Rotator Cuff Injury

Rotator cuff injury is the damage of the muscles surrounding shoulder joint which leads to dull pain around the shoulder and it often worsens when pressure is applied on the involved side.

It occurs most often in painter’s carpenters and in baseball or tennis players.

Many people recover with physical therapy exercises which improves the flexibility and strength of muscles.

Rarely tear of the muscles surrounding shoulder joint may occur due to a single injury and in those cases emergency care should be provided.

Rotator cuff injuries may range from simple inflammation to complete tears. 

The signs and symptoms of rotator cuff injury are dull pain around the shoulder associated with movement of the shoulder and reduced range of motions.

This dull pain often disturbs sleep while lying on the affected shoulder, makes it difficult to comb the hair, and reach back and often accompanied by weakness of arm.

Seek emergency care in case of tear of rotator cuff muscles. 

Rotator cuff injury is mostly caused by a substantial injury to the shoulder, progressive degeneration, wear and tear of tendon tissue. It can also be caused by direct shoulder injury.

Repetitive overhead activity, lifting heavy objects and development of bone spurs around the shoulder may irritate muscles and tendons.

Making a diagnosis of Rotator Cuff Injury is done during physical examination and by several tests.

In case of rotator cuff injury visit a general physician who will carry out a thorough physical examination of different parts of the shoulder and move the arm into different directions.

He or she could also test the muscle bulk, muscle strength, and tone of muscles around the shoulder.

In some cases, medical imaging tests are recommended such as x- ray of the shoulder, ultrasound particularly to see the soft tissues.

MRI to get a detailed display all structures of the shoulder. 

Mostly conservative treatment like rest, ice application and physiotherapy are enough to recover from rotator cuff injuries.

But if the injury involves complete tear then there may be a need of surgery. Sometimes if conservative treatment doesn’t help then the doctor might recommend a steroid injection into the shoulder joint in order to have proper sleep and to carry out daily activities.

Their Side effect is weakening of tendon. Physiotherapies help restore flexibility and strength of shoulder joint. The following types of surgeries are available for rotator cuff injuries.

Some of which include:

• arthroscopic tendon repair - in this procedure a tiny camera and tools are inserted through a small incision to reattach torn tendon with bone.
• Open tendon repair - in this type of surgery the tendon is attached to the bone through a larger incision. Such surgeries often require longer time. Bone spur removal. Sometimes an overgrowth of bone (bone spur) is irritating the rotator cuff, this excess bone is removed and the damaged portion of the tendon can be smoothed, it is mostly performed using arthroscopy, where fiber-optic camera and the require tools are inserted through tiny incisions.
• Tendon transfer - if the torn tendon cannot be attached to the arm bone due to extreme damage surgeons use a nearby tendon as a replacement.
• Shoulder replacement - such surgery is done only in cases of massive rotator cuff injuries. Reverse shoulder arthroplasty, an innovative procedure is used to improve artificial joint stability in this the ball part of the artificial joint is installed over the shoulder blade and the socket part over the arm bone.

A few preventive measures exist for rotator cuff injury.

Those people from risk groups of rotator cuff injuries or those people who had injuries from past should perform daily shoulder stretches and strengthening exercises.

Not only the front muscles of the chest shoulder and upper arm but strengthening of muscles in the back of the shoulder should be done to optimize shoulder muscle balance.

Avoid over the head hand movements. Repetitive rotation of the hand must be reduced as a preventive measure.

In case of minor rotator cuff injuries some simple home remedies and alternatives helps in healing.

Applying ice and heat- putting ice reduces swelling and pain. Cold packs should be used for 15-20 minutes every three to four hours.

When pain and inflammation has decreased using hot packs or heating pad helps in relaxing tightened and sore muscles.

Taking pain relievers must be taken to reduce pain.

The following changes must be brought in lifestyle to reduce the harm caused by rotator cuff injury.

Resting the shoulder proper rest will help to eradicate the lactic acid which is formed and is the cause of pain, hence proper rest will reduce the pain.

Avoid over the head movements of hand. Avoid lifting heavy objects.

Performing some mild physical exercises will improve the blood circulation and improve the healing process.

Help of a physiotherapist is required to establish faster coping. 

There are several risks and complications associated with rotator cuff injury.

The following risk factors may contribute the development of rotator cuff injury:

• Age - Older people above the of 40 have higher risk of rotator cuff injury.
• Certain sports - Those sports which require repetitive arm motions lead athletes to have a greater risk of rotator cuff injury.
• Construction job - Carpentry and house painting which often require repetitive arm motions over the head can damage the rotator cuff muscles over time.
• Family history - Some genetic components are shown to be involved with rotator cuff injuries.

Complications

If left untreated rotator cuff injuries can lead to stiffness or weakness and may also result in progressive degeneration of shoulder joint.

If the shoulder joint is immobilized for long time it can lead to frozen shoulder (connective tissue enclosing the joint become thick and tight.