Have you felt like there’s a near-constant pain in your shoulder? If yes, there is a good chance that it may very well be a rotator cuff injury. In most cases, these injuries occur in association with athletic sports, where you continuously move your arm in repeated motions. Just because you aren’t an athlete doesn’t mean you can’t injure your rotator cuff. Since we rely so heavily on our shoulders for day-to-day tasks, anyone can tear their rotator cuff. Therefore, any damage to this body part will leave you needing treatment as soon as feasible.
Before we dive into the different treatment options, it’s imperative to understand the rotator cuff and how it can suffer damage.
What is the rotator cuff?
The rotator cuff is the name given to four grouped and distinguished muscles and their tendons that provide strength and support to the shoulder complex during motion. These muscles originate from the scapula and make a firm connection with the humerus head, creating a cuff encompassing the glenohumeral joint. As the rotator cuff muscles are usable for a wide variety of upper movements, they can perform flexion, extension, medial rotation, and lateral rotation. Since they allow movement in more than one plane, they are essential parts in almost every shoulder movement. If there has to be any proper maintenance of the shoulder girdle, balance and flexibility in each of the four rotator cuff muscles are necessary.
To increase the range of motion in the glenohumeral joint and prevent mechanical hindrance, they hold the humerus head within the narrow glenoid fossa of the scapula. Rotator cuff dysfunction is well known for causing shoulder pain, diminished functional abilities, and a lower quality of life.
What are the causes?
In a torn rotator cuff, the tendon no longer effectively binds to the head of the humerus when one or more of the rotator cuff tendons break. The tendon rips away from the bone in most rotator cuff tears. The supraspinatus tendon is the most often torn, but other parts of the rotator cuff can also be involved.
The two foremost causes of rotator cuff tears are:
- Acute tear injuries: You can tear your rotator cuff if you fall on your outstretched arm or lift something too heavy with a jerking motion. Other shoulder injuries, such as a broken collarbone or a dislocated shoulder, can also cause this form of tearing.
- Degenerative tearing: The majority of tears arise from the tendon gradually breaking down over time. When we get older, our tendons eventually degenerate. The dominant arm is more prone to rotator cuff tears. There’s a higher chance of a rotator cuff tear in the opposite shoulder if you have a degenerative tear in one.
Are there any complications?
Without proper treatment, a torn rotator cuff can lead to permanent loss of strength and movement. As a result, the shoulder joint may have to deal with progressive degeneration. Even though resting your shoulder is advisable, keeping it immobilized for lengthy periods is a bad idea. If you keep your shoulder stationary for a long time, the connective tissue encapsulating the joint can tighten, making your shoulder freeze.
What are the risk factors?
Even though a rotator cuff doesn’t tear on its own, various determinants can make it more susceptible to damage. These factors include:
- Age: As you grow older, the rotator cuff muscles weaken naturally, increasing the risk of injury. Apart from that, the wear and tear in the glenohumeral joint with time aggravates the situation. Rotator cuff tears are most common in people above the age of 60.
- Physical jobs: If you have a construction job, such as carpentry or house painting, you may be at greater risk. As these jobs require repetitious arm motions, the rotator cuff suffers damage over time. To make matters worse, most of these movements are overhead, making the physical strain much more excruciating.
When to see a doctor?
When you start to experience any of these symptoms, it might be time to seek medical attention.
- Pain during resting and at night, especially when lying on the affected shoulder.
- Weakness during lifting and rotating movements
- Pain during specific arm movements
- Crackling sensations while bending arm in certain positions
Upon arrival at the hospital, you will undergo a few tests to determine the severity of your situation.
- Physical examination and medical history: Your doctor will examine your shoulder after reviewing your symptoms and medical history. They’ll check it to see whether there’s any tenderness or a deformity – the doctor will ask you to raise your arm in many different directions to determine your shoulder’s range of motion. Your arm strength will undergo tests as well, and the doctor will also examine your shoulder joint for any other issues. They may also check the neck to rule out other problems, such as arthritis. Moreover, it ensures that the pain is not the result of a pinched nerve.
- Imaging tests: Other tests that your doctor can use to confirm the diagnosis include X-ray imaging and MRI scanning. X-rays are typically the first imaging experiments conducted. Plain X-rays of a shoulder with rotator cuff pain are frequently seen or can display a slight bone spur because x-rays do not show the soft tissues of your shoulder, such as the rotator cuff. MRIs will reveal the presence of a rotator cuff tear, as well as the location and size. Because it can show the quality of the rotator cuff muscles, an MRI can also help your doctor determine how old a tear is.
What are the treatment options available?
Torn rotator cuff treatment should aim to relieve pain while also restoring function. A rotator cuff tear is repairable through various methods, and the best choice for each person is different. Your doctor will evaluate your age, activity level, general health, and the type of tear you have while preparing your procedure.
Nonsurgical care relieves pain and improves shoulder function in around 80% of patients. These treatments include:
- Rest: Rest and limiting overhead tasks are advisable. The doctor may also recommend a sling to help secure and stabilize your back. Moreover, you can steer clear of activities that aggravate your condition. This method is prudent for golf elbow treatment.
- Non-steroidal anti-inflammatory drugs: Ibuprofen and naproxen are pain relievers and swelling reducers.
- Physical therapy and chiropractic care: Specific exercises will help you regain mobility in your shoulder and reinforce it. Stretching can be part of the workout to increase flexibility and range of motion. The muscles that protect your shoulder can undergo strength training to alleviate discomfort and avoid further damage.
- Steroid injections: An injection of a local anesthetic like a cortisone preparation can be beneficial since cortisone is a very effective anti-inflammatory drug. It is not, however, effective for all patients.
After suffering from a torn rotator cuff, people prefer non-invasive treatment because it saves them from the nasty side effects of surgery. However, you may need surgery in case of severe injury. Early care will prevent the development of even worse symptoms. It will also help you return to your routine much faster. Even though prevention is not possible in most cases, you should actively make an effort to lessen the strain on your rotator cuff muscles and shoulder.