Rotator Cuff Disorders
What are rotator cuff disorders?
The rotator cuff is a group of tough, flexible fibers (tendons) and muscles in the shoulder. Rotator cuff disorders occur when tissues in the shoulder get irritated or damaged. Rotator cuff disorders include:
How does the shoulder work, and what does the rotator cuff do?
The shoulder is a joint with three main bones: the upper arm bone (humerus), the collarbone (clavicle), and the shoulder blade (scapula). The bones are held together by muscles, tendons, and ligaments. The rotator cuff keeps the upper arm bone in the shoulder socket and lets you raise and twist your arm.
The shoulder is a ball-and-socket joint. The ball at the top of the upper arm bone fits into the socket of the shoulder blade. This socket is shallow, which lets you move your arm in a wide range of motion. But it also means that the muscles and tendons of the rotator cuff have to work hard to hold the bones in place. As a result, they are easy to injure and are prone to wear and tear.
What causes rotator cuff disorders?
Most rotator cuff disorders are caused by a combination of:
Both normal wear and tear and overuse can lead to impingement, when a tendon rubs against bone. This damages and irritates the tendon, which causes bleeding and inflammation. Over time, damage to the tendon may build up, so the tendon is more easily injured.
It takes great force to tear a healthy rotator cuff tendon. This can happen during sports, an accident, or a severe fall. But even a simple movement like lifting a suitcase can cause a rotator cuff tear in an older adult or someone whose shoulder is already damaged.
What are the symptoms?
Symptoms of a rotator cuff disorder include pain and weakness in the shoulder. Most often, the pain is on the side and front of the upper arm and shoulder. It may hurt or be impossible to do everyday things, such as comb your hair, tuck in your shirt, or reach for something. You may have pain during the night and trouble sleeping.
How are rotator cuff disorders diagnosed?
To diagnose a rotator cuff disorder, doctors ask about any shoulder injuries or past shoulder pain. They also do a physical exam to see how well the shoulder works and to find painful areas or activities. Moving your arm in certain ways can help a doctor learn about the condition of the rotator cuff.
How are they treated?
It is important to treat a rotator cuff problem. Without treatment, your shoulder may get weaker and you may not be able to lift up your arm.
For most rotator cuff disorders, doctors recommend these steps first:
The doctor may also suggest physical therapy. Physical therapy can reduce pain and help make your shoulder stronger and more flexible. In physical therapy, you learn exercises to stretch and strengthen your shoulder. After you learn the exercises, you can do them at home.
It is important to give treatment time to work. It may take from a couple of weeks to several months to get good results.
If other treatments don't help, your doctor may give you shots of steroid medicine in the shoulder. The shots probably don't cure rotator cuff disorders. But they can help relieve pain and inflammation so you are able to do exercises to strengthen the shoulder. The shots may also help your doctor find out if your shoulder pain is from your rotator cuff. If a steroid shot near the rotator cuff relieves your pain, even if the pain comes back later, it means the rotator cuff—not some other shoulder problem—is causing the pain.
Most rotator cuff disorders aren't treated with surgery. But doctors may do surgery if a rotator cuff tendon is torn or if several months of other treatments have not helped.
Frequently Asked Questions
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