Rotator Cuff Injuries

What is the rotator cuff?

A rotator cuff is a group of muscles and tendons that surround the shoulder joint, keeping the head of your upper arm firmly within the shallow socket of your shoulder. The four tendons attach the muscles of your upper arm bone (humerus) to the shoulder blades and the ribs.

Common injuries of the rotator cuff

Tendons in the rotator cuff can be injured easily as they work in a very tight space. Some of the common injuries of the rotator cuff include:

Rotator cuff tendonitis:

Inflammation of any one of the four tendons causes pain only during specific movements where the tendon involved is the swollen one. This condition usually occurs over time when the shoulder is kept in one position for a long time or when one does an activity involving heavy shoulder movement. Many sportsmen suffer from this injury. It is also referred to as tennis shoulder, swimmer’s shoulder, etc.

What are the symptoms:

The symptoms of rotator cuff tendonitis include:

• Pain and swelling in the upper arm and shoulder
• Triggering pain in lowering and lifting your arm
• Stiffness of the shoulder
• Loss of mobility and strength in the affected arm

Causes:

Rotator cuff injuries become rather common once the person crosses 60 other risk factors including:

• A previous injury
• Progressive wear and tear of the tendon due to strenuous activities involving the shoulder joint
• Family history of shoulder problems
• Occupations that involve heavy lifting and constant muscle movement

   Treatment:

• Cold compress is the go-to treatment as the first step is to reduce swelling and pain management.
• Avoiding activities that flare up the pain
• Taking anti-inflammatory and pain medication (preferably non-steroidal) as prescribed by the doctor.
• Physical therapy to regain strength and flexibility in the joint.

Shoulder bursitis:

 There is a small fluid-filled sac in our shoulder joints called a bursa. Bursae (plural for bursa) protects the bones of our joints from friction. When this fluid-filled sac becomes inflamed it is known as shoulder bursitis. It is also known as subacromial bursitis, which can be treated in various ways.

Symptoms:

The bursa acts as the cushion for your joints and bursitis can cause pain and difficulty in shoulder movement. The symptoms include:-

• Discomfort on lying on the affected shoulder
• Pain on the top or outside of the shoulder joint
• Pain on opening or closing a door
• Pressure and pain on pressing your shoulder joint

Causes:

People who use their shoulders more than an average person are more prone to suffering from shoulder bursitis. This includes musicians, carpenters, construction site workers, and sports persons.

However, anyone can injure themselves and get shoulder bursitis.

Other causes include:

• Previous injuries caused by a car crash or other accidents
• Overuse of the shoulder joint
• Doing things that can put your shoulder under stress like baseball, tennis, and weight training
• Poor posture or rotator cuff tear

Treatment:

• Give rest to the shoulder, which includes taking a break from the activity that caused the symptoms to worsen in the first place
• Apply an ice pack 3-4 times a day on the affected area
• Physical therapy as advised by the doctor
• Wearing a shoulder brace and doing stretching exercises

Rotator cuff tear:

After the rotator cuff is severely injured or weakened by either bursitis or tendonitis, the rotator cuff tendons tear, which can cause a lot of pain and discomfort to the patient. It is a common injury in sports like baseball, cricket, and tennis, and jobs like painting, window cleaning, etc. these jobs cause wear and tear of the tendons that eventually leads to injuries like this.

There are two types of rotator cuff tears:

• Partial tear: This happens when one of the muscles which form the rotator cuff is frayed or damaged.
• Complete tear: This happens when the injured tendon completely comes off the joint.

Symptoms:

One cannot always recognize a tear in the shoulder tendon, but in some cases, one might suspect it.
Symptoms include:

• Trouble raising your arm
• Trouble moving your arm or sleeping on it
• Losing strength and flexibility in the affected arm
• Difficulty in lifting things
• Hearing clicking or popping sounds while moving your shoulder

Causes:

• Like most of rotator cuff injuries, the tear in tendons is also caused by overuse of the shoulder joint.
• Falling on your shoulder or hitting it in an accident can cause the tendon to tear.
• Lifting heavy things while already suffering from bursitis or a weakened shoulder joint. It can also be due to suddenly lifting heavy objects like weights in the gym

Treatment:

Tendon tears can be treated like all shoulder injuries;

• Resting the injured shoulder
• Physiotherapy
• Taking pain and anti-inflammatory medication
• Icing the area to reduce swelling and numb the pain
• Wearing a shoulder brace and other protective gear