Please note we will be closing early for a holiday celebration on Friday, December 9th. OrthoAccess Portland will close at 2:30pm, OrthoAccess Windham will be closed for the day, and our physician offices will close for the afternoon. Happy Holidays!

Understanding Your Shoulders: Rotator Cuff Injuries

If you watch baseball, you’ve heard of a rotator cuff injury. Yet non-athletes can also experience gradual degeneration of this body part, as well as tears due to sudden injury. But what exactly is the rotator cuff, and how can you tell if you’ve injured yours? Perhaps most importantly, what can be done about it?

A group of four muscles connect your shoulder blade to your upper arm bone (humerus), just below the outer end of your collarbone. These muscles become tendons where they attach to, and cover, the head of the humerus. This group of muscles and tendons form your rotator cuff. Your rotator cuff keeps your arm in your shoulder socket, and helps you lift and turn your arm.

How does the rotator cuff get injured?

Most rotator cuff tears occur due to repeated wear over time. Natural degeneration is part of aging, sadly – though careful, low-impact strengthening and stretching can help your shoulder muscles stay in better condition.

The shoulders of people over age 40 are at greater risk, along with those who do a lot of repetitive lifting and activities that require overhead arm actions (such as house painters and carpenters). Sports like baseball, tennis, rowing, and weightlifting increase your risk of overuse shoulder injuries.

Your rotator cuff can also tear due to a sudden accident – such as using a jerking motion to lift a heavy object, or falling on your outstretched arm. Most acute tears in young adults occur this way.

How do I know if I’ve damaged my rotator cuff?

Common symptoms include:

  • Pain when not moving your arm, and particularly if lying on the affected shoulder at night
  • Pain when lifting and lowering your arm or with specific movements – this may be mild at first and get worse over time, and may stop responding to over-the-counter pain medications
  • Weakness when lifting or rotating your arm
  • Crackling sensation when moving your shoulder in certain positions

Sudden tears (due to a fall or other sudden impact) may cause a snapping sensation and immediate weakness and pain in your shoulder.

It’s important to seek diagnosis and treatment from an orthopedic doctor sooner rather than later if you’re experiencing any of these symptoms. A rotator cuff tear can keep getting larger over time if you continue painful activities. Larger tears usually mean more intensive treatments and longer recovery times.

During a physical exam, your doctor will check your shoulder’s range of motion and strength. They’ll also check for other possible conditions that may be causing the pain. Be prepared to answer questions about when your shoulder pain started, what movements and activities make it worse, past shoulder injuries, additional symptoms, and how the pain is impacting activities you love.

Your doctor may order an x-ray to check for bone spurs in your shoulder, which could be irritating and wearing down the tendons. An MRI (magnetic resonance imaging) or ultrasound can show your doctor the exact location and size of the tear, as well as its age, and can help guide your treatment options.

How do rotator cuff tears get treated?

Non-surgical methods relieve pain and improve range of motion in a large majority of rotator cuff injuries. These can include:

  • Resting your arm and limiting or avoiding overhead activities and other motions that cause pain; using a sling to keep the shoulder still
  • Taking anti-inflammatory drugs (ibuprofen, aspirin, or naproxen) to reduce pain and swelling
  • Physical therapy exercises to strengthen the muscles supporting the shoulder and gently stretch them to restore flexibility and range of motion
  • Injection of a steroid (cortisone) if other methods do not relieve pain

If none of the non-surgical approaches reduce your shoulder pain – or if your job or preferred activities require you to raise your arms above your head frequently – your doctor may suggest surgery.

You may also be a surgical candidate if: you’ve had rotator cuff symptoms for six to twelve months; your tear is larger than three centimeters and surrounding tissues are in good condition; your weakness and loss of function is significant; or your tear was caused by a recent, acute injury. Your doctor will discuss your options based on the specifics of your personal injury and health needs.

Remember: you don’t need to grin and bear shoulder pain! The skilled sports medicine doctors, orthopedic surgeons, and physical therapists at Spectrum Orthopaedics are your best first resource to examine and treat your rotator cuff.

Reach out to us today to schedule an appointment.

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