Definition

Rotator cuff injury may include tendinitis, strain, or tear of the rotator cuff. The rotator cuff is made up of muscles and 4 separate tendons that fuse together to surround the shoulder joint.

Rotator Cuff Injury Copyright © Nucleus Medical Media, Inc.

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

Rotator cuff injury is more common in people 40 years and older. Other factors that increase your chance of a rotator cuff injury include:

• Heavy lifting
• Abnormalities of the shoulder, or in rotator cuff anatomy or function
• Activities that involve repetitive overhead arm motion such as throwing
• Weakened shoulder muscles from inactivity or previous injury

Symptoms

Rotator cuff injury may cause:

• 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

You will be asked about your symptoms and medical history. A physical exam will be done, paying particular attention to your shoulder. You will be asked to move your shoulder in several directions.

Tests may include:

• Ultrasound
• Arthrogram
• MRI scan
• Arthroscopy

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.

Prevention

To help reduce your chance a rotator cuff injury:

• Avoid overhead repetitive motion.
• Limit duration of work that involves:
  • Moving hands above shoulders
  • Using shoulder in extreme outward rotation
  • Vibrating tools
• Avoid heavy lifting.
• Exercise regularly to strengthen the muscles around the shoulder joint.