The rotator cuff is made up of four muscles that help move and stabilize the shoulder joint. Most rotator cuff disorders are caused by a combination of normal wear and tear and overuse. Using your shoulder for many years slowly damages the rotator cuff. As you age, everyday activities can lead to changes in the rotator cuff, such as thinning and fraying of the tendons. In addition, activities in which you use your arms above your head a lot (tennis, swimming, lifting, or even house painting) can lead to rotator cuff problems. Even normal motions made over a long period can stress or injure the rotator cuff.
The severity of injury may range from a mild strain and inflammation of the muscle or tendon, which will lead to no permanent damage, to a partial or complete tear of the muscle that might require surgery for repair. 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.
It takes great force to tear a healthy rotator cuff tendon., but over time, damage to the tendon may build up, so the tendon is more easily injured. This can happen during sports, an accident, or a severe fall. Sometimes 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.
Symptoms of a rotator cuff injury are due to the inflammation that accompanies the strain. This inflammation causes swelling, leading to pain and decreased range of motion. 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 also have pain during the night and trouble sleeping.
Not all shoulder pain arises from the shoulder and may sometimes be symptomatic of a much more serious problem. Pain from a rotator cuff injury is worsened with shoulder movement. If the unexplained shoulder pain is not affected by movement, it is reasonable to seek immediate medical care. If there is concern that the pain is coming from the heart, seek emergency medical care.
If your doctor suspects a rotator cuff injury, he or she will often order an x-ray to check the bones of the shoulder. In many cases, an imaging test, such as an MRI or ultrasound, may also be needed to accurately diagnose the injury.
Once diagnosed, 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, your doctor will recommend rest and reduced activity, ice or heat on the shoulder, and anti-inflammatory drugs. Steroid injections into the shoulder may be recommended if pain is severe. Your doctor may also suggest physical therapy to reduce pain and increase strength in the shoulder.
In most cases, the tendon will heal over time, but traditional treatment may take up to several months to resolve the injury. Older people may have a much longer time to complete recovery. If conservative treatment fails, patients may be referred to an orthopedic surgeon to discuss surgical repair of the injury.
Airrosti providers are experts at accurately diagnosing your injury, typically without the need for x-rays or imaging tests. Once diagnosed, most injuries are fully resolved in an average of three treatments based on patient-reported outcomes. Our goal is to get our patients pain free and back to normal activity as quickly as possible, while helping significantly minimize the risk of injury recurrence. Airrosti treatment is safe, noninvasive, and highly effective. We help patients avoid lengthy treatment and/or pain management plans, pharmaceuticals and injections, and unnecessary surgical procedures.