Causes and Treatment for Common Rotator Cuff Injuries
There are four distinct muscles-tendons that make up the commonly known rotator cuff, which provide both strength and stability to the shoulder. The muscles originate from the scapula (shoulder blade) and connect to the head of the humerus (arm bone) , forming a cuff around the joint. “SITS” is an easy way to recall the components of the rotator cuff:
- Supraspinatus
- Infraspinatus
- Teres Minor
- Subscapularis
These muscles-tendons are responsible for flexion, abduction, external rotation, and internal rotation of the shoulder. Dysfunction in one component may lead to dysfunction of the entire girdle. Rotator cuff injuries occur when any of the four muscle-tendon groups are damaged due to acute event or chronic overuse. These injuries are often accompanied by decreased mobility or severe pain. Common rotator cuff injuries include:
- Rotator cuff tears (partial tears or full-thickness/complete tears)
- Rotator cuff tendinitis (acute inflammation)
- Rotator cuff tendinopathy (chronic irritation, degeneration)
- Impingement syndrome (biomechanical dysfunction that causes abnormal wear and tear)
Commonsymptomsofrotatorcuffinjuriesincludepain and tenderness,primarilyon thelateral(outside) part of the arm. Pain can worsen at night and refer to the elbow, though does not typically refer down the entire length of the arm, or into the fingertips. Overhead motion or rotation may be difficult, and there may be strength deficits as well. Lying directly on the side, lifting, pushing, or pulling may aggravate pain.
Diagnosis of rotator cuff injuries depends on multiple factors such as patient history, physical examination that includes special tests which help determine affected area and severity of injury, and diagnostic imaging. X-rays can identify avulsions, calcifications, and degree of any underlying osteoarthritis. There are also certain x-ray findings that indicate rotator cuff tearing, though MRI is best practice for characterizing soft tissue.
Not all rotator cuff injuries require surgery. Age, activity level, type of rotator cuff injury, and size of trauma all affect the success of conservative treatment. Non-surgical options include rest, activity modification, physical therapy, oral medications, and injection-based treatment. In the event a patient is not successful with conservative options, surgical interventions are available, and Dr. Chahla can thoroughly review best options for decreased pain and restored function.
