Rotator Cuff Injury/Strain
The rotator cuff consists of a group of 4 muscles that helps to hold the shoulder joint together and allow it to function. These muscles include the supraspinatous, infraspinatous, teres minor and subscapularis. A rotator cuff injury occurs when you strain or tear the tendon or the fibers of one or more of these muscles.
This injury can occur when you fall landing on the shoulder or when you use your arm to brace the fall. It may also happen during an attempt to lift a heavy object. Sports that involve repetitive motions using the arm such as swimming, baseball, football and tennis can precipitate this injury.
Most rotator cuff injuries occur in older patients who have been experiencing pain for a longer period of time. Less often and usually as a result of trauma, the injury can occur in a young person.
The most common symptom of this condition is pain in your shoulder. Along with pain, you might also experience weakness and a loss of motion in your arm. Raising your arm above your head may be especially painful. A tendon that has been completely ruptured may make it impossible to raise the arm or even move it away from the side of the body. Rotator cuff injuries may make it difficult to sleep on the injured side because of the increased pressure placed on the joint.
Making the Diagnosis
Rotator cuff injuries are diagnosed by a detailed evaluation by a healthcare provider. Your physician will evaluate the function of your shoulder using multiple examination techniques. A thorough exam by your physician is necessary to fully assess the extent of the injury. X-rays or other imaging (such as an MRI or an arthrogram) may be taken as needed to make your diagnosis.
The rotator cuff tendons can be strained, partially torn, or completely torn. Your healthcare provider will determine whether your injury will heal with conservative management or whether you may require surgery to fix the problem.
Initial treatment options include:
• Applying ice to the shoulder to help reduce the pain. Apply the ice packs for 15-20 minutes every 2-4 hours until the pain has subsided
• Rest and avoidance of activities that worsen your symptoms
• Acetaminophen may be taken to reduce the amount of pain. Ibuprofen or other anti-inflammatory medications may be taken at the discretion of your physician
• Rehabilitation exercises are effective at treating this condition by helping to strengthen your rotator cuff muscles and stabilize your shoulder blade
• If non-surgical treatment does not remove your pain or there are certain activities that you are not able to do, a physician may recommend surgery
The recovery timeline will depend on multiple factors. The severity of your injury, your age, overall health, and whether or not you have injured your shoulder before will all impact the recovery. It is important that you avoid activities that aggravate your pain until you have had the time to heal and rehabilitate your shoulder. Continuing to perform activities that aggravate your pain may worsen your injury and prolong your recovery. Improving the stability of your shoulder may take several months.
Return to Regular Activities
Recovery time will vary between individuals. Return to your regular activity or sport can happen safely when your shoulder has fully recovered. If you return too soon, full recovery may be delayed and you may cause further damage or worsen your injury.
You may safely return to your activities when you have accomplished the following:
• You have achieved pain-free, full range of motion with the injured shoulder
• Your shoulder strength has returned to normal matching the opposite unaffected side
• You have achieved full function so that you are able to perform the specific motions and actions required for your sport
• Strengthening you rotator cuff and stabilizing muscles will help to prevent another injury
• Be sure to warm up properly and stretch before your activities
• If your shoulder starts to hurt during these activities, you may need to slow down until the pain goes away