The rotator cuff is a group of integral muscles, tendons and accompanying ligaments that stabilize the arm and shoulder. They are responsible for facilitating lifting and rotating movements in the arm, which are necessary for a tremendous range of daily tasks. These muscles and tendons link the ball joint of the upper arm with the collarbone and the shoulder blade. A torn rotator cuff can involve any of the muscles and tendons in the area, but injuries to the supraspinatus, the tendon that goes over the outer edge of the shoulder, are the most common cause.
Rotator cuff tears affect people in all age groups and have many causes. Tears fall into two categories. Traumatic tears are related to falls, dislocation, strain, lifting and injuries sustained during strenuous labor. The other group includes gradual tears that occur due to age, wear and tear, repetitive use and other non-traumatic conditions. Depending on the size and extent of the damage, rotator cuff injuries may be defined as partial tears or complete tears.
In the mildest cases, individuals experience soreness and stiffness related to the inflammation of the tendon, which is also called tendonitis. Younger individuals are more likely to recover from this condition, but it’s possible for the injury to worsen over time. With partial tears, fibers in the tendon are damaged or torn, but the tendon is still connected and functioning. Many patients with this condition experience pain, weakness and limited mobility. Complete or full-thickness tears are the most severe type of rotator cuff injury. These include instances where the tendon is severed but still attached to the bone and cases where the tendon has pulled away from the bone entirely.
Individuals with rotator cuff tears have access to a number of treatment options ranging from physical therapy to surgery. The best course depends on the patient’s age, occupation and the extent of the tear, which can be determined with an X-ray or MRI. After the injury, patients benefit from hot and cold compresses, analgesics and other-the-counter NSAIDs to relive pain and minimize inflammation.
Slings and elastic bandages are also helpful to immobilize the affected area, promote healing and stabilize the bones just as the tendons and soft tissues would normally. When the injury is sufficiently healed, patients can begin physical therapy to strengthen the muscles and reduce the chance of a recurrence. Non-surgical treatments are effective for many patients.
When conservative treatments and pain management techniques aren’t enough to rehabilitate a patient, doctors may recommend cortisone injections to reduce inflammation and provide relief. In extreme cases, arthroscopic surgery is the best option to restore the patient’s normal range of motion.
Rotator cuff injuries can be debilitating and are prone to being aggravated and reinjured during normal activities. It’s also possible for patients to develop stiffness and pain associated with “frozen shoulder” following the injury or trauma. Because the shoulder and rotator cuff are vital to many activities, it’s important to seek treatment for your condition. Your pain management specialist will develop a personalized plan to reduce your pain and help you regain mobility using the most conservative treatment options avaiable.