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Rotator Cuff Specialist

Urgently Ortho

Orthopaedic Urgent Care, Sports Medicine & Wellness Clinics located in Scottsdale, AZ

Rotator Cuff Q&A

Rotator cuff Injuries

 

The Rotator Cuff in the shoulder is commonly injured.  The shoulder is a complex series of joints and may incur many different injuries. 

 

Anatomy

 

 

 

Three bones meet to form your shoulder joint: the upper arm bone (humerus), shoulder blade (scapula), and collarbone (clavicle).  Muscles and tendons form a covering around the humerus and scapula to allow movement of the shoulder.

The Rotator Cuff is a group of four muscles that hold the head of the humerus in the small and shallow glenoid fossa of the scapula. The glenohumeral joint has been described as a golf ball sitting on a golf tee, where the head of the humerus is larger than the cup to which it sits.   

This group of muscles allow for abduction of the arm, moving it outward and away from the trunk, compression of the glenohumeral joint, and rotation of the shoulder.  So the Rotator Cuff works in almost all movements of the shoulder.

Pain in this area can be the result of:

  • Tendinitis: The rotator cuff tendons can be irritated, damaged or torn.
  • Bursitis: The bursa can become inflamed and swell causing pain.
  • Impingement: The space between the acromion and rotator cuff narrows when you lift your elbow higher than the shoulder. This can cause rubbing against the tendon and the bursa, causing irritation and pain.

 

Rotator Cuff injury   

 

This injury can occur in both young athletes and middle-aged people. Young athletes who use their arms for swimming, baseball, and tennis are particularly vulnerable. Those who do repetitive lifting or overhead activities, such as clothing retail, construction, or painting are susceptible.

Pain may also develop as the result of a minor injury or with no apparent cause.

 

Symptoms

Rotator cuff pain commonly causes swelling and tenderness in the front of the shoulder. There may be pain and stiffness when your arm is lifted or lowered from an elevated position.

At first, symptoms may be mild, and many people do not seek treatment. These symptoms may include:

  • Minor pain that is present both with activity and at rest
  • Pain radiating from the front of the shoulder to the side of the arm
  • Sudden pain with lifting and reaching movements
  • Athletes in overhead sports may have pain when throwing or hitting a ball

As the injury progresses, the symptoms increase to:

  • Pain at night
  • Loss of strength and motion
  • Difficulty doing activities that place the arm behind the back, such as buttoning or zippering

If the pain comes on suddenly, all movement may be limited and painful.

 

Physical Examination

During your first visit, be prepared to explain how you hurt your shoulder and how it feels since the injury.  The more you can explain to your provider, the more they can understand your symptoms and medical history.

At your visit, your provider will perform a physical exam and evaluate all the structures of your shoulder.  You will receive an x ray to determine if there are any fractures present.  X ray can not detect Rotator Cuff injuries but can rule out bone problems.

Many Rotator Cuff injuries can be diagnosed with a thorough physical examination of the shoulder, but other tests, such as a Magnetic resonance imaging (MRI) scan may be ordered.

The MRI creates better images of soft tissues like the Rotator Cuff .  These images allow the physician to determine if this injury requires non surgical or surgical treatment.

 

Treatment

Treatment for a Rotator Cuff injury comes down to two options:

  • Non-Surgical
  • Surgical

Depending upon the location of the injury, type of the injury and your age determines if the treatment can be completed in a non-surgical or surgical manner.  The physical exam and MRI results assist in determining the course of treatment.

Non-Surgical Treatment

If your injury is small and in the correct location it may not require surgical treatment. Initially, the standard treatment is rest and ice:

  • Rest. Take a break from the activity that caused the injury. You may need to use a sling to avoid using your arm.
  • Ice. Use cold packs for 20 - 30 minutes at a time, several times a day.

 

Besides rest and ice, there are many types of non-surgical treatments for Rotator Cuff injuries and all have their advantages and disadvantages. Your Orthopedic Specialist can review these options and assist you in determining which will be most effective in treating your injury:

 
 

 

 

Non-steroidal anti-inflammatory

medicines

Physical Therapy

Steroid injection

PRP (Plasma Rich Protein) injections

Stem Cell Therapy

 

 

 

Surgical Treatment

 

If the symptoms persist, you may need surgical treatment to repair the Rotator Cuff.  This is most commonly completed with arthroscopic surgery.  Three to four small incisions are needed to allow a miniature camera to be inserted into your shoulder to provide a clear view of the inside of the shoulder and miniature surgical instruments are used to repair the injury.

 

Rehabilitation

Whether your treatment involves surgery or not, rehabilitation plays a vital role in getting you back to your desired level of activities. A physical therapy program will guide you in regaining shoulder strength and function.