The rotator cuff is not really a cuff but rather an area in the shoulder where tendons, ligaments and muscles, which control arm movement from the shoulder, are located. These ligaments and tendons control the arm’s ability to rise out to the side of the body. With specific movement comes specific pain when there is an injury – either chronic or acute. There is a lot of information to cover when it comes to rotator cuff injuries, which is why we had to split it up into 3 different parts. This is part one of the series in which we cover rotator cuff injury symptoms.
Rotator Cuff Injury Causes
Rotator cuff injuries can be chronic, found in people who participate in occupations or sports that have excessive overhead movements such a painter, or baseball pitchers. Chronic injuries also occur in people who have an anatomic narrowing of the space in the shoulder which causes damage to the tendons with movement. Chronic injuries are also caused by tendonitis with degeneration in age or repetitive trauma. Rotator cuff injuries can also be caused from acute trauma to the joint such as when there is significant pressure against the shoulder during a fall, raising something overhead or a direct trauma to the shoulder. In people younger than 30 there is usually significant force to the shoulder to cause damage.
Rotator Cuff Injury Symptoms
Each of the different injuries to the rotator cuff has different symptoms if it is chronic or acute. In a chronic tear the symptoms happen more in the persons dominant arm because that is the side that receives the most trauma during repetitive movement. Chronic tears are more common in men older than 40. The symptoms generally include (but are not limited to:
- In an acute rotator cuff injury there is usually a tearing sensation followed by intense pain down the arm. Motion in the arm will be limited by pain and muscle spasms. The acute pain from the tear and bleeding into the muscle goes away in a short time, usually 3-5 days. There will continue to be point tenderness over the point of the tear and if the tear is significant the person won’t be able to raise their arm out to the side of their body.
- In either case, chronic or acute, the pain is generally located to the front and side of the shoulder and becomes more intense when the shoulder is moved away from the body. Interestingly the pain also becomes more intense at night and will increase when lying on the affected shoulder. As the pain gradually worsens it can also be accompanied by weakness. The person experiencing rotator cuff injury can usually still use the arm but will be unable to move the arm above the level of the shoulder.
- As the pain diminishes if the person doesn’t continue to move the shoulder it can result in a ‘frozen shoulder’. In other words the joint loses a significant amount of range of motion in all directions, even when the patient is relaxed and the doctor attempts to move the arm. Inflammation, scarring, thickening and shrinkage of the capsule all contribute to the frozen shoulder and resulting loss of function and increased pain with movement.
- Rotator cuff injuries are sometimes precipitated by a chronic tendonitis. Tendonitis in the shoulder is most common in women between 35 and 50 years old. They also experience a deep ache in the shoulder toward the front and outside of the upper arm. There is usually point tenderness. Women describe the pain as coming on gradually and becoming worse when they lift their arm to the side or turn it inward – the action used when glancing at a watch. This type of tendonitis can lead to a tear in the ligaments and tendons from chronic inflammation.
If these rotator cuff injury symptoms sound familiar then you should seek medical care if the shoulder pain lasts more than 2 days or you aren’t able to work or raise your arm above the level of your shoulder. If you aren’t able to engage in your daily activities or sports activities then you should schedule a visit to your doctor. Emergency medical attention should be sought if you are suddenly unable to move your shoulder whether it was immediately injured or not.
Rotator cuff injuries can be relatively minor or make a large impact in your ability to accomplish daily living tasks. Certainly without physical therapy and rehabilitation the latter will be the most likely result of either a chronic or acute injury. As with any other injury or damage done to the body, if you give your body the right tools early in the injury you are more likely to suffer less long-term problems than if you neglect the problem and then try to fix it later.
Before you go, have a look at the additional resources below if you want more information on rotator cuff injury symptoms and more. Also, have a look at the Shoulder Pain Treatment section of our Shop for products that may be able to help you.
American Academy of Orthopedic Surgeons: Rotator Cuff Tears
Cleveland Clinic: Rotator Cuff Tendonitis
Sports Injury Clnic: Rotator Cuff Tear