What Causes A Rotator Cuff Injury?

Rotator Cuff Injury?

We use our shoulders hundreds of times a day without really thinking about it. Every time you reach up to get something off a high shelf, comb your hair, wave goodbye, or throw a ball, your shoulders are working hard. Actually, more specifically, your rotator cuffs are working hard.

Shoulder motion with rotator cuff (supraspinatus)
Young Lae Moon via Wikimedia Commons

Your rotator cuffs are the unsung heroes of all your shoulder movements. They not only protect your shoulder joints, they also keep the balls of your humerus (upper arms) in your shoulder sockets. They allow you to move your arms through an incredible range of motions, which is why a rotator cuff injury can be so debilitating.

What Is A Rotator Cuff Injury?

Your rotator cuff is not actually a cuff in the traditional sense. It’s group of four muscles, each of which plays an important role in the functioning of your shoulder:

  • Supraspinatus – holds your humerus in place, keeps your upper arm stable and helps lift your arm.
  • Infraspinatus – allows you to extend your shoulder and rotate your arm.
  • Teres Minor – the smallest of the rotator cuff muscles, its main function is to help with the rotation of your arm away from your body.
  • Subscapularis – holds your humerus to your scapula (shoulder blade). It helps you rotate your arm, hold it out straight, and lower it.

A rotator cuff injury can occur as the result of a once-off injury, such as if you fall and land heavily on your shoulder, or, more commonly, due to progressive degeneration or wear and tear of these muscles and surrounding tendon tissue.

Symptoms Of A Rotator Cuff Injury

Rotator cuff injuries can range in severity from simple inflammation to complete tears. They commonly cause a dull ache in your shoulder, which becomes more severe when you use your arm, or sleep on the affected side. They can make it difficult to perform simple tasks such as combing your hair or reaching behind your back. Some patients also experience general weakness in the affected arm.

What Is A Rotator Cuff Tear?

A rotator cuff tear is usually caused by overstretching or rapidly twisting the joint and is either partial or complete. A partial tear is when the tendon protecting the top of your shoulder becomes damaged or frayed. This is a common overuse injury occurring often in people who repeatedly perform overhead motions in sport or at work. Tennis players, cricket bowlers and baseball players are particularly prone to rotator cuff tears, as are painters and carpenters. A complete tear is a more severe injury that can go all the way through to the bone. In some cases, the injury is severe enough to actually pull the tendon completely off the bone.

Shoulder pathology – Rotator cuff tear from Vladimir Mischenko on Vimeo.

Depending on how serious your rotator cuff injury is, you may not always be able to feel it. But symptoms can include:

  • Trouble raising your arm
  • Pain when you move your arm in a certain way, or when you lie on it
  • Inability to lift things normally
  • Weakness in your shoulder
  • A clicking or popping noise when you move your shoulder

If you’re experiencing any of these symptoms, it’s extremely important to see a doctor or sports medicine physician. If you leave a torn rotator cuff, the symptoms can become more severe, and other complications, such as arthritis or frozen shoulder, can develop.

What Is Frozen Shoulder?

Frozen shoulder is the common name for adhesive capsulitis. This occurs when the tissues in your shoulder joint become thicker and tighter, causing scar tissue to develop over time. It occurs most often when a rotator cuff injury is left untreated, or if your shoulder is kept immobilised for a long period of time following an injury. These can both cause permanent stiffness or weakness, and a thickening of the connective tissue enclosing the shoulder joint.

This thickening means your shoulder joint doesn’t have enough space to rotate properly, and you are likely to experience pain, swelling and general stiffness. Frozen shoulder can occur at any age, but is most common between the ages of 40 and 60.

Treatment For A Rotator Cuff Injury

If you have shoulder pain that lasts longer than a few weeks, or if you’ve been formally diagnosed with a rotator cuff tear, it’s important to see an orthopaedic surgeon or another shoulder specialist. There is a possibility that you may need corrective surgery, and some of these procedures are time sensitive.

Often, however, the injury can be treated non-surgically, with a combination of rehabilitative physical therapy (including mobility and strengthening exercises), medication and anti-inflammatory drugs.

Dr Sachin Baba is an orthopaedic surgeon and sports medicine physician specialising in sports, upper extremity and trauma orthopaedics.

If you’re experiencing ongoing pain in your shoulder and suspect you may have a rotator cuff injury, let Dr Baba assess your condition and recommend the appropriate therapy. Contact him at Health In Motion on 032 586 0020, 031 492 1244 or 031 584 6185.

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