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Rotator Cuff Injury

(Rotator Cuff Tear; Impingement Syndrome)

Definition

A rotator cuff injury may be tendinitis, a strain, or a tear of the muscles and tendons that support the shoulder. It can take 2 to 6 months or longer to fully heal.

Rotator Cuff Injury
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Causes

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

Risk Factors

This problem is more common in people 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

Symptoms

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

Diagnosis

The doctor will ask about your symptoms and health history. An exam will be done. The shoulder will be checked.

Images may need to be taken of the shoulder. This can be done with:

Treatment

The problem is treated based on the level of injury. Options are:

Initial Care

Initial care may be:

  • Rest to help the shoulder heal
  • Ice to ease pain and swelling
  • An arm sling to keep the shoulder in place as it heals
  • 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

Surgical

Bones, tendons, and muscles may need to be repaired with surgery. It may be done through small incisions using arthroscopy. Fractures that are worse may need to be done through larger incisions that take longer to heal.

Prevention

To lower the chances of this injury:

  • Try not to do overhead repetitive motions.
  • Limit tasks:
    • Using shoulder in an extreme outward rotation
    • Using vibrating tools
  • Avoid very heavy lifting.
  • Exercise often to strengthen the muscles around the shoulder joint.
RESOURCES:

The American Orthopaedic Society for Sports Medicine
http://www.sportsmed.org

Ortho Info—American Academy of Orthopaedic Surgeons
http://www.orthoinfo.org

CANADIAN RESOURCES:

Canadian Orthopaedic Association
http://www.coa-aco.org

The University of British Columbia Department of Orthopaedics
http://orthopaedics.med.ubc.ca

REFERENCES:

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. Updated February 16, 2017. Accessed September 19, 2019.

Last reviewed September 2019 by EBSCO Medical Review Board Teresa Briedwell, PT, DPT, OCS, CSCS  Last Updated: 9/19/2019