Overview

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 when you try to sleep on the involved side.

Rotator cuff injuries occur most often in people who repeatedly perform overhead motions in their jobs or sports. Examples include painters, carpenters, and people who play baseball or tennis. The risk of rotator cuff injury also increases with age.

Many people recover from rotator cuff disease 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 care should be provided as soon as possible. Extensive rotator cuff tears may require surgical repair, transfer of alternative tendons or joint replacement.

Video: Rotator cuff damage

Transcript

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.

Symptoms

The pain associated with a rotator cuff injury may:

  • Be described as a dull ache deep in the shoulder
  • Disturb sleep, particularly if you lie on the affected shoulder
  • 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.

Causes

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.

Risk factors

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 40.
  • Certain sports. Athletes who regularly use repetitive arm motions, such as baseball pitchers, archers and tennis players, have a greater risk of having a rotator cuff injury.
  • 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.

Complications

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).

Prevention

If you are at risk of rotator cuff injuries or if you've had a rotator cuff injury in the past, daily shoulder stretches and 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.

Rotator cuff injury care at Mayo Clinic

May 17, 2018
References
  1. Giangarra CE, et al. Rotator cuff repair. In: Clinical Orthopaedic Rehabilitation: A Team Approach. 4th ed. Philadelphia, Pa.: Elsevier; 2018. https://www.clinicalkey.com. Accessed Feb. 20, 2018.
  2. Rotator cuff tears. American Academy of Orthopaedic Surgeons. https://orthoinfo.aaos.org/en/diseases--conditions/rotator-cuff-tears. Accessed Feb. 20, 2018.
  3. Ferri FF. Rotator cuff disease. In: Ferri's Clinical Advisor 2018. Philadelphia, Pa.: Elsevier; 2018. https://www.clinicalkey.com. Accessed Feb. 20, 2018.
  4. Simons SM, et al. Presentation and diagnosis of rotator cuff tears. https://www.uptodate.com/contents/search. Accessed Feb. 20, 2018.
  5. Martin SD, et al. Management of rotator cuff tears. https://www.uptodate.com/contents/search. Accessed Feb. 20, 2018.
  6. AskMayoExpert. Rotator cuff surgery. Rochester, Minn.: Mayo Foundation for Medical Education and Research; 2017.
  7. Azar FM, et al. Shoulder and elbow injuries. In: Campbell's Operative Orthopaedics. 13th ed. Philadelphia, Pa.: Elsevier; 2017. https://www.clinicalkey.com. Accessed Feb. 22, 2018.
  8. Hattrup SJ (expert opinion). Mayo Clinic, Phoenix/Scottsdale, Ariz. March 8, 2018.
  9. Morrow ES. Allscripts EPSi. Mayo Clinic, Rochester, Minn. Oct. 2, 2017.