The rotator cuff is a group of muscles around the shoulder joint. They work as a unit helping to stabilize the shoulder joint and aid movement. The rotator cuff tendon is formed by the four tendons of these muscles which join to form one larger tendon attached to the humerus (at the top of the upper arm bone). It then passes through the subacromial space under the scapula.
It is injury and inflammation of this rotator cuff which most often causes shoulder pain. This may be rotator cuff tendonitis, rotator cuff impingement syndrome or a rotator cuff tear and can mostly be treated with rest, anti-inflammatory painkillers, physiotherapy and possibly steroid injections. In extreme cases, surgery may be necessary.
How does a rotator cuff tear happen?
A rotator cuff tear is an extremely painful condition which is mainly suffered by people over 40 when the tendon becomes trapped in the space under the scapula. In younger people tears tend to occur as a result of a fall or accident. The tears occur in the tendon, not in the muscles themselves and their severity very much depends on the extent of the injury.
Symptoms of a rotator cuff tear
Usually, it is pain that alerts you to the injury. It tends to be over the outer and front part of the shoulder and feels worse depending on the position of your shoulder. For example, the pain can be agonizing if you move your arm above your head while doing something as simple as dressing. The shoulder may also feel weak and difficult to move, possibly catching or clicking when moved.
Diagnosis of a rotator cuff tear
Initially, your doctor will need to examine your shoulder.
It is probable that the doctor will also suggest an ultrasound or MRI scan to ensure diagnosis.
In the event that the doctor suspects a complete rupture of the rotator cuff, there may be the need for surgery.
Treatments for a rotator cuff tear
Over the counter painkillers will usually help, but stronger ones may be needed if the pain is acute. The doctor may also suggest that you take anti-inflammatories to assist the healing and pain. Ice packs may also help to lessen pain as will physiotherapy. A physiotherapist will be able to advise on which exercises would be most useful.
On occasion, steroid injections may be recommended. These are administered into the shoulder joint and help to reduce inflammation caused by the tear.
Nutritional supplements are effective in treating muscular and tendon problems. They help to prevent and relieve swelling, bruising and pain.
As a last resort, surgery may be required. This involves the widening of the space in which the tendon is trapped and may also involve repair of the tear. This can be carried out using open or keyhole surgery.
Prevention of rotator cuff tears.
People who are at risk of rotator cuff injuries or have previously suffered a rotator cuff injury should develop a routine of daily shoulder stretches and exercises to help prevent future injury.
