Shoulder pain can be a very frustrating condition that can lead to multiple visits to the doctor. Although there are numerous conditions that cause it, rotator cuff injury is a common source of discomfort. The rotator cuff is comprised of a dynamic group of four muscles that help initiate and stabilize the shoulder during motion, thus undergoing a lot of stress during the course of normal daily activity. From gardening to the pounding of a mountain bike, these muscles can often be overworked. Problems with the rotator cuff span a spectrum of issues from inflammation of the tendon (tendonitis or bursitis) to a complete tear of the tendon from the bone (rotator cuff tears).
Signs and Symptoms of Rotator Cuff Injury
A specific event is not always associated with a rotator cuff injury. Sometimes, rotator cuff injuries present with a slow progression of symptoms over time. Determining tendonitis from a tear can be difficult to diagnose on your own. However, the signs and symptoms associated with rotator cuff injury are quite classic. Symptoms include:
- Pain, located primarily in the front or side of the shoulder, that frequently radiates down the side of the upper arm
- Pain when raising the arm or reaching overhead
- Weakness or inability to raise the arm
- Difficulty sleeping
If these symptoms persist for more than a week, a visit to an orthopaedic surgeon can assist in making the correct diagnosis and help form a treatment plan.
Treatment Options
Treatment options for rotator cuff problems vary with the severity of the injury. A common misconception is a trip to an orthopaedic surgeon will result in surgery as the only treatment option. More often than not, surgery is not required. Often, injuries can be treated with non-operative methods such as anti-inflammatory medicines, occasional cortisone injections and physical therapy. Reducing inflammation within the shoulder while building up the strength of the rotator cuff muscles with specific exercises typically reduces shoulder pain. Those individuals who do not find relief with conservative treatment may need further imaging studies, like an MRI, to evaluate the extent of the rotator cuff injury.
A common misconception is a trip to an orthopaedic surgeon will result in surgery as the only treatment option. More often than not, surgery is not required.
At times, surgery is required to treat rotator cuff injuries, especially if the tendon has torn away from its attachment site. Reliable studies have shown that a rotator cuff tendon torn away from bone does not have the ability to heal itself and the tear persists. This can lead to long-term pain and functional loss as well as make later attempts of surgical repair unsuccessful. Surgical techniques continue to evolve, and often the repair of the rotator cuff can be accomplished through a minimally invasive approach using three small band-aid size incisions. Surgery is often done on an outpatient basis with the patient going home the same day as the procedure. Outcomes following rotator cuff surgery frequently result in lasting pain relief and improvement in function.
How to Prevent a Rotator Cuff Tear
As with most things, prevention is the key. For good shoulder health, maintain a consistent well-rounded shoulder exercise program that focuses on stretching of the shoulder to maintain flexibility and a low-weight rotator cuff strengthening program for joint stability and conditioning. Following this regime will not only help you stay out of the doctor’s office, but will also allow you to continue to enjoy the activities you love.
