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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 sac of fluid around the joint).

Shoulder Anatomy

What causes a rotator cuff injury?

Everyday wear and tear can weaken tendons as you get older. The tendon can become trapped by your arm bone when you lift your arm. Heavy lifting or throwing can cause overuse or an injury. This may happen if you play a sport such as baseball or tennis. These kinds of sports 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 that may be constant or come and go (such as only when you lie on the injured shoulder)
  • Pain or stiffness in your shoulder that travels down your arm
  • Trouble lifting your arm or placing it behind your back
  • Trouble moving or using your shoulder
  • A swollen shoulder that may be painful to the touch
  • Numbness in part or all of your arm, more common in athletes who throw as part of their sport (such as baseball)
  • A popping noise along with pain when you lift your arm

How is a rotator cuff injury diagnosed?

Your healthcare provider will ask if you have had an injury or surgery on your shoulder. He or she 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 pictures may show fluid or swelling around your rotator cuff.
  • X-rays may show injury to the bones and tissues in your shoulder.
  • CT or MRI pictures may show an injury or other problems causing your symptoms. You may be given contrast liquid to help your shoulder show up better in the pictures. Tell the healthcare provider if you have ever had an allergic reaction to contrast liquid. Do not enter the MRI room with any metal. Metal can cause serious injury. Tell the healthcare provider if you have any metal in or on your body.

How is a rotator cuff injury treated?

  • Medicines may include acetaminophen or prescription pain medicine. NSAIDs or steroids may be used to relieve inflammation. This can decrease pain caused by inflammation. Steroids may be injected into the rotator cuff area. NSAIDs and acetaminophen are available without a doctor's order. Ask your healthcare provider which medicine is right for you. Ask how much to take and when to take it. Take as directed. NSAIDs and acetaminophen can cause stomach bleeding, kidney problems, or liver problems if not taken correctly.
  • Physical therapy can help you improve movement and strength, and decrease pain. A physical therapist will teach you safe exercises. The exercises may help you move your shoulder normally again and strengthen your rotator cuff. You may learn changes to make to your daily activities that will help decrease stress on your tendons.
  • Surgery may be needed 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. Surgery may be used to clean away damaged tissue or fix a tear. A piece of another tissue or muscle may be used to fix a badly torn tendon. The bone of your shoulder joint may be reshaped so it stays in place. An artificial joint made of metal and plastic may be put into your shoulder.

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

  • Rest may help your shoulder heal. Overuse of your shoulder can make your injury worse. Avoid heavy lifting, putting 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. Use an ice pack, or put crushed ice in a plastic bag. Wrap a towel around the bag before you put it on your shoulder. Apply ice for 15 minutes every hour, or as directed. After the first several days, heat may help relax the muscles in your shoulder. Use a heat pack or heating pad. Apply heat for 20 minutes every hour, or as directed.

When should I call my doctor or orthopedist?

  • You suddenly cannot move your arm.
  • 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 questions or concerns about your condition or care.

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 healthcare providers 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.

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Further information

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