Spotlight on Rotator Cuff Injuries
Find out how to recognize rotator cuff injuries and what to do to feel better.

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Picture of rotator cuff x-ray Spotlight on Rotator Cuff Injuries

Screwing in a light bulb, lifting a plate off a top shelf, or throwing a ball shouldn't hurt. All these actions involve reaching above the head and are usually taken for granted - as long as your rotator cuff is working OK.

Rotator cuff injuries happen to athletes, especially baseball pitchers, swimmers, and tennis players. People who deliver mail, carry newspapers, paint, hang curtains, and have jobs in which they perform repetitive movements can also suffer from rotator cuff injuries. The elderly are especially prone and sometimes the injury comes from very insignificant trauma or light lifting.

What is the rotator cuff?
The rotator cuff is a group of tendons and muscles that stabilize the shoulder joint, allowing you to raise and rotate your arm. The shoulder joint is a ball and socket with three main bones: the clavicle (collarbone), the humerus (upper arm bone), and the scapula (shoulder blade). Muscles, tendons, ligaments, and the joint capsule hold these bones together. The shoulder joint is capable of a huge range of motion. But it is also vulnerable to injury that results in pain, weakness, and even joint dislocation. The good news is that rotator cuff injuries are often treatable.

Types of Injuries

  • Sudden: Lifting a heavy object, falling, or making a sudden, powerful motion can result in a sudden injury. For instance, a single 90 mph fastball or one winning overhead tennis shot may be all it takes to tear a rotator cuff muscle - causing sudden, intense pain.
  • Gradual: Injury can happen gradually, as a result of repetitive use. Any kind of activity that involves repeated overhead arm movements or repetitive lifting carries the risk of rotator cuff injury.

Symptoms of rotator cuff injuries
Symptoms of acute injury can include:

  • Sudden severe pain (or a tearing feeling) in the shoulder, followed by pain down the entire arm
  • Very limited use of the involved arm
  • Pain that continues when the arm is at rest

The following symptoms may occur with gradual injuries:

  • Pain when lifting the arm forward, above the head
  • Pain that is worse at night
  • Pain that eventually is accompanied by increasing difficulty moving the arm, especially out to the side

Warning signs
Shoulder pain may also be a sign of a heart attack.

Call 9-1-1 immediately if you have sudden shoulder pain with:

  • Chest pain or discomfort
  • Shortness of breath
  • Lightheadedness or passing out
  • Sweating or nausea

Also seek emergency medical care if you have shoulder pain and:

  • It is red, swollen, or warm to the touch
  • You have a high fever or shaking chills
  • There is new weakness, numbness, or tingling in the arm
  • You are pregnant
  • You have ulcers or other problems with your stomach or intestines
  • It is severe after an injury

Call the doctor if:

  • The pain is severe or doesn't get better with treatment
  • You are unable to carry out your usual tasks
  • You can't move your arm through the normal range of motion

Treatment
Minor inflammation of a rotator cuff muscle tendon usually goes away completely with time. Your doctor will suggest avoiding the activity that caused the pain. You may be referred to physical therapy.

Pain and inflammation are often treated with oral medications called nonsteroidal anti-inflammatory drugs (NSAIDs), such as aspirin, naproxen, and ibuprofen. However, NSAIDs are not safe for everyone, including those with liver, kidney, heart disease, stomach problems, and other conditions. Talk to your doctor before taking NSAIDs. Never give aspirin to anyone under the age of 19 as it may cause a very serious condition called Reye's syndrome.

Narcotic pain medicine may be needed for severe pain. A steroid injection into the shoulder joint may also be used for acute pain. A partial or complete tear of a rotator cuff tendon with weakness, loss of function, or limited motion that does not get better with medicine and physical therapy may require surgery.

By Louis Neipris, MD, Staff Writer
Created on 06/24/2005
Updated on 06/22/2010
Sources:
  • American Academy of Orthopaedic Surgeons. Rotator cuff tears and treatment options.
  • National Guideline Clearinghouse. Rotator cuff tear. In: The medical disability advisor: workplace for guidelines for disability duration, sixth edition.
  • National Institute of Arthritis and Musculoskeletal and Skin Diseases. Questions and answers about shoulder problems.
  • American Academy of Orthopaedic Surgeons. Rotator cuff tears.
Copyright © OptumHealth.
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