Rotator Cuff Injury : Symptoms, Treatment & Exercises
Medically Reviewed By : Dr K. Hari Chandana
MBBS, MS ORTHOPAEDICS ( Fellowship in Trauma, Fellowship in pain Management )
Introduction
Is your shoulder pain telling ‘NO’ to your favorite activities? Well, sometimes your shoulder also needs a break from all the work. There are several reasons why your shoulder needs a break and the most common cause is rotator cuff injury. You may be wondering what a rotator cuff injury is, so just stick with me!
Before we discuss rotator cuff injury, let me tell you about rotator cuff!
Rotator cuff? What is it?
The rotator cuff is a set of muscles and tendons, responsible for holding your shoulder in place. They form a cuff around the upper arm bone’s head (humerus). They keep the shoulder stable, help lift your arms and reach upward.
When one or more rotator cuff tendons are damaged, your shoulder becomes stiff and can lose its mobility. This is called rotator cuff injury also referred as rotator cuff tear, rotator cuff syndrome, rotator cuff tendonitis and shoulder impingement syndrome.
What exactly causes rotator cuff injury?
You know, we really don’t concentrate on our shoulders until we feel pain. So, we don’t usually try to find out the cause, instead we try to reduce the pain until it’s chronic. But, sometimes even an acute pain may be caused because of some damage, comorbidities or other factors.
Some of them include:
- Rotator cuff injuries often occurs when there is a fall or an accident
- General wear and tear with age and repetitive use can cause the injury.
- Poor posture
- Repetitive actions(overuse) like lifting weights, painting and playing sports like cricket, tennis, badminton etc.
- Family history with rotator cuff injuries
How common are rotator cuff injuries?
Approximately 2 million people are visiting doctors for shoulder pain caused by rotator cuff injury. Impingements and tears are the most prevalent rotator cuff injuries. Impingements cause rotator cuff muscle to swell and pinching. Whereas tears cause when a rotator cuff tendon muscle is torn and they are less common.
Rotator cuff tears can be either partial (acute) or complete. With a partial tear your tendon is not completely separated from the arm bone i.e., it is still partially attached to it. This usually happens from one particular incident such as lifting heavy objects, falling. People who are young are mostly at risk for partial or acute tears.
When it comes to complete tear, your tendon completely separates from your bone and a hole or a rip is seen in the tendon. This usually happens in case of long-term overuse. Athletes like baseball players, wrestlers, tennis players and carpenters, painters and people above 40 years of age are at risk for this condition.
Symptoms of rotator cuff injury:
The most popular and annoying symptom of rotator cuff injury is “shoulder pain”.
- Living with shoulder pain is like having a knife stabbed in your shoulder, and it keeps getting worse at night or while resting your arm.
- Shoulder pain keeps you from sleeping.
- Difficulty and discomfort while lifting, lowering or rotating your arm.
- Popping or crackling sounds while moving your arm in certain positions.
- Difficulty in lifting weights, reaching behind the back.
- Weakness of the shoulder
These are the most common rotator cuff injury symptoms and since there are many options to treat this condition, there’s no need to worry!
How is a rotator cuff injury treated?
- Applying cold or hot packs can help reduce the swelling of the affected shoulder.
- You need to rest your arm and give it a break from all the labor. Because if you want to be your best, you need to rest!
- Physical therapy and strengthening exercises will help improve your range of motion. They also help strengthen your shoulder.
- OTC NSAIDs like Ibuprofen, naproxen and other medications like corticosteroid injections may help reduce pain and swelling.
Your doctor may recommend surgery in case of complete torn rotator cuff, but the treatment for rotator cuff injury will start with non-surgical treatment.
A complete torn rotator cuff treatment may include surgeries like arthroscopy. Most of the cases are done arthroscopically through small cuts(incisions).
How is it performed?
In this procedure, an arthroscope(small camera) is inserted through a small cut(incision) in your shoulder. Later insert small instruments into the incisions to remove bone spurs and reattach the tendon to your upper arm bone.
As for the partial tears, the surgeon will trim the worn out pieces of the partially torn tendon. This debridement procedure keeps your tendon from tearing it more.
Some tears are nor repairable due to the age and size of the tear. For these types of tears, you may require reverse shoulder replacement, tendon transfer or scar tissue debridement without repair. Most of the tears don’t require surgery.
How long does it take to recover from a rotator cuff tear?
Post surgery, you may need to wear a sling to prevent your arm from moving for at least 4 to 6 weeks. Your doctor then recommends physical therapy. Most people recover their shoulder strength and its functioning within 4 to 6 months after surgery, but complete recovery may take up to 12 to 18 months.
5 easy rotator cuff strengthening exercises:
Rotator cuff strengthening exercises will help improve your shoulder’s strength, range of motion so that you can return to doing your favorite activities. Here are some strengthening exercises recommended by medical experts:
1. Pendulum exercise:
- Lean forward and support yourself with one hand on the counter or any table. Allow your affected arm to hang at your side freely.
- Now slowly swing your arm front and back. Repeat doing this side-by-side and in circular motion again.
- You can do this 2 to 10 sets daily
2. Lawn mower pull:
- You need a 3-foot long elastic band to do this exercise. Tie the ends of the band and place the one end of the band under the foot opposite to your affected arm.
- Hold the other end with your affected arm and place your other hand on your waist.
- Now imagine you are starting a lawn mower in slow motion, straighten your back & move your elbow across your body to your outside ribs.
- As you stand, relax your shoulders and push your shoulder blades together. Repeat 3 sets of 10 per day.
3. Scapula setting:
- Lie down on your stomach with your arms by your sides. You can use a pillow under your forehead for comfort, if required.
- Now gently move your affected arm upwards to the level of your body while lying in that position. Now hold it for 10 seconds and slowly bring it down.
- Relax and repeat this 10 times a day up to 3 days in a week.
4. Side- lying external rotation:
- You need a dumbbell weighing around 1-2 pounds to do this exercise. Lie down on the side opposite to your affected arm on a firm and a flat surface.
- Cradle your head with your unaffected arm under you.
- Hold the dumbbell in your hand which is affected to your side and slowly raise your elbow towards the ceiling. Now, slowly bring it down to your side.
- If you feel any bit of strain, stop doing it. Repeat this at least 3 sets of 10 up to 3 times a day. Later, you can increase the sets when it becomes easy.
5. Elbow extension:
- You need a dumbbell weighing around 1 pound and can increase up to 10 pounds.
- Raise your injured arm and bend your elbow with the dumbbell behind your back. You can support your arm by placing your opposite hand on your upper arm.
- Now slowly straighten your elbow and bring the dumbbell overhead. Hold it for 2 seconds.
- Slowly bring your arm down behind your back and repeat it again.
- Repeat 3 sets of 8 up to 3 times in a week.
How to prevent a rotator cuff injury?
- Say hello to good postures! Because sometimes poor postures can lead to this condition.
- Athletes and people who use their shoulders often in their occupation should take frequent breaks and rest. This can reduce the load on your shoulder.
- Consult a physiotherapist for some stretches and strengthening exercises which can help strengthen and increase the range of motion of your shoulder.
- Do not lift any heavy objects and avoid doing repetitive actions if you are having shoulder pain.
Rest… Reboot… Rise!
Rotator cuff injury is quite common. All you need to do is rest to achieve your best outcomes. If you experience pain even after that, consult your doctor and seek medical attention immediately. Don’t let your shoulder load hurt a lot! As an athlete or person who works a physical job, it will bench you. But it doesn’t mean you can give up on your career. So as long as you take care of yourself, nothing can stop you!