Rotator Cuff injuries and treatments

The rotator cuff is familiar to most athletes who have either experienced injuries to it or have seen others suffer from injuries. Injuries do not happen exclusively to athletes home gardeners, construction workers, and painters can also suffer from injuries related to rotator cuff.

The rotator cuff is located at the end of the shoulder. It consists of a series of tendons and muscles that work in concert with the scapula and the acromion joints that allow the types of movements the shoulder is capable of performing with such ease.

shoulder xray

What types of motions may cause injuries?

Overhead movements that are done repetitiously tend to cause injuries to the rotator cuff. Pitchers and Quarterbacks use the motion with tremendous force as do tennis players, golfers, swimmers, and weight lifters. Home gardeners use a forward motion that may irritate the rotator cuff. Construction workers and painters often reach overhead and use a swinging motion in the course of their jobs.

Types of injuries

Although most people use “rotator tear” as a blanket term to describe their pain, it is not always the correct term to describe the injury. Although most people notice the injury more after an accident that results in severe pain, rotator cuffs can be injured over time through repetition.

  • Rotator cuff tear: The injury can occur suddenly after extreme use or in an accident. What happens is that the tendons located at the end of the shoulder can become torn. The resulting pain is usually acute and can cause restriction of normal movement.
  • Impingement: This injury usually occurs over time, but it can happen suddenly. The rotator cuff muscles and tendons tend to become irritated and inflamed during normal movement because the sub acromial space beneath the acromion (located between the scapula and the head of the humerus) may become too small as a result of spurs on the joints or bones. The pain can be acute and the patient may experience weakness in the arm as a result of the injury.


What kinds of treatments are available for these injuries?

Doctors prefer to take the path of least resistance when it comes to treating patients with rotator cuff injuries. Most patients also prefer non-invasive treatments, so in-home care is the starting point. Surgical care is only considered if other paths have not worked effectively.

  • In-home: Rest and ice on the shoulder for 15-25 minutes at a time, at least 3 times a day. If you use a sling, be careful not to wear it too long because over use can result in the stiffening of the joint.
  • Medical treatments are triaged bases on the type of injury:
    • Chronic tear: The treatment plan starts with pain control and physical therapy to help maintain shoulder function and help increase strength. Steroid injections may be added to the treatment.
    • Acute tear: Initial treatment starts with ice to reduce swelling and anti-inflammatory medications to reduce both pain and swelling. A sling may help with the pain, but overuse can be counterproductive. If all previous treatments are not working, then you doctor will recommend an orthopedic specialist who may perform surgery to repair the injury.

Scientists and doctors are always working toward finding better treatments to get people back to their normal day to day activities. Sports scientists work with athletes to reduce the chances for injuries. Prevention and physical therapy is the best path to get people moving sooner with as little down time as possible. Surgery helps the more severe cases, but the down time is a necessary part of the recovery.

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