“Rotator cuff” might sound like some sort of car part, but it’s actually a part of your shoulder joint — a really important part. Your rotator cuff is a collection of muscles, tendons, and ligaments that work together to help your shoulder move. The cuff also keeps the ball part of the shoulder joint inside the concave socket. Rotator cuff injuries are common, partly because so many structures are involved. Plus, since you use your rotator cuff for most shoulder movements, even a minor injury can wind up causing a lot of pain. Some types of rotator cuff injuries respond well to conservative treatments, while others need more aggressive medical care. Here’s what to do if you have rotator cuff shoulder pain.
Rotator cuff injuries: Types and symptoms
Both traumatic injuries and everyday wear and tear can cause rotator cuff damage. Most rotator cuff pain involves tendon inflammation (tendinitis). The most common cause of tendonitis is repetitive use. If you use your shoulders a lot for lifting, reaching, or throwing, you’re more likely to have tendinitis. It tends to be more common among athletes and older people whose tendons are weaker. In more extreme cases, the tendons can start to fray, a condition called tendinosis.
Rotator cuff tears occur when a tendon is completely or partly torn away from its attachment to the bone. Traumatic injuries cause most tears, but in older people, wear and tear can cause tears, too. Smoking also increases your risk of tendon tears.
Rotator cuff symptoms can vary to some degree based on the type and extent of your injury. The most common symptom is pain when you move your shoulder. Usually, the pain feels like a deep aching along the top and side of the joint. Sometimes, you’ll feel pain in your arm as well as around the front and side of your shoulder. You’ll have pain when you lift your arm over your head or try to use your arm to lift something heavy. Pain is often accompanied by weakness in the arm, and if you try to sleep on your side, your pain can intensify. Like other types of muscle and tendon damage, rotator cuff injuries may cause very mild symptoms or no symptoms at all during their early stages.
How is a rotator cuff injury diagnosed and treated?
Dr. Van Thiel uses an array of tests and exams to diagnose rotator cuff injuries, beginning with a thorough exam of your shoulder. During your office visit, he’ll move your shoulder in different ways to pinpoint your rotator cuff pain location and test your shoulder function and strength. He’ll also ask you about your activities, your medical history, and the specific nature of your symptoms. Often, he’ll prescribe diagnostic imaging, like X-rays or MRI, to obtain images of the inside of your shoulder. The exam and imaging tests enable Dr. Van Thiel to prescribe a customized course of rotator cuff injury treatment.
In most cases, rotator cuff treatment begins conservatively, with exercises and gentle stretching designed to reduce inflammation and restore normal joint function. You might benefit from ice packs and over-the-counter pain medicines, and in some cases, Dr. Van Thiel may recommend joint injections to provide more immediate and targeted relief.
Physical therapy often plays a big role in rotator cuff treatment, with a focus on rotator cuff injury exercises to help you get back to your normal activities. Often, patients get the most benefits from a combination of these conservative options. In more severe injuries, you might need rotator cuff surgery to repair the damage. Most surgery is performed using very small incisions for faster recovery and fewer risks.
Can a torn rotator cuff heal on its own?
Like other rotator cuff injuries, rotator cuff tears can range from mild to severe, and that means your treatment will vary as well. Generally, very small rotator cuff tears can heal on their own with proper medical treatment. Complete tendon tears or severe partial tears are more likely to need surgery, especially if you’re young or lead an active lifestyle. Without surgery, the tendon may not heal properly or it may not heal at all, leaving you with chronic pain and decreased use of your shoulder. If you have any type of shoulder symptoms — even mild symptoms — you should schedule an appointment to have your pain evaluated.
Although rotator cuff injuries can be painful, most injuries can be treated conservatively. The key to a quick and complete recovery is to have your pain evaluated as soon as possible, before serious or even permanent damage occurs. To find out what’s causing your shoulder pain, schedule an office visit today.