5 Key Indicators of a Rotator Cuff Injury
One of the most common shoulder injuries involves damage or a strain of the rotator cuff muscles. Descriptions such as shoulder bursitis, impingement, tendinitis, tendinosis, partial and full thickness tears are used to describe the nature and severity of rotator cuff specific pain and dysfunction.
Understanding the Rotator Cuff Muscles
The rotator cuff is made up of four small muscles: the supraspinatus, subscapularis, infraspinatus, and teres minor. These muscles are crucial for creating the necessary humeral head depression, which keeps your shoulder joint centered. This centering allows your shoulder to move freely in multiple directions.
Sports and Exercises Impacting the Rotator Cuff
Pain in the rotator cuff is common in sports like baseball, tennis, swimming, volleyball, and gymnastics. Additionally, weight training and calisthenic exercises can place significant stress on the rotator cuff.
Training Factors Leading to Rotator Cuff Injuries
When training or participating in sports, one major risk factor for injury is the sudden onset of training. This is especially true during pre-season or early in-season periods when activity levels rapidly increase. Improper training plans and faulty movement patterns can further increase the risk of injury.
Other Causes of Rotator Cuff Pain
Besides training errors, several other factors can lead to rotator cuff pain. These include bone spurs, trauma, and overuse, particularly with overhead or repetitive activities. Over time, wear and tear or shoulder dislocations can also contribute. Similar shoulder pain and symptoms might arise from conditions like frozen shoulder, arthritis, or nerve pain.
Signs and Symptoms of a Rotator Cuff Injury
- Pain with Reaching Motions:
Reaching overhead, to the side, across the body, or behind your back can cause pain. Everyday tasks like fastening a bra, tucking in a shirt, or reaching for items on a high shelf may aggravate the shoulder. The pain typically occurs at the front or side of the shoulder and may radiate down the upper arm. - Weakness or Reduced Lifting Capacity:
You might feel as though your arm can’t lift, carry, push, or pull its usual weight. These symptoms often worsen when the arm is extended. - Decreased Range of Motion:
Pinching or sharp pain in certain movements can limit your ability to perform daily tasks like dressing, washing your hair, driving, and other routine activities. - Tenderness in the Shoulder or Deltoid Region:
Pressing on the front, side, or back of the shoulder may cause pain, particularly during the acute inflammatory phase. - Difficulty Sleeping or Lying on the Affected Side:
A hallmark sign of a rotator cuff tear is pain at night. As you lay down, your shoulder and upper arm may ache or throb. This pain often worsens when you try to lay on the affected side.
Understanding the Symptoms and Treatment of Rotator Cuff Injuries
Common Treatment Approaches for Rotator Cuff Injuries
The most common treatment for a rotator cuff injury involves several steps:
- Rest and Activity Modification
Begin with relative rest and modify activities based on your pain level. - Medication
Take non-steroidal anti-inflammatory medication as directed by your doctor to reduce inflammation. - Exercises
Perform range-of-motion (ROM) and strengthening exercises focused on the scapular stabilizers and rotator cuff muscles. - Ice Therapy
Apply ice regularly to reduce pain and inflammation.
Diagnostic Procedures for Rotator Cuff Injuries
Physicians often start by performing x-rays. These help assess the bony structure and detect bone spurs, arthritis, or instability. In very acute situations, your doctor might offer a corticosteroid injection, but only if there is no concern about a rotator cuff tear. If soft tissue damage is suspected, an MRI may be required. However, most insurance companies mandate six weeks of physical therapy before authorizing an MRI.
The Role of Physical Therapy
A physical therapist does more than just treat shoulder pain. They assess the entire body to identify any asymmetries or imbalances contributing to the issue. Typically, therapy occurs 1-2 times per week for 4-6 weeks. If symptoms do not improve during this period, your physician will discuss the next steps, which may include imaging or surgical options.
Even if you have a partial thickness rotator cuff tear, it may not mean surgery is necessary to overcome your symptoms. Consider this article published in 2023 looking at conservative measure including injections, PRP and physiotherapy to manage partial tears.
In the end, if you are unsure about the extent of a your shoulder injury, contact us to schedule an evaluation. Our staff can assess your shoulder and determine if you need to see the doctor, perform routine physical therapy or simply do some some basic exercises at home. Early recognition and treatment is essential to achieve the best outcome.