1. The Rotator Cuff
A rotator cuff injury means that there is damage to one or more of the four rotator cuff muscles or tendons in the shoulder. The rotator cuff muscles (SITS = supraspinatus, infraspinatus, teres minor, and subscapularis) help to stabilize the shoulder by keeping the head of the humerous against the shoulder blade. This injury can range from minor inflammation to a complete tear of a muscle or tendon needing surgery to repair.
2. Injuries of the Cuff
The cause of rotator cuff injuries stems from variations in the structure causing narrowing under the outer edge of the collar bone. Falls, heavy lifting, repetitive movements and poor ergonomics (slouched shoulders) contribute to this injury. In addition, overhand sports (baseball, tennis), occupations where overhead activity is stressed (painters, mechanics) and various hobbies (archery, weight lifting) may lead to a higher risk of rotator cuff injury.
3. Time to See Your Doctor
Signs of a rotator cuff injury may include continuous pain and tenderness of the shoulder during lifting, pulling, overhand movements, reaching behind the back or sleeping on the affected side. In addition, weakness, loss of range of motion and an inclination to not use the affected shoulder may indicate that a doctor's visit is needed.
4. Finding the True Cause
Diagnosis consists of a thorough medical history to determine the cause and symptoms of the injury as well as a previous history that may suggest chronic problems. Physical examination consists of the doctor comparing both shoulders in regards to tenderness, sensation, blood flow and range of motion. In addition, the doctor may order X-rays to rule out broken bones. If the condition does not improve within a month of proper care, the doctor may order further advanced imaging studies such as arthrography, ultrasonography and magnetic resonance imaging to investigate the problem further.
5. Road to Recovery
Controlling pain is the ultimate goal of treatment with rehabilitation depending on the severity of injury. For chronic tears, treatment consists of rest, over-the-counter pain medication, passive range of motion exercises and (in some cases) surgery or steroid injections. For acute tears, icing, anti-inflammatory drugs, slings and (in serious cases) early surgery is needed to repair the tear. Finally, treatment for tendonitis includes rest, icing, anti-inflammatory drugs, slings, passive range of motion exercises and Codman's exercises (for low stress range of motion). All three types of treatment may include rehabilitation with a physical or occupational therapist.
