The rotator cuff is a group of muscles and tendons that surround the shoulder joint, keeping the head of the upper arm bone firmly within the shallow socket of the shoulder. A rotator cuff injury can cause a dull ache in the shoulder that worsens at night.
Rotator cuff injuries are common and increase with age. These injuries may occur earlier in people who have jobs that require repeatedly performing overhead motions, such as painters and carpenters.
Physical therapy exercises can improve flexibility and strength of the muscles surrounding the shoulder joint. For many people with rotator cuff problems, these exercises are all that's needed to manage their symptoms.
Sometimes, rotator cuff tears may occur from a single injury. In those circumstances, people should seek medical advice quickly because they might need surgery.
The pain associated with a rotator cuff injury may:
Some rotator cuff injuries don't cause pain.
Your family doctor can evaluate short-term shoulder pain. See your doctor right away if you have immediate weakness in your arm after an injury.
Rotator cuff injuries are most often caused by progressive wear and tear of the tendon tissue over time. Repetitive overhead activity or prolonged bouts of heavy lifting can irritate or damage the tendon. The rotator cuff can also be injured in a single incident during falls or accidents.
The following factors may increase the risk of having a rotator cuff injury:
Without treatment, rotator cuff problems may lead to permanent loss of motion or weakness of the shoulder joint.
During the physical exam, health care providers will press on different parts of the affected shoulder and move your arm into different positions. They'll also test the strength of the muscles around your shoulder and in your arms.
Imaging tests may include:
Conservative treatments — such as rest, ice and physical therapy — sometimes are all that's needed to recover from a rotator cuff injury. If your injury is severe, you might need surgery.
Physical therapy is usually one of the first treatments suggested. Exercises tailored to the specific location of your rotator cuff injury can help restore flexibility and strength to your shoulder. Physical therapy is also an important part of the recovery process after rotator cuff surgery.
A steroid injection into the shoulder joint might be helpful, especially if the pain is interfering with sleep, daily activities or physical therapy. While such shots often provide temporarily relief, they also can weaken the tendon and reduce the success of future shoulder surgery.
Many different types of surgeries are available for rotator cuff injuries, including:
The pain from a minor rotator cuff injury often diminishes on its own, with proper care. Stop doing what caused the pain and try to avoid painful movements. Limit heavy lifting or overhead activity until the shoulder pain subsides. Icing the shoulder may help it feel better. Over-the-counter pain relievers such as ibuprofen (Advil, Motrin IB, others) or acetaminophen (Tylenol, others) also may be helpful.
You'll probably start by seeing your family doctor or sports medicine physician. If your injury is severe, you might be referred to an orthopedic surgeon. If you've been treated for a similar problem in the past, you may need to bring past records and imaging studies with you to your appointment.
Before the appointment, you might want to write a list that answers the following questions:
Your doctor is likely to ask you a number of questions. Being ready to answer them may reserve time to go over any points you want to spend more time on. Your doctor may ask:
