Rotator Cuff

The rotator cuff, a critical component of the shoulder, is the group of tendons at the joint between the scapula and humerus bones that stabilizes the shoulder. During rotation of the arm, the tendons within the rotator cuff keep the arm bone secure in the socket of the shoulder. If any of these tendons become irritated or damaged, motion within the rotator cuff becomes painful.

Each year, more than two million people seek help from a physician for rotator cuff pain. Athletes and people over the age of 40 are at the greatest risk for rotator cuff injury, but strain on the cuff can be a result of a variety of factors.

Injury can be caused by overextension of the arm or shoulder during daily activity, such as lifting or pulling something improperly. It can also be the result of a fall or other trauma to the shoulder. Aging also contributes to incidence of shoulder pain.

Following are some conditions that contribute to rotator cuff pain:

• Tendinitis –  Common in athletes, tendinitis is the inflammation of muscles within the cuff due to overuse. By extending the arm overhead–such as the swinging or reaching motions in baseball, hockey, and racquet sports–the tendons become overextended and inflamed.
• Bursitis – The bursa, or the fluid sac within the cuff, allows the tendons to move freely. In Bursitis, the bursa becomes irritated, which leads to chronic pain.
• Rotator Cuff Tear – Partial tears occur when the tendon is damaged while still intact, but a full-thickness tear happens when the tendon is actually severed into two pieces. In this case, the tendon has a hole in it.
  

Tears are mostly caused by one of two factors: trauma or degeneration. An acute tear is a tear caused by a rapid movement or unnatural motion, like athletic injury. A degenerative tear can be caused by overuse of the joint or lack of blood supply to the tendon due to age. The tendons can also tear as a result of untreated tendinitis. Bone spurs–or bone overgrowth–may also occur on the arm bone and are another possible cause of tears.

Symptoms and Diagnosis

Pain is the most common symptom of a rotator cuff injury. Extreme pain may be present in the shoulder when performing activities that extend or reach the arm, like putting on a jacket or lifting something heavy. The shoulder may also be tender to the touch.

Some other signs of an injury in the rotator cuff are:

• Loss of range of motion
  
• Weakness in the shoulder
  
• Pain while sleeping or putting pressure on affected side
  
• Crackling sensation within the joint
  

Treatment

If pain lasts for more than a week without improvement, or it severely restricts daily activities, it may be time to see a physician like Dr. Leah Urbanosky of Hinsdale Orthopaedics, who specializes in shoulder pain and treatment. After a full review of your medical history, Dr. Urbanosky may prescribe non-surgical or surgical steps to prevent daily pain.

Similar to other muscle or tendon injuries, physical therapy is often recommended as a first step to strengthen the cuff and surrounding areas. Often, rotator cuff pain improves dramatically after a few weeks of therapy. In addition to physical therapy, extra rest and activity modifications may be recommended. Corticosteroid injections may also be used to relieve pain. In some cases, surgery is required to repair the tear.

If the rotator cuff injury goes untreated for a long period of time, it may develop into arthritis. Severe arthritis is one of the leading causes of total shoulder replacement surgery. Surgery should be thoroughly discussed with a doctor regarding your individual condition.

To schedule a consultation with Dr. Urbanosky about your shoulder condition, please call: (815) 462-3474.

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Shoulder Conditions
Instability
Labral Tears (including SLAP tear)
Shoulder Arthritis
Rotator Cuff
Frozen Shoulder
Total Shoulder Replacement

Total Shoulder Replacement Animations

Advantage TSR (shown top)
Global TRS (shown bottom)