Consisting of a group of four muscles and multiple tendons, the rotator cuff surrounds the upper arm bone (humerus). It plays a crucial role in stabilising and mobilising the shoulder, and facilitating arm rotation.
There are three common types of rotator cuff injury:
- Rotator cuff tendonitis
- Rotator cuff tendonitis is a condition where the tendons of the rotator cuff become inflamed due to injury or overuse of the shoulder.
- It is a common condition in those who are engaged in activities that involve repetitive movements of the shoulder.
- This condition can cause pain and weakness in the shoulder, especially when lifting the arm or reaching overhead.
- Rotator cuff tear
- A rotator cuff tear occurs when one or more of the tendons in the rotator cuff become partially or completely torn.
- This normally happens due to a fall, accident, or other traumatic injury.
- Rotator cuff impingement syndrome
- Rotator cuff impingement syndrome occurs when the tendons in the rotator cuff become compressed or trapped between the bones of the shoulder joint.
- This can be caused by a bone spur, inflammation, or repetitive overhead movements.
You may be experiencing some form of rotator cuff injury if you have shoulder pain that limits your ability to perform certain activities especially when reaching overhead or behind your back.
Some symptoms are characteristic of specific types of rotator cuff injury.
- Rotator cuff tendonitis: Generalised shoulder pain, or pain that worsens when lifting the arm or reaching overhead.
- Rotator cuff tear: Pain, weakness, and limited range of motion in the shoulder.
- Rotator cuff impingement syndrome: Chronic pain that worsens with limited range of motion in the shoulder.
- Common in individuals older than 40 years old because the tendons are more susceptible to injury with age.
- Those who are doing certain sports and occupations that involve repetitive overhead motions, such as basketball, tennis, carpentry, are at a higher risk.
- Traumatic injury such as a fall or a direct blow to the shoulder can cause a rotator cuff injury.
- Poor posture may cause imbalances in the shoulder muscles and increase the risk of rotator cuff injury.
- Individuals with medical conditions such as diabetes, thyroid disorders, and heart disease are at a higher risk.
Your doctor would first question your general health and symptoms before conducting a thorough physical examination.
Diagnosis is made based on your reported symptoms, physical examination, and investigations.
Imaging tests such as X-ray and MRI may also be done to evaluate the extent of injury and rule out other causes of pain. An X-ray can help rule out other conditions, such as arthritis or a fracture. An MRI can provide a more detailed view of the soft tissues in the shoulder joint.
Treatment for rotator cuff injury depends on the type and severity of the injury. Treatment options may include the following:
- Rest: Avoid activities that aggravate the injury to reduce strain on the shoulder and help to reduce pain and inflammation.
- Pain relief: Nonsteroidal anti-inflammatory drugs (NSAIDs) can help to reduce pain and inflammation.
- Physiotherapy: Exercises to improve range of motion and strengthen the muscles around the shoulder joint to prevent further injury.
- Surgery: Surgery to repair the damaged tendons may be considered in severe cases and if all other treatments have not been successful.
Gleneagles Hospital works with orthopaedic specialists to assist patients through diagnosis and treatment. The caring and multidisciplinary team of healthcare professionals are available for consultation and to provide the best care.