Rotator Cuff Injury

What is a rotator cuff injury?

A rotator cuff injury is damage to the muscles or tendons of your rotator cuff. A tendon is a cord of tough tissue that connects your muscles to your bones. The rotator cuff is made up of a group of muscles and tendons that hold the shoulder joint in place. The damage may include stretching of your muscle or tears in the tendons. It may also include inflammation of the bursa (small sack of fluid around the joint).

What causes a rotator cuff injury?

  • Wear and tear of the tendons: Your tendons get weaker as you get older.

  • Impingement: This happens when the bone of your upper arm presses on the tendon of your shoulder when you lift your arm. Impingement causes pain and inflammation that weaken your rotator cuff.

  • Overuse or injury: Heavy lifting, throwing, or overuse may damage the rotator cuff. Sports such as baseball and tennis may injure your rotator cuff when your arm goes over your head. A fall or other shoulder injury may also damage your rotator cuff.

What are the signs and symptoms of a rotator cuff injury?

  • Pain or stiffness: You may feel pain in your shoulder that travels down your arm. You may feel pain all of the time or only sometimes. You may feel pain when you lie on the side of your injured shoulder.

  • Decreased range of motion: You may have trouble lifting your arm or placing it behind your back. It may also be hard to use your shoulder. If you have a severe injury, you may not be able to move your shoulder at all.

  • Tenderness or swelling: Your shoulder area may swell and be painful to the touch.

  • Numbness: You may lose feeling in part or all of your arm. This is more common in athletes who throw as part of their sport, such as baseball pitchers.

  • A popping noise: You may hear this noise and feel pain when you lift your arm.

How is a rotator cuff injury diagnosed?

Your caregiver will ask if you have had an injury or surgery on your shoulder. He will examine your shoulder, and test the strength and movement of your arm. You may need other tests to show what is causing your symptoms.

  • Ultrasound: An ultrasound uses sound waves to show pictures on a monitor. An ultrasound may be done to show fluid or swelling around your rotator cuff.

  • X-ray: An x-ray may show injury to the bones and tissues in your shoulder.

  • CT scan: This test is also called a CAT scan. An x-ray machine uses a computer to take pictures of your shoulder. You may be given a dye before the pictures are taken to help caregivers see the pictures better. Tell the caregiver if you have ever had an allergic reaction to contrast dye.

  • MRI: This scan uses powerful magnets and a computer to take pictures of your shoulder. An MRI may show damage to your muscles or tendons. You may be given dye to help the pictures show up better. Tell the caregiver if you have ever had an allergic reaction to contrast dye. Do not enter the MRI room with any metal. Metal can cause serious injury. Tell the caregiver if you have any metal in or on your body.

How is a rotator cuff injury treated?

  • Medicines:

    • Acetaminophen: This medicine decreases pain. Acetaminophen is available without a doctor's order. Ask how much to take and how often to take it. Follow directions. Acetaminophen can cause liver damage if not taken correctly.

    • NSAIDs: These medicines decrease swelling, pain, and fever. NSAIDs are available without a doctor's order. Ask your caregiver which medicine is right for you. Ask how much to take and when to take it. Take as directed. NSAIDs can cause stomach bleeding or kidney problems if not taken correctly.

    • Pain medicine: You may be given a prescription medicine to decrease pain. Do not wait until the pain is severe before you take this medicine.

    • Steroids: This medicine may be injected into the rotator cuff area to decrease inflammation and pain.

  • Physical therapy: A physical therapist can teach you exercises to help improve movement and strength, and to decrease pain. These exercises may help you go back to your usual activities or return to playing sports.

  • Surgery: You may need surgery if your injury is severe or your symptoms do not improve. You may also need surgery to decrease your signs and symptoms if other treatments have not worked.

    • Debridement and repair: This surgery is done for partial or full tears of your rotator cuff. Your caregiver will clean away damaged tissue and fix your tear.

    • Tendon transfer and graft: This surgery is done for badly torn rotator cuffs that cannot be repaired easily. Your caregiver will use a piece of another tissue or muscle to fix the torn tendon.

    • Arthrodesis: This surgery is to reshape the bone of your shoulder joint so it stays in place. This is done if the muscles of your rotator cuff are not working.

    • Arthroplasty: During this surgery, an artificial joint made of metal and plastic is put into your shoulder. This surgery may be done if the rotator cuff cannot be fixed, or if your pain and swelling do not go away.

How can I care for my rotator cuff injury at home?

  • Rest: Rest may help your shoulder heal. Overuse of your shoulder can make your injury worse. Avoid heavy lifting, using your arms over your head, or any other activity that makes the pain worse.

  • Put ice or heat on your shoulder: Use ice on your shoulder every few hours for the first several days. This may help decrease pain and swelling. After the first several days, a heating pad may help relax the muscles in your shoulder.

When should I contact my caregiver?

Contact your caregiver if:

  • The pain in your shoulder or arm is not improving, or is worse than before you started treatment.

  • You have new pain in your neck.

  • You have a fever.

  • You have questions or concerns about your condition or care.

When should I seek immediate care?

Seek care immediately or call 911 if:

  • You suddenly cannot move your arm.

  • You have severe stomach or back pain, are vomiting blood, or have black bowel movements.

Care Agreement

You have the right to help plan your care. Learn about your health condition and how it may be treated. Discuss treatment options with your caregivers to decide what care you want to receive. You always have the right to refuse treatment. The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.

© 2013 Truven Health Analytics Inc. Information is for End User's use only and may not be sold, redistributed or otherwise used for commercial purposes. All illustrations and images included in CareNotes® are the copyrighted property of A.D.A.M., Inc. or Truven Health Analytics.

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