Rotator Cuff Injury – An Overview
A rotator cuff is a group of muscles and tendons present around the shoulder joint. It helps stabilize the joint by keeping the head firmly in the socket. Any injury to this group of muscles causes a dull ache in the shoulder joint. Not only the pain but rotator cuff injury also affects the ability of the person to effectively use the shoulder. As per the reports, the risk of rotator cuff tear increases with age and is also common in athletes. In many people with injured rotator cuff, targeted physical therapy is enough to improve associated symptoms.
What Are the Types of Rotator Cuff Injuries?
Two types of injuries can occur in the rotator cuff:
Partial tear – In this condition, the tear is incomplete as some part of the tendon remains attached to the upper arm bone.
Complete Tear – Here, the tendon completely separates from the bone.
What Are the Causes of Rotator Cuff Injuries?
In most cases, rotator cuff tear occurs because of gradual wear & tear to the tendon tissue. Besides this, repetitive overhead movements required while playing a sport or doing occupational activities may also cause injury to the rotator cuff. In some cases, trauma like accidents or falling on the shoulder can also be the reason.
Some of the risk factors for rotator cuff injury include:
Age – The risk of rotator cuff tear increases with age and people above 60 are highly prone.
Occupational and Athletic Activities – Some occupational and athletic activities require frequent overhead motions and with time, and injury to the rotator cuff may occur over time.
Family History – Some genetic traits running in the family may make those families more prone to rotator cuff injuries.
Bone Spurs – Overgrowth of bone in the shoulder may also cause tears in the tendons and muscles surrounding the joint. This is generally the case in older people.
Restricted Blood Supply – As age increases, the blood supply to certain parts of the body gets affected. If this occurs in the shoulder joint, small tears in the rotator cuff may occur. These tears may be hard to repair and as a result, larger tears may occur.
What is the Diagnosis of Rotator Cuff Injuries?
The diagnosis of the rotator cuff injury is done with a physical examination first. Here, the doctor gently presses the areas around the shoulder to look for swelling and stiffness. Besides this, the doctor will ask to make certain hand/shoulder movements to identify what causes pain. The doctor will also test the strength of the muscles and tendons of the shoulder.
After a physical examination, the doctor will order certain imaging tests including:
X-rays – Though there is no direct significance of an x-ray as it cannot show tears in the rotator cuff, it can identify bone spurs, if there, in x-ray films along with arthritis.
Ultrasound – It is required to assess the structures of the shoulder when it moves and help compare a healthy joint with an affected one.
Magnetic Resonance Imaging (MRI) – MRI is the best when X-ray and/or ultrasound cannot identify the right cause of symptoms. This test can depict minute details of the shoulder.
What is the Treatment of Rotator Cuff Injury?
In most cases, the symptoms associated with rotator cuff injury improve with conventional treatment methods like rest, the use of an ice pack, and physiotherapy. In severe cases, the treatment given may include:
Physical Therapy
Targeted exercises to strengthen the rotator cuff and regain flexibility are often helpful. It also shows a positive response in many cases of rotator cuff tears.
Steroids
If the pain associated with the condition does not improve with conventional methods and interferes with daily activities or while sleeping, steroid injections into the shoulder may help. This is a temporary solution to the symptoms of the condition. Steroids may also weaken the tendons while reducing the success rate of shoulder surgery in the future.
Surgery
When the tear is large and other treatments cannot improve the condition, surgery is helpful. Different types of surgical options are there:
Arthroscopic Repair- In this procedure, the surgeon makes a tiny hole in the shoulder and inserts a small camera and special tools to repair torn tendon(s).
Open Tendon Repair – Sometimes, arthroscopy is not feasible, and hence, in such cases, open surgery for tendon repair is the option.
Tendon Transfer – In some cases, the tendon is so badly damaged that reattaching it to the arm bone is not possible. Here, the surgeon uses a nearby tendon to replace the damaged one.
Shoulder Replacement – When the rotator cuff damage is severe, the repair work is not feasible. In such cases, the healthcare service provider may decide to perform shoulder replacement surgery.
