Rotator Cuff Injuries
Causes of a rotator cuff injury include:
- Direct blow to the shoulder area
- Falling on an outstretched arm
Chronic degenerative wear and tear on the tendons:
- Arthritis may decrease the space for the tendons
- Chronic instability of the humerus may traumatize the tendons
Repetitive overhead motion of the arm such as in:
- Baseball (mainly pitching)
Rotator cuff injury is more common in people 40 years and older. Other factors that increase your chance of a rotator cuff injury include:
- Heavy lifting
- Abnormalities of the shoulder, or in rotator cuff anatomy or function
- Activities that involve repetitive overhead arm motion such as throwing
- Weakened shoulder muscles from inactivity or previous injury
The treatment will depend on the extent of your injury, level of pain, and amount of immobility. The first step is usually a nonsurgical approach.
Nonsurgical approaches may include:
- Rest to help the shoulder heal; an arm sling may be advised to help rest the shoulder area
- Nonsteroidal anti-inflammatory drugs (NSAIDs) to control the pain and/or inflammation
- Topical pain relievers, such as creams or patches, that are applied to the skin
- Corticosteroid injections to help reduce pain and inflammation
- Injection of platelet rich plasma (PRP) to promote healing
- Ice to help relieve pain and inflammation
- Physical therapy to help strengthen and increase motion in the shoulder area
Acromioplasty is surgery on the bony structures that impinge the rotator cuff. Surgery can be arthroscopic or open.
A small instrument is inserted into the shoulder and used to remove bone spurs or degenerated portions of the rotator cuff tendons. Lesser tears can be repaired during arthroscopy as well.
Mini-Open Repair with Arthroscopy
This combines arthroscopy with an incision in the shoulder joint. Through the incision, larger tears in the tendons or muscles can be sutured.
This is used to repair the injured tendon or muscle in more severe cases. A tissue transfer or a tendon graft can be done during surgery if the tear is too large to be closed together. In the most severe cases, a joint replacement may be necessary.
Depending on the extent of your injury, full recovery can take anywhere from 2 to 6 months or longer.
To help reduce your chance a rotator cuff injury:
- Avoid overhead repetitive motion.
- Limit duration of work that involves:
- Moving hands above shoulders
- Using shoulder in extreme outward rotation
- Vibrating tools
- Avoid heavy lifting.
- Exercise regularly to strengthen the muscles around the shoulder joint.
This content is reviewed regularly and is updated when new and relevant evidence is made available. This information is neither intended nor implied to be a substitute for professional medical advice. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with questions regarding a medical condition.
Edits to original content made by Denver Health.
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a (Rotator Cuff Tear; Impingement Syndrome)
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Canadian Orthopaedic Association http://www.coa-aco.org
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