Rotator Cuff InjuryA Rotator cuff strain is a tear that causes a dull and prolonged pain in the shoulder which degrades over time with normal use and laying on the injured shoulder. The Rotator Cuff is the collective group of muscles along with the tendons that surround and encircle the shoulder joint, and aids in keeping the head of the upper arm bone in the cushions of the shallow socket that is present in the shoulder. 

Symptoms

The symptoms of a Rotator Cuff injury are pretty clear and laid out. The dull, yet throbbing pain worsens with the passing time, and the patients often neglect the pain as minor muscle cramps or a simple stretch of the muscle, but this injury needs to be taken proper care of because they tend to get worse if left untreated.

A few of the most common symptoms experienced by patients are as follows:

  • A dull and prolonged pain is evident in the primary stage which worsens with the passing time if left untreated. The pain is often accompanied by swelling in the side of the arm and also in the front of the shoulder.
  • The pain is often triggered when the patient tries to raise or lower their arms and daily activities are heavily hampered.
  • Raising the injured arm is accompanied by a clicking sound which is due to the rigidity and stiffness of the arm.
  • Like mentioned before, the sharp pains that are witnessed in the somewhat later stages tend to get worse and up to such a level that they can interrupt the patient’s sleeping.
  • The pain tends to be dynamic and can even spread. When patients try to reach behind their back, the initial feeling of the pain tends to be very bad.
  • The continued pain and the stiffness around the affected area tend to immobilize the area and the strength of the particular area tends to deteriorate.

Explanation

A Rotator Cuff tear is mainly the inflammation and irritation present in the muscles and tendons of the shoulder joint. If left untreated, the injury can lead to a shoulder impingement. This condition is not something that happens overnight. Continued degradation  and overuse of the shoulder can cause of the pain and stiffness around the affected area.

This injury is mainly seen in people who indulge themselves in a lot of arm activities and the continued action may result in this impairment. For example, Athletes who have a regular need to extend their arms over their heads are at a higher risk of being affected by this problem. The injuries are so common that they have been often referred to as “swimmer’s shoulder” or “tennis shoulder”.

Diagnosis

If a prolonged aching pain is sustained even after taking painkillers, it is advised to not delay and consult a doctor right away. The doctors tend to first examine the shoulder region for any evident symptoms of the problem, and then proceed further with the treatment depending on the severity of the injury. The doctor will check the mobility of the arm by testing the arm movements of the patients in all directions and often will check the strength of the shoulder joint by pressing their hands against it while the patients are asked to apply an opposite pressure to the hand. As mentioned earlier, the pain tends to spread over to the adjoining areas as well, so it’s fairly common for the doctors to check the neck and the adjoining areas of the shoulder of any symptoms of a pinched nerve, or even arthritis which can be mistaken for a Rotator Cuff Injury. One of the more solid diagnoses for the problem is an x-ray or even an MRI for locating the amount of inflammation in the affected area.

Causes and Types

There are mainly two types of causes for a rotator cuff strain:

Acute Tear: Simple injuries that are caused by any strenuous work or any heavy lifting can cause acute tears to the rotator cuff. This may come as a side-effect for a shoulder dislocation or a broken collarbone, and are less severe, so they tend to be easily treated over time.

Degenerative tear: The most  common causes of a degenerative tear is aging.  After years of use, the shoulder tendons begin to wear away. It has been observed that the rotator tear then occurs most often in dominant arm, and tend to be a sign that it will develop in the opposite shoulder as well. One of the most common degenerative tears are a supraspinatus tendon tear.

Some of the causes of the degenerative tear are:

  • Prolonged stress: the repeated movements of the shoulder over time can wear out the muscles and the tendons surrounding the area, causing the tear.
  • Lack of blood supply: with senescence, the blood regulation tend to become unregulated and thereby the blood supply in the rotator cuff areas lessen. Without a proper blood supply the repair mechanism of the body is not optimum.

Treatment

There are many treatments that can be used during the recovery process. In minor injuries and rotor cuff discomfort, doctors recommend resting and putting ice on the injured spot to reduce swelling and inflammation. In addition, it is recommended to support the shoulder with a sling or support it while lying. Moreover, if the situation does not improve, some anti-inflammatory drugs may be prescribed. Please note that such drugs should not be administered without proper medical checkup and treatment. In cases of more severe pains, doctors usually prescribe anti-inflammatory drugs and regular physical exercises which should be adjusted to the severity of the injury. If you suffer from rotator cuff discomfort, it would be best to visit your doctor, who will surely recommend exercises with physical therapist. Your physical therapist will recommend the proper exercises and will recommend the frequency and the duration of such exercises.

Rotator cuff injuries tend to get worse with time due to the fact that they are often neglected and left untreated. It is also best to get the arms and shoulders examined for chronic or any prolonged pain . If left untreated, the injury can get larger with the passing time.

The main factors that the doctor will consider before administering any treatment are the patient’s age, activity level, general health, and the type of degeneration the patient has.

The types of treatment involved are classified into two broad types; non-surgical treatments and surgical treatments.

Non-surgical treatments:

The doctors tend to suggest as many non-surgical treatments they can in order to relieve the pain, however, if the pain sustains, surgical methods are opted.

Non-surgical treatments cater the following treatment methods:

Complete Rest: the actions of the arms and the shoulders are restricted to a minimum when diagnosed with rotator cuff injury.doorway stretch

Exercises: there are many rotator cuff exercises that can help ease the pain. Some of which are:

  • The doorway stretch is one of the main types in which the patient needs to stand in an open doorway with outstretched arms on either side and carefully leaning forward with the pressure on the doorway and keeping a straight back.
  • Side-lying external rotation involves lying on the side of the unaffected arm and then slowly lifting a dumbbell with the injured arm carefully without overstretching.
  • Stretching resistance bands with the arms is yet another important exercise that helps relieve the pain.

Read more about physical therapy

Surgical treatment:

Surgical treatment is the last resort  if the pain persists, even after all the implementations of the non-surgical treatments.  The surgical treatment mainly involves the reattachment of the tendon to the head of the humerus. While this is just one of the surgical treatments, there are a varied other treatments which the orthopedic surgeon will discuss with you about depending on the degree of the degeneration.