Rotator Cuff Injuries explained by Dr. Scott Curtis:
As a sports medicine doctor, one of the most common complaints that I’ll see from patients is shoulder pain. And one of the most common reasons for one to develop shoulder pain is because of a rotator cuff injury or tear. The rotator cuff is a group of four muscles that hold the shoulder together. So in this model, the collarbone sits in the front, the shoulder blade sits in the back, the collarbone and shoulder blade form to meet the AC joint. And underneath that is where the arm humorous head sits in the arm socket. The arm socket ball complex is held together by four muscles called your rotator cuff. And these muscles help act as kind of ropes and pulleys to allow your arm to do all the activities that you do overhead, whether it’s throwing a baseball or hitting a tennis ball, or even just reaching up to get something out of the counter.
Over a period of time, sometimes those rotator cuff muscles will actually start to fray or tear, which can lead to a chronic rotator cuff tear. This Is very common in the population over the age of 60. If you were to do MRIs of everybody over that age, about 55% of people will have some degree of rotator cuff tear. And for a lot of people that doesn’t cause pain at all. But for some people it could cause significant pain, swelling or even changes within their activities of daily living. The best way to figure out whether or not the rotator cuff is injured or torn is through a thorough evaluation, taking a proper history and physical exam to help identify exactly where in the shoulder your pain may be coming from. If we need to do further diagnostic testing, x rays can be done to look at the bone and the joints and make sure that there’s no other issues such as osteoarthritis or calcification along where the rotator cuff is. But if we needed to do a further diagnostic tests, an MRI would be warranted to help look at the tendons and look at the tissues.
In terms of treatment of rotator cuff tears or injuries we always try to start out with the conservative approach first. Things such as physical therapy, a strengthening program to help stabilize the Scapula and work on some of the movements of the rotator cuff. Pain medication such as nonsteroidal antiinflammatory medications or topical medicines may be beneficial to help reduce your pain. Simple things such as icing and resting it away from your sport, which aggravated in the first place will also be beneficial. When those kind of conservative management fail or you’re having too much pain to actually participate in it, then we’ll often talk about injection therapy to reduce some of the pain and inflammation within the rotator cuff. If we’ve tried everything that we can and we still have significant pain and changes within our activities of daily living, we’ll often talk about surgical intervention, which may be appropriate for some people, but hopefully we can treat your rotator cuff tear or a tendinitis appropriately and get you back playing the sports you want to play and doing all the activities you want to do.