Rotator Cuff Injury | Orthopaedics | Loyola Medicine

Rotator Cuff Injury

Overview and Facts about Rotator Cuff Injury

Your rotator cuff is a group of muscles that keeps your arm in your shoulder socket. These muscles come together to form tendons covering your upper arm bone (humerus), which help you lift and rotate your arm. When you injure your rotator cuff, you tear the tendons, resulting in a dull ache that can get worse with pressure (i.e., when sleeping on the affected arm).

Rotator cuff tendon tears may be partial or complete, depending on the severity of the injury. You should seek immediate medical attention if you experience a rotator cuff injury in order to prevent further damage. 

Symptoms and Signs of Rotator Cuff Injury

Rotator cuff injuries are either the result of a sudden injury or the breaking down of rotator cuff tendons over time. A dull ache in the shoulder is the most common symptom, as well as:

  • Difficulty reaching behind your back
  • Pain that gets worse at night or wakes you from sleep
  • Pain in the shoulder when you lie down on the affected side
  • Arm weakness, especially when lifting or rotating your arm
  • Pain when lifting or lowering your arm

Intense pain in the affected shoulder or sudden weakness are signs of a complete tear. Seek immediate medical attention if you have these symptoms.

Causes and Risk Factors of Rotator Cuff Injury

Rotator cuff injuries are either the result of a sudden injury or the breaking down of rotator cuff tendons over time. Overhead, repetitive activities, such as throwing or lifting weights may cause chronic, or degenerative tears. The development of bone spurs in the shoulder may also cause the tendon to weaken and tear.

A sudden injury to the rotator cuff may be the result of a fall or lifting a heavy object.

Risk factors for rotator cuff injury include:

  • Age: People over 40 are at a higher risk for this type of injury
  • Jobs or activities (including certain sports) with repetitive overhead motions or lifting

Tests and Diagnosis for Rotator Cuff Injury

After your doctor reviews your medical history and discusses your symptoms, your doctor will examine your shoulder, testing for signs of tenderness, pain and/or weakness. Your doctor may also order imaging tests in order to rule out other causes or injury/pain, such as arthritis or a pinched nerve. These tests include X-rays, MRI scans or ultrasounds.

Treatment and Care for Rotator Cuff Injury

Your doctor will recommend the best course of treatment for your specific case, depending on the severity of the injury, your age and your level of activity. Sudden or chronic shoulder pain should be addressed promptly to avoid further damage to the area.

Nonsurgical treatment options include:

  • Rest, accompanied by a temporary arm sling and limiting overhead activities (or any activity that causes pain) for a period of time
  • Anti-inflammatory medication
  • Physical therapy to restore flexibility and range of motion
  • Steroid injection

Surgical treatments may be recommended if the tear is substantial, due to a sudden injury, or if chronic pain persists with non-operative treatment. Surgical treatment options include arthroscopy for tendon repair or bone spur removal and open surgical repair of torn tendons.

Following surgery, your doctor may prescribe medication for pain management and a physical therapy program to rehabilitate the affected muscles and tendons.