What is the rotator cuff?
The rotator cuff of the shoulder corresponds to a group of four muscles and their tendons that wrap around the front, top, and back of the shoulder. These muscles play an integral role in helping us to move our arms around. The four muscles all insert at various spots on the top of the arm bone, or humerus. In addition to helping us with motion they help keep the head of the humerus centered in the socket, or glenoid.
With repetitive motion, the portion of the rotator cuff that inserts on the humerus, typically the tendon, can get inflamed and aggravated and can even develop microtears or large tears. This can often be felt as pain on the outer portion of the upper arm. Pain may become aggravated with reaching above your head or behind your back. Those can be early signs of an injury.
Rotator cuff injuries often present in many ways on a spectrum from mild to severe. This can range from some inflammation of the tendon and space around the tendons, to severe tears of one or more tendons that can sometimes accelerate shoulder arthritis.
Who is at risk?
People who have occupations requiring significant overhead motion may be at increased risk. Individuals who do a lot of chalk board writing, painters, and construction workers may be at increased risk due to the overhead motion required in their jobs. People who have had prior shoulder injury or have family members who have had them may also be at increased risk. Often, however, individuals without any of these risk factors can develop symptoms. The risk of injury tends to increase with age. Studies suggest that 22% of the adult population may be affected with a combination of asymptomatic and symptomatic rotator cuff tears with the prevalence increasing with age.1
What are common symptoms?
Often patients will feel an aching or dull pain on the outer parts of their upper arm. Laying on one’s side like while sleeping, or overhead motions can often aggravate one’s symptoms. Reaching behind one’s back often also can cause pain. Later stages can make motion very difficult, often presenting with significant weakness and limited painful motion of the shoulder.
How is it diagnosed?
A short course of pain can often be first addressed with shoulder specific exercises targeted at the rotator cuff, activity modification, and sometimes medication. Physical exam combined with one’s history and symptoms often can be suggestive of a rotator injury. While x-rays are helpful for assessing any bony abnormalities or levels of arthritis, MRI or Ultrasound is often necessary to confirm a rotator cuff if there is high suspicion.
How is it treated?
Rotator cuff injuries can often be treated successfully with nonoperative treatments. Some of these include anti-inflammatory medications, shoulder exercise treatments, avoidance of certain activities, and physical therapy. Depending on the nature of injury, sometimes targeted injection treatments can be considered to help to decrease inflammation or promote healing. Surgical treatments are sometimes necessary depending on the injury and/or one’s response to nonsurgical treatments. Please consult your physician before initiating any treatment option, so that a plan can be individualized for your specific condition.
At Ascend Orthopaedics and Sports Medicine, we are happy to help. We are equipped with the latest treatment options for shoulder issues and injuries including a variety of nonsurgical treatments and surgical treatments for rotator cuff injuries and orther orthopedic issues. If you have any questions, please give us a call.
Ascend Orthopaedics and Sports Medicine
6450 38th Ave N. Suite 320, Saint Petersburg, FL 33710
 Prevalence of symptomatic and asymptomatic rotator cuff tears in the general population: From mass-screening in one village. Mingawa H, et al. J Orthop. 2013 Mar 10(1): 8-12.