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The rotator cuff is a group of muscles and tendons that helps keep the shoulder joint together. It allows the upper bone to securely sit in the socket and enables full range of motion.
Due to the amount of wear placed on the shoulder, rotator cuff injuries are common and often associated with repetitive-motion activities. Ignoring an injury results in pain, decreased range of motion and a potential disability.
An estimated 2 million Americans experience a rotator cuff tear each year and risk increases with age. Learn how physical therapy treatment can help with range of motion, flexibility and pain.
How Does a Rotator Cuff Injury Occur?
The shoulder area consists of three bones – the humerus, collarbone and scapula – which all meet at a shallow ball-and-socket joint. Muscles and tendons keep the joint stable and a bursa sac provides lubrication for full range of movement. Injuries typically involve the muscles, ligaments or the bursa, primarily caused by inflammation and damage.
With the exception of a sudden impact from a fall or car accident, most rotator cuff injuries are progressive, resulting from gradual wear to the tissues. This degenerative condition can stem from heavy lifting, repetitive motion or age-related tissue damage.
Types of Rotator Cuff Injuries
Rotator cuff injuries fall into the following categories:
- Tendonitis: Repetitive motion or poor form can cause the tendon to become inflamed and swollen.
- Bursitis: The bursa sac starts to experience irritation and swelling after adjacent muscles and bones repeatedly rub against it.
- Rotator Cuff Tear: Partial or full-thickness tears, whether gradual or the result of falling down on an outstretched arm, cause the tendon to detach from the bone.
Symptoms of a Rotator Cuff Injury
Not every rotator cuff injury involves constant pain. Instead, this sensation is often related to position or motion. Common symptoms of a rotator cuff injury include:
- Pain as you lift your arm, lie down on your shoulder or reach behind your back
- Decreased arm strength
- A popping or clicking sound as you move your arm
- Achiness in your shoulder and around the joint
- Finding it difficult to dress yourself or comb your hair
Risks for a Rotator Cuff Injury
People have a higher risk of experiencing a rotator cuff injury if they:
- Are over age 40
- Play a sport involving repetitive movement, like baseball, tennis, swimming or weightlifting
- Have poor posture
- Work in construction, carpentry, painting or a warehouse setting
- Experience decreased blood supply to the shoulder, which can occur as a result of aging
- Live with bone spurs, which can place additional pressure on this area
- Have a family history of the condition
Diagnosing and Treating a Rotator Cuff Injury
A doctor will start by assessing your shoulder, including range of motion and strength. You’ll be asked to move or hold your arm in different positions and the doctor may press down on certain areas. Based on these results, you may also undergo imaging to look for bone abnormalities or to observe tissues and ligaments in more detail.
If the injury is minor, you may simply be asked to go through RICE – rest, ice, compression and elevation – to reduce swelling and use a pain reliever to manage symptoms.
Most people are referred to a physical therapist to strengthen the muscles in this area and work on range of motion. You’ll be prescribed exercises to help reach these goals and may undergo various passive therapies like transcutaneous electrical nerve stimulation (TENS).
Some patients may additionally need a steroid injection or surgery to repair, re-attach or replace a damaged tendon or rebuild part of the shoulder joint.
The PTs at Integrated Rehab help patients manage rotator cuff injuries or recover from surgery. To learn more about our services or schedule an appointment, contact us today.