Rotator Cuff Injury
(Rotator Cuff Tear; Impingement Syndrome)
A rotator cuff injury may be tendinitis, bursitis, or a tear of the muscles and tendons that support the shoulder. Changes and swelling in tissue can also increase pressure in the joint. Raising the arm to shoulder height can pinch tendons and other tissue. It can cause pain called impingement.
A rotator cuff injury can take 2 to 6 months or longer to fully heal.
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It may be caused by:
- A blow to the shoulder
- Falling on an outstretched arm
- Moving your arms over your head often doing things like swimming, throwing, and tennis
- Wear and tear from problems like arthritis
This problem is more common in people aged 40 years and older. Other things that may raise your risk are:
- Heavy lifting
- Playing sports where your arms are over your head a lot, such as tennis
- A shoulder that does not look or work as it should
The injury may cause:
- Pain, often when reaching over your head
- Pain that makes it hard to sleep
- Shoulder weakness, especially when lifting the arm
- Popping or clicking sounds when the shoulder is moved
- Problems fully moving the shoulder
The doctor will ask about symptoms and past health. An exam will be done. The shoulder will be checked.
Images of the shoulder may be done with:
The problem is treated based on the level of injury. Options are:
Initial care may be:
- Rest to help the shoulder heal. An arm sling to keep the shoulder in place as it heals for severe pain.
- Ice to ease pain and swelling.
- Medicine to ease pain and swelling.
- Medicine injected in the shoulder to help it heal and ease pain and swelling
- Exercises to make the shoulder stronger and help it to move better
Corticosteroids may be injected into the joint. It can quickly relieve pain and swelling. However, there are some risks to this treatment. It cannot be used often. The injection may only be used to treat pain that is severe or not going away with basic treatment.
Exercises may be recommended to improve shoulder strength. This may prevent future injuries.
Bones, tendons, and muscles may need to be repaired with surgery. An arthroscopy is done through small incisions. The doctor will be able to see the joint and repair areas as needed. Larger fractures or injuries may need open surgery for repair. Recovery will take longer with open surgery.
To lower the chances of this injury:
- Avoid repetitive overhead motions. Use step stools or ladders to ease strain on shoulders.
Limit tasks that use:
- Extreme outward rotation of shoulder
- Vibrating tools
- Avoid very heavy lifting.
- Exercise often to strengthen the muscles around the shoulder joint.
The American Orthopaedic Society for Sports Medicine
Ortho Info—American Academy of Orthopaedic Surgeons
Canadian Orthopaedic Association
The University of British Columbia Department of Orthopaedics
Matthewson G, Beach CJ, Nelson AA, et al. Partial Thickness Rotator Cuff Tears: Current Concepts. Adv Orthop. 2015;2015:458786.
Rotator cuff tear. EBSCO DynaMed website. Available at: https://www.dynamed.com/condition/rotator-cuff-tear. Accessed September 19, 2020.
Last reviewed September 2020 by EBSCO Medical Review Board Teresa Briedwell, PT, DPT, OCS, CSCS Last Updated: 6/3/2020