A mild rotator cuff injury can be treated at home, but there are instances when the patient needs the help of a rotator cuff doctor. A rotator cuff involves tendons and muscles surrounding the shoulder joint, firmly keeping the head of your upper arm bone within the shoulder's shallow socket. A rotator cuff injury could cause a dull ache in the shoulder that worsens during the night.
Rotator cuff injuries are very common and increase with time. These injuries might occur earlier in people with jobs requiring repeatedly performing overhead motions, such as painters and carpenters.
Physical therapy exercises can improve the flexibility and strength of the muscles surrounding your shoulder joint. For many people with rotator cuff issues, these exercises are all needed to manage their symptoms.
Usually, rotator cuff tears may occur from a single injury. In those instances, people should seek medical help from a rotator cuff doctor quickly, because they may need surgery.
There are different types of rotator cuff injuries. The primary ones include:
Rotator cuff tears occur when one or more of the tendons and muscles that make up your rotator cuff tear. You could have a partial or a full tear. A tear could happen suddenly after a single injury. Or it could develop gradually over time.
This term covers a lot of different conditions affecting the tendons around your shoulder. Some tendons could become trapped between a bone at the top of the arm and your shoulder blade. This is called subacromial or shoulder impingement. The tendon can eventually tear over time.
The cause of the rotator cuff injury depends on the type of rotator cuff injury involved:
The primary symptom of a rotator cuff injury is pain at the side and top of the shoulder. The pain could be a dull general ache, or it could feel severe and sudden if you accidentally tear your rotator cuff. Sometimes the pain can spread down toward your elbow.
Shoulder pain often gets worse if you are doing something where you lift the arm or raise it above your head. You might also find the pain worse at night, especially if you sleep on your injured shoulder. In this case, it could affect your sleep and make you tired throughout the day.
Other signs of a rotator cuff injury include:
There are other problems affecting the shoulder that may cause these symptoms. If you get any of these symptoms, see your rotator cuff doctor for advice.
The first step to diagnosis is an exam and history by your rotator cuff doctor. The rotator cuff doctor needs to identify where your pain is coming from. They will do this by asking you about the quality and timing of your pain. Not every shoulder pain is related to a shoulder injury. Some shoulder pain comes from other places, like the neck or the heart.
If your doctor worries about a general rotator cuff injury, they may order imaging tests.
This could start with an x-ray. Although x-rays don't show the rotator cuff muscles, bursa, and tendons, they could diagnose issues with the bone spurs or arthritis of your shoulder. These bony issues may be the source of your pain or could be a reason for a rotator cuff tear.
However, if your rotator cuff doctor is worried about a rotator cuff tear, getting an MRI is the best way to diagnose it. An MRI will show the location and size of tears or inflammation. The MRI can determine how many tendons are affected. It can determine if there is tendinosis, where there are changes in how a tendon looks, but the tendon is still connected. It can show if there is a partial or a complete tear. It can show if the tear is displaced and how far the tendon is from the expected bone attachment site. It can also show if the muscle looks normal or has been filled with fatty tissue. This information will help determine the proper treatment.
Some doctors will also recommend arthroscopy. Arthroscopy is a surgical treatment that allows the surgeon to use a small camera to see inside the shoulder joint.
The treatment type you'll have depends on several factors. These include the injury type you have, how serious it is, your age, and how active you normally are.
Sometimes, your rotator cuff doctor might recommend surgery to repair a rotator cuff tear. A rotator cuff tear won't normally heal on its own without surgery. However, non-surgical treatments could help to relieve pain and build up strength in your shoulder. Not all rotator cuff tears need surgery. For many, non-surgical management could be enough to let you use your shoulder again.
Your doctor would discuss your options and help you decide what is best for you.
Your rotator cuff doctor might also advise a period of resting your shoulder first. Avoid lifting heavy weights or doing activities involving lifting your arm over your head. You can gradually increase your activity when your shoulder starts to feel better.
It helps to utilize an ice pack to help alleviate pain. Wrap the ice pack in a dishcloth or towel before using it. Never put an ice pack directly on your skin, as it might cause damage or give you a burn.
If you need pain relief, you could take over-the-counter painkillers, such as paracetamol or ibuprofen. Your pharmacist or doctor may recommend certain other painkillers.
Your physiotherapist will show you some rotator cuff stretches and exercises you could do at home to help improve the movement and strength of your shoulder. The exact exercises you must do will depend on your injury type. You may continue getting physiotherapy sessions for up to six weeks. Many individuals make a good recovery within this time.
If the shoulder pain is still severe despite trying the measures above, your rotator cuff doctor might offer you a steroid injection. A steroid injection could help to reduce swelling and pain in your shoulder. This might reduce your symptoms enough to continue with physiotherapy exercises. However, steroid injections can have side effects. Your rotator cuff doctor will help you weigh the risks and benefits of having one.
Your doctor may suggest surgery if you have a rotator cuff tear induced by a sudden injury. They might also suggest surgery if you have a long-term injury and other treatments have not helped.
Various types of surgeries are available for rotator cuff injuries, such as:
You'll need to commit to a rehabilitation program after rotator cuff surgery to help regain strength and movement in your shoulder. This could be a slow process. It could take up to six months or more to get back to normal function. But sticking to the rehabilitation program will increase your chances of a successful recovery.
Left untreated, a rotator cuff injury may worsen and limit movement due to persistent pain and discomfort. The injury can lead to a frozen shoulder (adhesive capsulitis) if the tightness or stiffness worsens. Over time, a frozen shoulder can lead to permanent weakness or loss of motion and progressive shoulder joint degeneration.
If you are unsure if your shoulder pain is just a strain or something more serious, get your shoulder checked by a rotator cuff doctor without further delay.