After knee and hip, shoulder injuries are the most common orthopedic injury. Perhaps the most frequently diagnosed shoulder condition orthopedic surgeons treat is rotator cuff injuries. Rotator cuff injuries make up more than six million shoulder injuries diagnosed annually in the U.S. With an aging population, that number is expected to rise over the next five years.
The rotator cuff is comprised of four muscles and several tendons that work to lift and rotate the shoulder, allowing people to perform tasks such as putting items away, swinging a tennis racquet and many other everyday activities. This intricate combination of tendons and muscles makes the shoulder susceptible to injury through normal wear and tear.
What is a rotator cuff injury?
Rotator cuff injuries stem from falling, lifting and repetitive arm activities – especially those done overhead, such as swimming, lifting weights, playing tennis or throwing a baseball.
Rotator cuff injuries require individualized treatment and attention from a physician who specializes in advanced solutions for shoulder conditions. The board-certified doctors at Midwest Orthopaedics at Rush (MOR) are among the best shoulder physicians in the country for treating even the most complex rotator cuff conditions. The MOR shoulder doctors are team physicians for the Chicago Bulls and the Chicago White Sox. They have a proven track record in treating rotator cuff injuries, and conduct research on cutting-edge procedures and new technology that will make a difference in shoulder patient care for years to come.
What is the cause of a rotator cuff condition?
There are several reasons people have pain in their rotator cuff:
- Wear and tear: As people age, especially those over 40, everyday activities begin to take a toll on the rotator cuff. Gradually, the collagen (fibrous protein) in the rotator cuff muscles and tendons begins to break down, leading to a greater chance of injury.
- Sudden trauma: Breaking a fall with an arm or an arm injury during sports, can tear or bruise the rotator cuff tendon or muscles. For more information, visit our Orthopedic Trama section.
- Repetitive stress: Repeated overhead motion of your arms can lead to inflammation and even tearing of the rotator cuff muscles and tendons. This often afflicts those in the building trades, such as painters and carpenters. It can also affect overhead athletes, such as swimmers, baseball players and tennis players.
- Pulling and lifting: Straining and tearing the rotator cuff tendons and muscles can occur if you lift an object that is too heavy or you improperly lift an overhead object.
- Poor posture: Slouching can lead to rotator cuff problems because when you slouch, the shoulders and neck come forward and restrict the space where the rotator cuff muscles sit. This can result in the muscle or tendon getting pinched beneath the shoulder bone.
What are the symptoms of rotator cuff injury?
Symptoms include the following:
- Deep ache in the shoulder, perhaps also felt in outer part of the shoulder
- Pain at night that interferes with sleep
- Gradual weakness and decreased shoulder motion develop as the pain worsens
- Decreased ability to move arm out or to the side
What are treatment options for rotator cuff injury?
Surgical and non-surgical treatments are the two main courses of action for treating rotator cuff injuries.
- Rest: Resting the injured joint is the first step to swelling and pain reduction. Be sure to keep using the arm gently. Keeping it immobilized can lead to a painful condition called frozen shoulder.
- Ice: In the first 24 hours of an injury, apply ice to reduce swelling and pain.
- Heat: After 24 hours have passed, a heating pad or hot compress can help.
- Anti-inflammatories: Reduce pain and swelling by taking ibuprofen (Advil), naproxen (Aleve) or aspirin.
- Physical therapy and exercise: Gentle exercises and stretches designed to strengthen the muscle can treat many rotator cuff injuries. Physicians at MOR advise their patients to begin a physical therapy regimen soon after surgery.
- Steroids: Cortisone can be injected directly into the rotator cuff to reduce inflammation and pain, but steroid injection should be used under the careful direction of a doctor. Multiple injections should be avoided.
Most rotator cuff injuries are treated non-surgically, but our shoulder physicians may do surgery if a rotator cuff is torn or if months of physical therapy and other treatments have not helped.