The rotator cuff comprises a group of 4 muscles that function to stabilise and move our shoulders. Though the rotator cuff muscles are extremely important structures in the shoulder, they are also prone to tears and weakening. A rotator cuff injury, which is fairly common, involves any type of irritation or damage to your rotator cuff muscles or tendons. The risk of injury increases with age, and is particularly common in middle-aged persons.

 

Causes

Normal wear and tear
As the tendon of the rotator cuff has poor blood supply, it tends to be prone to degeneration due to ageing. The degeneration can be aggravated by repetitive shoulder movements. Hence this condition typically occurs if you are above 40.

Repetitive movements
Athletes who regularly use overhead repetitive movements such as swimmers, rowers or tennis players are at higher risk of rotator cuff injuries. However, the injury can also happen through seemingly trivial activities like carrying a heavy load, lifting things overhead or hanging the clothes out.

Trauma
The rotator cuff can also be damaged from a single traumatic injury such as a fall or a hard direct hit to the arm.

Heavy lifting or pulling
Lifting or pulling an object that is too heavy or lifting in the wrong way can cause the strain or a tear to the rotator cuff muscle or tendon.

Poor posture
Slouching forward of the head and neck can cause the muscle or tendon to be pinched leading to inflammation.

 

Symptoms

In many people with underlying rotator cuff injury, they can often have no pain or limitation of motion though they can have inflammation or early injury to their rotator cuff resulting from degeneration with chronic overuse from repeated usage. These patients often present only after an injury, like a fall which causes a tear in the already injured rotator cuff. When there is a tear in the rotator cuff , the most common symptom is pain in the shoulder especially when lifting the arm. Pain may be experienced when you reach up to comb the hair, or bend the arm back to wear a piece of clothing. You can also experience weakness, and tenderness in the shoulder and pain when sleeping on affected arm. The shoulder can also experience a loss of range of motion. With a large tear, there can be continuous pain and muscle weakness. In cases of a complete tear of the rotator cuff, there is likelihood that you may completely be unable to lift the arm.

 

Diagnosis

If your injury appears to be severe or your doctor can’t determine the cause of your pain through physical examination, he or she may recommend diagnostic imaging tests to better delineate your shoulder joint, muscles and tendons. These may include:

  • X-rays
  • A magnetic resonance imaging (MRI) scan
  • An ultrasound scan

 

Treatment

Try to do some gentle range-of-motion exercises in a pain-free range to keep your shoulder muscles limber. Total inactivity can cause stiff joints. In addition, favoring your shoulder for a long period of time can lead to frozen shoulder, a condition in which your shoulder becomes so stiff you can barely move it. Once your injury heals and you have good range of motion in your shoulder, continue exercising. Daily shoulder stretches and a balanced shoulder-strengthening program can help prevent a recurrence of your injury.

*Source: Singapore Health Service

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