical therapy: Physical therapy is a fundamental component of treatment for rotator cuff injuries. A physical therapist can design a tailored exercise program to strengthen the muscles surrounding the shoulder, improve flexibility, and restore range of motion. These exercises can help reduce pain and improve shoulder function.
  3. Ice and heat: Applying ice to the shoulder can help reduce pain and inflammation, while heat can promote relaxation and improve blood flow. Alternate between ice and heat treatments as recommended by your healthcare provider.
  4. Activity modification: Modifying activities that exacerbate the injury, especially those involving overhead motions or heavy lifting, can prevent further strain on the rotator cuff.
  5. Supportive devices: Using a brace, sling, or other supportive devices may help stabilize the shoulder and limit excessive movement during the healing process.
  6. Ultrasound therapy: Therapeutic ultrasound may be used to promote blood flow, reduce inflammation, and accelerate the healing process in the affected area.
  7. Electrical stimulation: Electrical stimulation, such as transcutaneous electrical nerve stimulation (TENS), can help manage pain and promote muscle contraction and healing.

Recovery Time for a Rotator Cuff Injury

The healing time for a rotator cuff injury is going to depend on the severity of the injury. While some simple cases of tendinitis might heal in a few weeks, other severe rotator cuff injuries could take six months or more to heal. The goal of the treatment of any rotator cuff injury is to strengthen the shoulder to the point that it can be used pain-free once again.

Preventing Rotator Cuff Injuries

Rotator cuff injuries most commonly affect athletes and active individuals, but nearly everyone faces some risk. Some options for preventing these shoulder injuries include:

  • Strengthening your shoulders. People with weak shoulder muscles that perform repetitive motions with their shoulders can aggravate the muscles and tendons. The stronger your shoulder muscles are, the more resilient they are against physical stress and trauma.
  • Avoiding overuse. If you play sports that require a lot of shoulder rotations, like swinging a tennis racket or throwing a baseball, give your body time off to recover afterwards.
  • Working with a trainer. Whether it’s weightlifting or pitching a softball, proper form is vital to maintaining healthy rotator cuffs. Consider using a professional trainer to ensure you are exercising and practicing safely.

Schedule an Appointment Today

Don’t let shoulder pain or injury keep you in a bind. Reach out to Restored Hope Hand Therapy today and take a decisive step towards reclaiming your life from the clutches of shoulder pain. We are well-equipped to provide the support and professional guidance necessary for a successful rehabilitation journey. Call us today to schedule an appointment and embark on the path to recovery.

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At Restored Hope, we will help you to maximize your recovery and develop
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