What You Need to Know about Rotator Cuff Problems
Whether you simply call it your shoulder, your “rotor cuff,” or use the official term, rotator cuff problems are certainly something to address, and quickly, to avoid further pain and damage. You may be personally familiar with your rotator cuff if it is causing you pain or mobility limitations. However, many people do not know much about the rotator cuff–what it is and how it functions. If this describes you, learn everything you need to know about the rotator cuff, common rotator cuff problems, and what to do when your rotator cuff becomes injured:
What is the rotator cuff?
You use your shoulders everyday for many different tasks. It could be reaching for an object, getting something off of a shelf, playing sports, or simply picking up your child. Each of these requires you to lift your arms, sometimes up above your head. As you lift your arms, the sockets of your humerus bones rotate in the shoulder joint. This is where the rotator cuff plays an important role. It protects the shoulder joint from the friction of movements.
The rotator cuff is comprised of tendons and muscles that not only protect the joint, but also keep the humerus bone in the shoulder socket. When all is functioning properly, this system allows you to raise and rotate your arms with free mobility and no significant pain. However, with multiple components to the rotator cuff system, there are several things that can go wrong, which may result in mobility issues and pain, either during movement or even when at rest.
The primary muscles considered as part of the rotator cuff include the following:
Supraspinatus-This muscle holds the humerus in the shoulder socket and maintains stability. It is also one of the muscles that helps to lift the arm.
Infraspinatus-This muscle allows you to rotate and extend the shoulder.
Teres Minor-This smallest muscle assists when rotating the arm away from the body.
Subscapularis-This muscle secures the upper arm bone to the shoulder blade. It assists in arm rotation, straightening of the arm, and lowering of the arm.
What are the common rotator cuff injuries?
Thinking of all the ways in which you can use your shoulders on a daily basis, it is easy to imagine that rotator cuff injuries can easily occur. It could happen when you lift a box that is just too heavy. It could happen from repeated movements that you might engage in during work or during sports activity. It could even happen during a single sports play gone wrong.
Regardless of the circumstances, there are a few common physical symptoms that you may notice which could be taken as signs of a rotator cuff injury:
- Dull ache in the shoulder
- Difficulty reaching up or behind the back
- Arm weakness
- Sleep disturbance when lying on the affected shoulder
These shoulder symptoms may be due to a rotator cuff injury. The most commonly seen rotator cuff injuries include the following:
Torn rotator cuff-This injury is most often due to wear and tear from repeated motions or simple daily use. Painters and carpenters are at high risk for this injury as they often move their arms in the same types of motions each day. Tennis players and baseball players also often experience this type of rotator cuff injury. Occasionally a fall could lead to this injury. At times, overuse, such as when trying to lift a heavy box, could also result in a rotator cuff tear.
Bursitis-This painful condition occurs when fluid filled sacs in the shoulder, designed to protect the rotator cuff, become irritated. Such irritation can occur as the result of repeated motions, similar to a rotator cuff tear. In some cases, it can be caused by an infection.
Tendinitis-This rotator cuff problem centers around the tendons that attach to the shoulder bones. In this condition, the tendons become irritated and inflamed. Untreated, this condition can lead to weaknesses and stiffness in shoulder movement. It can result from injury or repeated motions. This condition is often seen in baseball pitchers and swimmers. It is sometimes called swimmer’s or pitcher’s shoulder. The risk for tendinitis increases with age.
Impingement-This condition begins when the rotator cuff catches on the acromion (the underside of the top of the shoulder bone). When this happens, the bursa narrows, which increases pressure in the space. The increased pressure leads to the impingement.
How to treat rotator cuff problems?
If you notice pain or mobility limitations in the shoulder, your first step for treatment is to take it easy. As much as possible, reduce the use of your shoulders. In particular, avoid movements that might exacerbate the injury such as repetitive motions. If the pain or mobility problems persist, you should visit a doctor to assess the injury. In many cases, rotator cuff problems can be treated with medications and physical therapy. However, sometimes surgery is required.
A rotator cuff tear is usually treated with medication and physical therapy. In some cases surgery will be needed to repair the tear. Bursitis and tendinitis can both get better with rest alone. During rest, applying a combination of ice and heat, will also help to reduce swelling.
Sometimes over-the-counter medications will be sufficient to address any pain and swelling. Other times, steroids may be injected into the shoulder joint to reduce soreness. If the bursitis is due to an infection, then antibiotic medications will be needed to resolve the cause. As long as it is determined okay to do so, stretching and light exercise can help to restore mobility.
If at-home treatments have not sufficiently reduced any pain and restored mobility, then you likely want to visit a medical provider. For example, a doctor of chiropractic care can examine the rotator cuff area to determine the problem and make recommendations for further treatment options. Chiropractors may do a visual or physical exam and they may also use imaging tests such an ultrasound or an MRI to more thoroughly assess the damage.
If left untreated, rotator cuff injuries can lead to permanent problems, including arm weakness and loss of motion. The untreated injury can also cause the shoulder joint to degenerate, meaning that over time, pain and functioning may become progressively worse. Even at-home treatment methods can go awry if not used correctly. For example, rest may seem helpful. However, prolonged rest can also cause problems for the connective tissues around the joint.
For these reasons, consultation with a medical provider, is recommended. General doctors and specialists, such as chiropractors can assess your joint, spine, and general bone health. They can make recommendations to help you prevent problems or address any that do occur.
Dr. Brent Wells, D.C. is the founder of Better Health Alaska and has been a chiropractor for over 20 years. His practice has treated thousands of patients from different health problems using various services designed to help give you long-lasting relief.
Dr. Wells is also the author of over 700 online health articles that have been featured on sites such as Dr. Axe and Lifehack. He is a proud member of the American Chiropractic Association and the American Academy of Spine Physicians. And he continues his education to remain active and updated in all studies related to neurology, physical rehab, biomechanics, spine conditions, brain injury trauma, and more.