Your rotator cuff is an amalgam of four muscles, all of which are connected to the humerus (or the upper arm bone), attaching the bone to the shoulder to help with arm movement. Each of these muscles has a tendon attaching to the arm.
The Four Tendons of the Rotator Cuff
The four tendons of the rotator cuff all have equal importance in offering support to the humerus. Each tendon attaches to the top of the arm bone, tethering it to either the back or the shoulder.
- Supraspinatus- This is the largest of the tendons and handles most of the lifting of the arm.
- Infraspinatus- This tendon is essential for rotating the arm in outward motions.
- Teres Minor- Like the infraspinatus, this tendon is used in rotating the arm in outward motions.
- Subscapularis- Anterior to the Infraspinatus and Teres Minor, this tendon is important rotating the arm in inward motions.
An injury to the rotator cuff involves any or all of these tendons, depending on the type and severity of the accident causing the injury.
Common Rotator Cuff Injuries
There are two main types of injuries associated with the rotator cuff, rotator cuff tears, and rotator cuff tendinitis.
Rotator Cuff Tears
A tear of the rotator cuff involves injury to any or all of the muscles and tendons of the rotator cuff. The causes of rotator cuff tears are many and varied including falls, the impact of a car accident, a sustaining a blow to the shoulder, or overuse in sports or other activities.
The symptoms of a rotator cuff tear can be fickle. The main signs that a tear has occurred are weakness in the shoulder or feelings of pain. However, the pain associated with a rotator cuff tear can be misleading. Occasionally, a serious tear can come with very minor pain; and a minor tear can come with more intense pain. For this reason, any rotator cuff tear should be fully evaluated by a medical physician.
Rotator Cuff Tendinitis
This injury is due more to overuse than accidents. The repetition of acts which cause stress to the rotator cuff could result in tendinitis. Such actions include overhead lifting. Sports that can lead to rotator cuff tendinitis include weightlifting, swimming, volleyball, and gymnastics.
The symptoms of rotator cuff tendinitis include severe pain usually focused on the area where the upper arm meets the shoulder. This pain can be felt in most movements, including lifting, pulling, swimming, and other sporting activities. Even common everyday movements can put stress on your tendinitis injury: dressing yourself, grabbing an object from a high shelf, etc.
Common Causes of Rotator Cuff Injuries
Two of the most common causes of rotator cuff tears that we see in our practice are from:
- Car accidents that cause a driver or passenger to thrown around the vehicle;
- Slip-and-falls in which the victim lands on an outstretched arm in an attempt to break the fall;
- Motorcycle accidents and bicycle accidents where the biker is thrown from the cycle or bike.
Car accidents, slip-and-falls, motorcycle accidents and bicycle accidents will often lead to acute tearing of the rotator cuff tendons. However, there is also a more gradual tearing of the rotator cuff which is called degenerative tearing. This can often be associated with sports and weightlifting; activities which wear on the arm muscles and tendons over time.
Sometimes it is difficult to know if the discomfort you are feeling is simple soreness or if its something more serious, like a rotator cuff tear. The following are some common symptoms of rotator cuff tears to help you understand the seriousness of your injury. Rotator cuff tears will often cause:
- Pain and/or weakness while raising or lowering your arm.
- Pain and/or weakness while rotating your arm.
- Pain while lying on your arm.
- Snapping or cracking sounds when attempting to move your arm.
Rotator Cuff Injury Treatments
The goal of most rotator cuff injury treatment is to bring the shoulder back to normal functioning by way of reducing any swelling and building the shoulder’s strength. In addition to use of anti-inflammatory meds, treatment measures for rotator cuff injuries include the following:
- Ice & Rest- Applying ice to the injured area for roughly twenty minutes every six-to-seven hours, if done routinely, can effectively reduce any swelling. Coupling this practice with regular rest can significantly help your recovery. However, rest does not mean merely lying down. In fact, lying in the wrong position can actually cause your shoulder stress. Rest, in the case of a rotator cuff injury, means avoiding movements which will cause pain or weakness in your shoulder. Avoid sports. Avoid overhead lifting. Take it easy — don’t put undue strain on your shoulder.
- Physical Therapy– Putting your shoulder through stretches and exercises can help with the recovery of your rotator cuff. Doing some range-of-motion exercises and pendulum exercises can help to strengthen your muscles again. These exercises may cause a small amount of manageable pain — if you begin to experience intense pain, hold back a bit. Do not push yourself too hard.
If you are experiencing intense pain, or the discomfort you are feeling is continuous, you should seek medical attention. In diagnosing you, your doctor will examine your arm, shoulder, and neck to check for limited mobility or tender spots. Your doctor might also order X-ray testing or Magnetic Resonance Imaging (MRI) to get a better view of your bones and muscles.
If your doctor finds either partial tearing or full-thickness tearing, he or she will decide whether to treat the injury non-surgically—meaning rest, medication, and physical therapy—or surgically. In all cases, a torn rotator cuff is an injury which demands proper medical treatment.
Stuart A. Carpey, who has been practicing as an attorney since 1987, focuses his practice on complex civil litigation which includes representing injured individuals in a vast array of personal injury cases.