Let’s talk about your rotator cuff. Though it may be small, it is mighty. It helps you make that three-pointer, reach for things on the top shelf and even brush your hair.
What’s the rotator cuff?
The rotator cuff is composed of four muscles—one in the front, one on the top, and two on the back of your shoulder—that connect the shoulder blade to the arm bone and serves as the primary muscles that powers range of motion and movement in your shoulder.
If you overuse or overwork your shoulder, or suffer a fall, the tendons in the rotator cuff can easily get injured causing inflammation such as tendinitis or bursitis or a more significant injury known as a rotator cuff tear.
We connected with Evan Lederman, MD, an orthopedic surgeon and chief of sports medicine at Banner - University Orthopedic and Sports Medicine Institute, to learn more about the causes and treatments for one of the common causes of pain and disability in adults.
What causes a rotator cuff to tear?
There are three main causes of rotator cuff tears: injury from a fall, chronic overuse and degeneration from the wear and tear that can occur with aging.
“Tendons in the rotator cuff can be injured easily because they are confined within a tight space,” Dr. Lederman said. “Occasionally, these tendons can bump or rub against bone. If this friction continues, it can wear down and weaken the tendon tissue causing it to tear. Other times, it can occur suddenly from a fall.”
How do you know if you’ve injured your rotator cuff?
Symptoms may vary depending on the person and the cause of the injury, but the most common symptoms include:
- Pain when lifting and lowering your arm
- Dull, aching pain in your shoulder at night
- Weakness in the shoulder and arm
- Clicking or popping noise when you move your arm
“As with any injury, if the symptoms are persistent or significant, you should seek an evaluation from a physician,” Dr. Lederman said. “If you don’t do anything to treat the tear, you could suffer more serious problems.”
What treatment options are available?
The good news is that most partial tears of the rotator cuff resolve with nonoperative care. If your injury is severe and involves a complete tear of the muscle or tendon, however, you might need surgery.
Nonsurgical treatments may include:
- Modified activity
- Physical therapy
- Anti-inflammatory medication
- Steroid injection
What can I expect from surgical treatment?
Surgery to repair a torn rotator cuff most often involves reattaching the tendon to the head of the humerus, or upper arm bone. If the tendon is too damaged to be reattached, your surgeon may use a nearby tendon or a graft as a replacement. In cases of longstanding or untreated tears, the rotator cuff may be unrepairable and you may require shoulder replacement surgery.
“These days, with the advances in surgical care and advanced training, most surgeries can be completed arthroscopically through a series of little incisions,” Dr. Lederman said. “Your orthopedic surgeon will be able to guide you on the best procedure to meet your individual needs.”
What is the outlook for a rotator cuff injury?
People with this type of injury typically recover well with treatment.