The Rotator Cuff consists of four muscles and their associated tendons that envelop the upper arm like an upside down shoebox. These important muscles are responsible for all the movements of the upper arm and shoulder. They aid in raising your arm to comb your hair, scratching your mid-back, swinging a golf club, carrying a suitcase and throwing a ball overhand.
Rotator Cuff Injuries can result from several sources. In younger individuals, they usually are the result of a traumatic fall. In middle age individuals, they often result from repeated overuse and end-stage impingement syndrome. In the elderly, they usually result from attrition and thinning of the rotator cuff over time. Small partial tears can cause bleeding and deposits of calcium within the tendon.
Pain and weakness with shoulder use are the primary symptoms. One of the hallmarks of rotator cuff tears is pain even when lying down flat on your back. This is because without gravity the ball of the upper arm presses into the rotator cuff tear causing pain. The quality of the pain is usually sharp. Early evaluation and initiation of a treatment program is very important. Your physician will obtain a detailed history of when your shoulder hurts. He then will do a specific examination to find the location and cause of your shoulder pain. An x-ray or MRI may be ordered to evaluate your shoulder in greater detail.
Treatment initially is aimed at non-surgical treatment. The rotator cuff has the capacity to repair itself in certain situations. Resting your shoulder with a pillow between your arm and your body when sitting or lying down can help. Do not stop using your shoulder altogether as this can cause a frozen shoulder. Gentle pendulum exercises (stir the pot, bowling, rock the baby and saw wood) can keep your shoulder active while resting it at the same time. Cold and heat can sometimes help. Your physician may prescribe anti-inflammatory medications to control the pain and inflammation. A formal physical therapy program with ultrasound treatments and electrical stimulation can reduce pain levels. If the pain is severe, your physician may inject cortisone directly into the shoulder. If conservative treatment fails, surgery may be needed. Today, many rotator cuff injuries can be treated arthroscopically through three tiny incisions as same-day surgery. Talk to your doctor for more information.