The term “Rotator cuff” describes a group of four small muscles that hold your shoulder in its shallow socket while larger muscles move it. Strains and injuries to the rotator cuff are the most common cause of shoulder problems, accounting for 4.5 million doctor visits per year. Injuries are classified by the amount of damage as “partial tears”, “full-thickness tears” or “ruptures”. A “partial tear” means that one side of your tendon has been partially frayed. A “full-thickness tear”, sometimes called a “complete tear”, describes a hole or slit in your tendon, much like what would be created by running a knife lengthwise down a rope. A “rupture” is the most serious injury and means that your tendon has been torn into two pieces.
Less than 10% of rotator cuff tears are the result of an acute injury like falling, pushing, pulling, throwing or lifting. The vast majority of injuries are the result of repetitive strains over a long period of time. One of the most common reasons that patients develop a rotator cuff tear is something called ”impingement”. Impingement means that the area where your rotator cuff tendons live have become too crowded and the rotator cuff tendons are being pinched each time you raise your arm. Those who perform repeated overhead activities are at greatest risk for impingement and rotator cuff tendon problems. This includes athletes who play baseball, volleyball, tennis, rowing, weight lifting, swimming and archery, and jobs that include carpentry, painting, wallpaper hanging, cleaning windows and washing/waxing cars. Other known risk factors for rotator cuff problems include smoking, obesity, high cholesterol, and prior cortisone injection.
Patients who have suffered a rotator cuff injury often report a “tearing” or “snapping” sensation accompanied by severe pain and weakness. Most chronic strains begin silently with symptoms becoming more evident as the tear progresses. Pain is often localized to the front and outside of your shoulder but can sometimes radiate down your arm. Symptoms are usually aggravated by overhead activity and may progress to the point that you have difficulty raising your arm overhead. Pain is often worse at night, especially when you lie on the affected shoulder.
Be sure to tell us if you suffer from significant neck pain, shortness of breath, chest pain or chest pressure. Young patients who have suffered an acute tear or rupture may require surgery, while most others will benefit from conservative treatments, like the type provided in this office. Most rotator cuff strains can be treated conservatively without surgery. Be sure to avoid painful overhead activity or carrying heavy objects. Try not to sleep on your irritated side, especially with your arm stretched overhead. You may benefit by sleeping on your unaffected side with a pillow between your arm and trunk. Smokers should consider a program to help them quit, and overweight patients will recover quicker if they begin a diet and exercise program. Performing your home exercises is especially important.
If you are having shoulder pain, give us a call at (434)293-3800 to see if we can help. Email questions to Bryan Esherick, DPT at [email protected]