Definition

Rotator cuff injury may include tendinitis, strain, or tear of the rotator cuff. The rotator cuff is made up of muscles and four separate tendons that fuse together to surround the shoulder joint.

Rotator Cuff Injury

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Causes

Causes of a rotator cuff injury include:

• Direct blow to the shoulder area
• Falling on an outstretched arm
• Chronic degenerative wear and tear on the tendons
  • Arthritis may decrease the space for the tendons
  • Chronic instability of the humerus may traumatize the tendons
• Repetitive overhead motion of the arm such as in:
  • Swimming
  • Baseball (mainly pitching)
  • Tennis

Risk Factors

A risk factor is something that increases your chance of getting a disease or condition. Risk factors for a rotator cuff injury include:

• Age: 40 or older
• Heavy lifting
• Activities that involve repetitive overhead arm motion
• Weakened shoulder muscles from inactivity

Symptoms

• Recurrent, constant pain, particularly when reaching overhead
• Pain at night that prevents you from sleeping
• Shoulder muscle weakness, especially when lifting the arm
• Popping or clicking sounds when the shoulder is moved
• Limited range of motion in the shoulder joint

Diagnosis

The doctor will ask about your symptoms and medical history, and perform a physical exam. The doctor will carefully examine your shoulder. You will be asked to move your shoulder in several directions.

Tests may include:

• X-rays —to rule out fractures and bone spurs.
• Arthrogram—dye is injected into the shoulder joint and then an x-ray or MRI is taken. The doctor will look for dye that leaks out of the joint, which may indicate a tendon tear.
• MRI scan—a test that uses a strong magnetic field and radio waves to make pictures of the inside of the shoulder. This will show bones and tendons, and is an excellent way to determine either large or small tears of the cuff.
• Arthroscopy—a thin, lighted tube is inserted through a small incision in the shoulder to look at the structures inside the shoulder. Arthroscopy can also be used for treatment.
• Ultrasound—a test that uses sound waves to examine the rotator cuff for inflammation or tears.

Treatment

The treatment will depend on the extent of your injury, level of pain, and amount of immobility. The first step is usually a nonsurgical approach.

If you are diagnosed with a rotator cuff injury, follow your doctor's instructions .

Prevention

To reduce your chances of getting a rotator cuff injury:

• Avoid overhead repetitive motion.
• Avoid heavy lifting.
• Exercise regularly to strengthen the muscles around the shoulder joint.