Rotator cuff injuries often result in an inability to raise the arm above the level of the shoulder. That means a real change in the way that you can get dressed, go to work, play sports and even play with your children. But the damage, unless it’s a significant tear, doesn’t have to be permanent and doesn’t have to result in permanent disability. This is our second post in our series covering rotator cuff injuries, where we get into more details about the rotator cuff injury diagnosis side of things. If you haven’t already read our first post (Rotator Cuff Injury Symptoms), we highly recommend that you do so before continuing.
Rotator Cuff Injury Diagnosis
Before the correct treatment can be prescribed, depending upon the amount of damage and whether it’s a result of chronic, acute, tendonitis or anatomical reasons, a doctor must diagnose the injury and the causative agents. Without this basic information your treatment could result in even more damage. Although it might vary from doctor to doctor, here’s the general process:
- When you arrive at the doctor the first thing that they’ll do is a history of the event. The medical history will help them to determine the cause of the injury, any immediate symptoms and any chronic symptoms, as well as how the injury may be impeding your current daily activities.
- After a history they’ll do a physical examination to compare the range of motion and strength in both shoulders. To do this you’ll have to put on a gown so that the doctor can more fully evaluate the shoulders for any redness or swelling that may indicate another problem in the joint.
- During the examination the doctor will carefully feel the entire shoulder and the one that isn’t injured to compare sides. The doctor will evaluate the range of motion of the shoulder both actively – you doing the movement – and passively – when they move the shoulder while you’re relaxed. If the doctor believes there might be a broken bone in the shoulder this part of the exam can be delayed.
- Included in a physical exam will be an evaluation of neurological innervation, or rather sensation impairments in the arm. They’ll also evaluate blood flow to the arm. Some doctors will do this first before causing discomfort with the range of motion to get a more accurate evaluation.
- Doctors will perform several tests in the office, the most common of which is the drop arm test. You will stand facing the doctor and raise your arm to 90 degrees. The doctor will apply a slight pressure to your wrist or hand which may cause you to drop your arm. This gives your doctor an indication of the severity of the injury.
Most often an x-ray is ordered if the doctor wants to rule out a potential broken bone. In the case of a rotator cuff injury an x-ray is normal without any deformities. There are other more advanced imaging studies that might be ordered if there isn’t any improvement after a month of treatment and consistent rehabilitation. Doctors may use an arthrography, ultrasound or MRI to determine the amount of degeneration to the tendons and ligaments. The exact test ordered will be determined based on the amount of damage that the doctor believes is present and the age of the patient.
Before you go, have a look at the additional resources below if you want more information on rotator cuff injury diagnosis and more. Also, have a look at the Shoulder Pain Treatment section of our Shop for products that may be able to help you.
MayoClinic: Rotator Cuff Injury
University of Washington Medicine: Diagnosis of Rotator Cuff Tears