Four muscles and tendons make up the rotator cuff, which helps to support the shoulder. They support mobility as well. Injury to the rotator cuff occurs commonly. Strains, tendinitis, and tears are the most common injuries.
What Causes a Rotator Cuff Injury?
There are different types of rotator cuff injuries. These include –
- Acute – caused by a specific incident as a fall
- Degenerative – caused by prolonged, repetitive use Younger age groups are more prone to experience acute injuries. Degenerative injuries are much more likely to develop –
- For athletes, especially those who play baseball and tennis, degenerative injuries are more likely to develop.
- People whose occupations involve frequent lifting, like painters, are at risk.
- With ageing in those over 40, rotator cuff tendons’ blood flow declines, and the body’s capacity to heal tendon injury is hindered. Older people also tend to have more bony spurs. When the arm is raised, the spurs press against the rotator cuff tendon, causing tears.
- Overuse from regular household tasks.
What Is Shoulder Instability?
Your shoulder joint enables you to perform a broad range of upper-limb movements essential for your daily activities. However, the shoulder joint is frequently injured due to its range of motion.
Shoulder instability occurs when your shoulder slips out of its socket as a result of torn or damaged ligaments. Tennis and volleyball are two sports that can cause shoulder instability without causing a significant tear in the ligaments.
What Is Frozen Shoulder?
Adhesive Capsulitis, also known as frozen shoulder, commonly affects people over 40. Even minor injuries can bring on this condition, which is more common in people with diabetes.
The pain from a frozen shoulder worsens over weeks to months, with symptoms worsening at night or during sudden movements.
This pain is caused by joint inflammation and can make it difficult to fall asleep at night. However, when scarring and stiffening of the joint occur, this pain gradually lessens. When this happens, the shoulder joint ‘freezes,’ hence the term ‘frozen shoulder. The frozen shoulder restricts your movements and makes it difficult to complete daily tasks.
What Are the Symptoms of Rotator Cuff Injury?
The rotator cuff comprises four groups of shoulder muscles that insert into the upper part of the arm. The rotator cuff muscles, along with other back and chest muscles, help to initiate shoulder movements. As a result, some rotator cuff injury symptoms are unique to certain types of injuries. For example:
- Rotator cuff tendonitis is generalized shoulder pain that worsens at night or during overhead tasks. Rotator cuff tendonitis can also result in reduced cuff strength.
- Rotator cuff impingement syndrome is characterized by persistent shoulder discomfort made worse by overhead motions or at night.
- Rotator Cuff Tear – Shoulder pain and stiffness
- Bursitis – discomfort that increases when you move frequently or above.
When the rotator cuff is injured, the first line of treatment is to ice and rest the joint while taking anti-inflammatory medications. Physiotherapy also improves rotator cuff mobility. However, surgery may be required in severe cases (arthroscopy or minor incision surgery).
Who Is at Risk for Rotator Cuff Injuries?
Several groups are at a greater risk for rotator cuff tears. Rotator cuff tears are more common in older men and women. Over time, tendon strength and flexibility are decreased. The ligaments are more prone to partial or complete rupture as a result.
The biggest group of those who have the injury are those over 40. People over 60 are frequently affected to some extent without any symptoms. Athletes are at risk too. A rotator cuff tear can result from the repeated use of force or motion on the shoulder. For example, sports players frequently throw, dodge, aim, or accelerate while using their shoulders.
Particularly baseball and tennis players exert a lot of strain on their rotator cuffs when they pitch, hit, and throw. Shoulder injuries occur in more than 55% of professional athletes.
How Is a Rotator Cuff Injury Diagnosed?
Your doctor will need to examine your medical history, do a physical examination, and will recommend scans or x-rays to help spot rotator cuff strains to evaluate your injury. They might also need to assess your arm strength and range of motion. They can inquire about your interests and job duties.
Your doctor may need to rule out arthritis or bone spurs pushing on the tendon as potential causes of your shoulder pain before recommending the proper treatment.
How Is a Rotator Cuff Injury Treated?
The initial nonsurgical treatment for rotator cuff injuries begins with rest, ice, and physical therapy to strengthen the rotator cuff muscles and restore the shoulder’s complete range of motion. Satisfactory recovery might take weeks or more.
Other nonsurgical methods for treating rotator cuff problems include ultrasound scans, shockwave therapy, dry needling, and steroid injections to reduce swelling and inflammation in the restricted areas where the muscle tendons cross the shoulder joint.
Surgery could be the option to strengthen and repair those identified injuries if early conservative rotator cuff treatment is ineffective or the rotator cuff is completely torn. An orthopaedic surgeon can implant an arthroscope (a device) through a small incision to fix the damage.
An open surgical technique, where an incision is made into the joint region to allow the repairs to occur, could well be considered by your surgeon, depending on the operation to be done. Early surgery is generally offered to professional athletes who want to get back to playing.
How Can Shoulder Instability Be Treated?
Proper physiotherapeutic exercises can help treat shoulder instability. However, surgery may be required to repair or reconstruct the ligaments when the injury is severe. The surgery is minimally invasive and involves inserting a small camera (arthroscope) into the joint through a small incision in front of the shoulder. Arthroscopy is now the most commonly used surgical procedure for correcting shoulder instability.
What Happens After a Rotator Cuff Repair?
You will be brought to the recovery area for observation following the procedure. Your recovery time will differ depending on the type of anaesthetic used and the operation performed. Your arm’s sensation and blood flow will be observed.
You will be brought to your hospital room or discharged to your home after your breathing, pulse, blood pressure, and cardiac rhythm are all stable and awake.
Before you return home, you could be given an immobilizer or sling. Keeping the surgery area clean and dry after you get home is crucial. Depending on your unique condition, your healthcare professional might provide an alternative or additional instructions following the surgery.
How Do I Get Ready for a Rotator Cuff Repair?
It’s critical to check the medications you take. You must stop taking drugs such as NSAIDs and blood thinners two weeks before surgery.
Organize help – After surgery, you won’t be able to drive for a few weeks, and you’ll need help around the house, so plan appropriately.
Loose Clothes – Have open-fronted, loose-fitting shirts at the ready. Try to find clothes with buttons or zippers. Avoiding shirts that you have to pull over your head is the aim.
Your Daily Meals – Purchase plenty of quick-to-make meals. Move commonly used pots, pans, and utensils to counter height while you’re at it.
Bathroom comforts – Consider investing in bathroom comforts like a shower chair or a shower head that can be removed.
What Are the Complications of a Rotator Cuff Injury?
Delaying rotator cuff injury treatment can lead to complications. For example, you could find it challenging to move around due to persistent discomfort or stiffness. This could worsen the pain or stiffness and increase the risk of adhesive Capsulitis or a frozen shoulder.
This can result in the shoulder joint degenerating gradually over time and developing permanent weakness or loss of motion. Therefore, rotator cuff injuries must be identified and treated immediately to reduce the chance of developing a frozen shoulder or permanent stiffness.
How Can a Rotator Cuff Injury Be Prevented?
There are several ways by which you can prevent a rotator cuff injury –
Avoid engaging in activities where you must spend much time raising your arms over your shoulders. For example, pay careful attention to the number of reps and sets while completing weight training exercises like the military press to prevent injury.
Always warm up before playing if you enjoy sports like tennis, golf, or others that might be hard on the shoulders. Before participating in any activity or exercise, you should stretch your shoulder muscles as part of your regimen to prevent injury.
When sitting or standing, pay attention to your posture. Do you tend to lean forward or push your head on? If so, your shoulder blades may change position due to this hunching forward, increasing your risk of rotator cuff injuries.
When To See Your Doctor?
If you are feeling pain in your shoulder or have noticed a reduced range of motion, it’s essential to see your orthopaedic surgeon, who can help with your injury with a proper diagnosis and treatment. Avoid attempting to self-treat the injury at home without consulting a doctor or resuming your regular activities.
If you’re looking for the proper rotator cuff injury treatment in Singapore, look no more. At, our orthopaedic surgeons are trained in sports medicine. We are experts in identifying, managing, and preventing injuries to the shoulder, arm, wrist, elbow, and hand, as well as other conditions. We are in the perfect position to diagnose and handle individuals with active lifestyles and physically demanding jobs, thanks to our expertise in sports medicine.
FAQ About Rotator Cuff Tears
Lifting weights or engaging in overhead exercises is challenging for patients with rotator cuff involvement. Additionally, they could find it challenging to reach behind them or outwards. These individuals also experience significant discomfort and night awakenings due to the shoulder's involvement. Only an MRI can prove a rotator cuff tear; however, a physical exam and medical history suggest the diagnosis.
Patients can first use over-the-counter relievers and painkillers to treat shoulder pain. When a patient visits a doctor, a physical exam will be done. They may be given a Medrol Dosepak or a cortisone injection in the rotator cuff if they experience no improvement. However, if a patient experiences chronic pain, more tests could be necessary to determine the source of the problem. If a rotator cuff tear is found, the patient may need surgery to relieve pain.
Although rotator cuff tears cannot heal independently, more minor tears may not cause as many symptoms as bigger ones. If a patient has few symptoms, these cuff tears can be addressed non-surgically. Medication, cortisone injections, and therapy to build muscle and manage chronic pain will all specifically assist these people.
Physical therapy may not be sufficient to help the patient if there is a decline in discomfort, range of motion, and strength. The patient should consult a sports physician for further care in this case.
Patients with rotator cuff surgery must work with a physical therapist to recover. Regaining full range of motion and strength often takes 2 to 5 months, depending on the degree of the rotator cuff rupture and the technique used.
