Rotator Cuff Injury FAQ

A rotator cuff injury can be particularly debilitating, affecting your ability to work and perform everyday tasks at home. The muscles and tendons that make up the rotator cuff area of your shoulder must be in good condition in order for you to be able to lift your arms and reach items above your head. Resting your shoulder and taking basic first aid precautions is often all that is necessary to heal a rotator cuff injury, but in some cases, surgery is needed.

What Causes a Rotator Cuff Injury?

• Injuries, such as falling on your arm while it is extended or a direct hit to your shoulder, can cause rotator cuff problems. Wear and tear on the tendons over the years can also contribute to the problem, as can arthritis in the shoulder joint. If you participate in a sport that requires you to constantly move your arm over your head, such as tennis, swimming or baseball, you may be more likely to eventually develop a rotator cuff injury.

What Are the Symptoms?

• One of the primary symptoms of a rotator cuff injury is pain when you are extending your arms over your head or lifting your arm. The muscles in your shoulder may seem weaker or you may notice that you don't have the normal range of motion in the joint. The pain can be severe at times and may radiate down the side of your arm. When you move your shoulder, you may hear a crackling or popping sound. Rotator cuff injuries can cause the tendons that attach muscle to bone to become inflamed and sore, can strain the shoulder muscles, or can cause tears in the tendons. If you tear your tendon during a fall or while lifting something, you may notice acute pain, immediate weakness in the arm or a snapping sensation when you use the affected arm, according to the American Academy of Orthopaedic Surgeons.

How Is an Injury Diagnosed?

• After examining your shoulder and listening to your symptoms, your doctor may recommend that you have an X-ray, a magnetic resonance imaging (MRI) scan or an ultrasound of the shoulder. The ultrasound and MRI scans may show a tear or injury in soft tissue more clearly than an X-ray will and may be recommended if the X-ray does not show a problem. An arthrogram, a test performed by injecting dye in the shoulder and then X-raying or scanning the shoulder with an MRI, may also be recommended. If there is a tendon tear, your doctor will be able to see that some of the dye has leaked from the joint when reading the arthrogram.

How Is a Rotator Cuff Injury Treated?

• If you have a rotator cuff injury, your doctor may suggest that you wear a sling and do not attempt to lift anything or raise the affected arm. Ice and over-the-counter or prescription anti-inflammatory medication can help reduce pain and inflammation associated with a rotator cuff injury. If pain is severe, steroid injections may be needed. You doctor may recommend that you begin physical therapy and perform exercises to strengthen your shoulder.

When Is Surgery Needed?

• Surgery may be recommended if you have a torn tendon and nonsurgical treatment hasn't improved your condition. It may also be needed if you have a painful recent tear in your tendon or if a tear in your dominant arm is affecting your daily activities. The type of surgery depends on the size of the tear. Arthroscopic repair can be used for small tears and to remove bone spurs. This minimally invasive procedure is performed by inserting a thin, fiber-optic scope and equally thin instruments through small incisions in your shoulder. For slightly larger tears, mini-open surgery, using a bigger incision, may be needed. Large repairs or reconstruction of the shoulder joint may require an open surgical procedure.