The muscles and tendons of the rotator “cuff” hold the upper arm bone in the socket of the shoulder joint. Every year, millions of people in the United States visit their doctors with a rotator cuff problem. Usually occurring in the dominant arm, a rotator cuff injury weakens the shoulder and makes daily activities and routines difficult. Injuries are categorized as acute or chronic:
- Acute injuries are tears and strains to the rotator cuff that result from a traumatic event, such holding out the arm to break a fall.
- Chronic injuries are injuries that result from overuse and occur over time. Athletes and construction workers are especially prone to rotator cuff injuries.
What causes it?
Most rotator cuffs are caused by the normal effects of aging. Thus, people over 40 are at greater risk of a rotator cuff tear. Those engaged in repetitive lifting or overhead activities – think pitchers in baseball, or painters – are also at risk.
The majority of tears in young adults are caused by a traumatic injury, such as a fall.
How do you know you have it?
Symptoms of an acute rotator cuff tear include:
- Intense pain
- Immediate arm weakness
- A “snapping” sensation
Symptoms of a chronic rotator cuff tear include:
- Mild shoulder pain at first, then increasing, especially at night
- Muscle weakness
- Pain when lifting the arm over the head
- Limited motion
How we fix it
The OSI orthopedic team is here to listen, discuss your concerns, and examine you for signs and symptoms of rotator cuff injury. Our goal is to restore shoulder function so you can continue with the activities you love. While under our expert care, you may undergo the following:
- Physical exam: Your doctor will discuss your symptoms and general medical history, then test the range of motion in your shoulder. Your doctor may also check for a pinched nerve, which can present similar symptoms.
- X-rays: X-rays may show the development of a bone spur.
- MRI: An MRI can show the location and size of the rotator cuff tear.
Continued use of your arm with a rotator cuff tear – in spite of increasing levels of pain – generally creates further damage. Getting treatment earlier rather than later will prevent the worsening of your symptoms. The type of tear you have, as well as your age and activity level, will be considered when planning treatment.
Nonsurgical approaches include:
- Activity modification
- Non-steroidal anti-inflammatory medications
- Steroid injections
- Physical therapy
A surgical approach is considered if your pain persists in spite of the above methods. Also, active people needing full function for sports or work are candidates for surgery. Surgery to repair a torn rotator cuff most often involves re-attaching the tendon to the head of the upper arm bone.
Degenerative conditions or a severe injury might require a total shoulder replacement.