Types of rotator cuff injuries
Rotator cuff injuries can range in severity from simple inflammation to complete tendon tears.
The rotator cuff is a group of muscles and tendons that surround the shoulder joint, keeping the head of your upper arm bone firmly within the shallow socket of the shoulder. A rotator cuff injury can cause a dull ache in the shoulder, which often worsens with use of the arm away from the body.
Rotator cuff injuries are common and increase with age. These may occur earlier in people who have jobs that require repeatedly performing overhead motions. Examples include painters and carpenters.
Many people with rotator cuff disease can manage their symptoms and return to activities with physical therapy exercises that improve flexibility and strength of the muscles surrounding the shoulder joint.
Sometimes, rotator cuff tears may occur as a result of a single injury. In those circumstances, medical evaluation should be provided as soon as possible to discuss the role of surgery. Extensive rotator cuff tears may not be fixable, and transfer of alternative tendons or joint replacement may be possible.
Video: Rotator cuff damage
The rotator cuff is a group of muscles and tendons that hold the shoulder joint in place and allow you to move your arm and shoulder. Problems occur when part of the rotator cuff becomes irritated or damaged. This can result in pain, weakness and reduced range of motion.
The pain associated with a rotator cuff injury may:
- Be described as a dull ache deep in the shoulder
- Disturb sleep
- Make it difficult to comb your hair or reach behind your back
- Be accompanied by arm weakness
When to see a doctor
Shoulder pain that is short-lived may be evaluated by your family doctor. See your doctor right away if you have immediate weakness in your arm after an injury.
Rotator cuff disease may be the result of either a substantial injury to the shoulder or to progressive degeneration or wear and tear of the tendon tissue. Repetitive overhead activity or heavy lifting over a prolonged period of time may irritate or damage the tendon.
The following factors may increase your risk of having a rotator cuff injury:
- Age. As you get older, your risk of a rotator cuff injury increases. Rotator cuff tears are most common in people older than 60.
- Construction jobs. Occupations such as carpentry or house painting require repetitive arm motions, often overhead, that can damage the rotator cuff over time.
- Family history. There may be a genetic component involved with rotator cuff injuries as they appear to occur more commonly in certain families.
Without treatment, rotator cuff problems may lead to permanent loss of motion or weakness, and may result in progressive degeneration of the shoulder joint. Although resting your shoulder is necessary for your recovery, keeping your shoulder immobilized for a prolonged time can cause the connective tissue enclosing the joint to become thickened and tight (frozen shoulder).
Rotator cuff exercises
Exercises that involve pressing your arm against a wall can help strengthen the muscles that make up your rotator cuff. With your elbow at a 90-degree angle, put the palm of your hand on the side of a wall or door frame that's in front of you (A). Place a folded towel between your side and upper arm. Your goal is to keep the towel there as you press your palm against the wall or doorframe for several seconds. For the second exercise, keep the towel in place (not shown) and shift your body so that you're standing next to a wall (B). With your elbow at a 90-degree angle, press your elbow and forearm against the wall for several seconds. Repeat each exercise 10 times for five sets.
If you are at risk of rotator cuff injuries or if you've had a rotator cuff injury in the past, daily shoulder strengthening exercises can help prevent future injury.
Most people exercise the front muscles of the chest, shoulder and upper arm, but it is equally important to strengthen the muscles in the back of the shoulder and around the shoulder blade to optimize shoulder muscle balance. Your doctor or a physical therapist can help you plan an exercise routine.