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Rotator Cuff Injury

What is a Rotary Cuff Injury?

Woman with shoulder pain

Rotator cuff injury can result from twisting the joint, over-stretching or rapid movement.

A rotary cuff injury, tear, or strain refers to a tear in one of the four rotator cuff muscles located in the shoulder. Since the shoulder joint is so mobile, a rotary cuff tear – a common cause of shoulder pain – can easily occur as a result of over-stretching, rapid movement, or twisting of the joint.

Rotary Cuff Injuries: Risk Factors

People who regularly perform overhead motions in their sport or as part of their job are at greater risk of sustaining a rotary cuff tear. Rotary cuff injury risk factors include:

  • Baseball players (especially pitchers)
  • Racket sports players
  • Painters
  • Carpenters
  • Elderly (over the age of 40)

Rotary Cuff Injury Symptoms

Symptoms of an acute rotator cuff tear include:

  • Tenderness at the point of the injury
  • Muscle spasms
  • Shoulder pain
  • Inability to move shoulder
  • Inability to raise arm to the side without assistance

Symptoms of a chronic rotator cuff tear, which develops over time, include:

  • Shoulder pain which worsens over time
  • Tear typically occurs on the dominant side
  • Pain is worse at night, affecting sleeping
  • Shoulder weakness
  • Inability to raise arm to the side
  • Difficulty with overhead movements (combing hair, dressing, reaching behind the back)
  • May be associated with shoulder impingement (impingement syndrome) 

Rotary Cuff Injuries Common Causes

The following can cause rotator cuff strain or tear:

  • Repetitive motion of the arms which stresses the rotary cuff tendons and muscles, leading to inflammation and eventual tearing
  • Falling on your arm or use of your arm to break a fall
  • Improper lifting of heavy objects overhead
  • Bone spurs (an overgrowth of bone on the shoulder blade) which can irritate and damage the rotary cuff tendon

How to Treat a Rotary Cuff Tear

Minor rotary cuff injuries typically heal on their own with rest and some moderate care. If you have injured your rotator cuff, follow these guidelines:

  • Rest your shoulder
  • Avoid painful movements
  • Apply ice or a cold pack to reduce shoulder inflammation and pain
  • Once inflammation has subsided, apply heat (i.e. a heating pad or hot packs) to relax tight or sore muscles
  • Limit overhead activities until shoulder pain subsides
  • Avoid heavy lifting
  • Wear a sling during the day to immobilize the shoulder
  • Use over-the-counter pain relievers such as ibuprofen and acetaminophen
  • Consult a physiotherapist regarding rotator cuff exercises which help restore strength and flexibility to the shoulder

Surgery for a Rotator Cuff Tear

Surgical options for a rotary cuff injury include:

  • Tendon repair
  • Tendon replacement
  • Bone spur removal
  • Shoulder replacement (in severe cases, usually associated with arthritis of the shoulder or degenerative joint disease)

How to Prevent a Rotary Cuff Injury

If you are at risk for or have sustained a rotary cuff injury in the past, consult a sports doctor or physiotherapist regarding daily shoulder exercises and stretches you can do to help prevent injury. Recommended are exercises that strengthen the front muscles of the shoulder, upper arm, and chest, as well as those that work the shoulder blade and muscles in the back of the shoulder.