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Rotator Cuff Injury
Our rotator cuff muscles refers to a group of muscles and tendons that surround our shoulder joint, and it functions to keep the head of your upper arm bone (humerous bone) firmly within
the shallow socket of the shoulder.
A rotator cuff injury can cause a
dull ache in the shoulder, which often worsens
- when you try to sleep on
the involved side
- with aggravation ie lifting weight/load
- wrong angle of shoulder usage
Rotator cuff injuries occur most often in people who tends to have repeated overhead motions in their jobs or sports. Examples includes
- housewives and househusbands
- people who play badminton, squash, baseball or tennis
of rotator cuff injury also increases with age.
Many people recover from rotator cuff disease with shoulder physiotherapy that improve flexibility and strength of the muscles
that surround and make the shoulder joint.
Unfortunately, sometimes rotator cuff muscle tears and pains may happen as a result of a single
For these cases, medical and physiotherapy care should be provided as soon
as possible. Extensive rotator cuff tears may also/even require
- surgical repair
- transfer of alternative tendons
- joint replacement.
Rotator Cuff Injury Symptoms
The pain associated with a rotator cuff injury may:
- Patients often describe the pain experienced as a dull ache deep in the shoulder
- That this condition disrupts/influence/disturb sleep, particularly if you lie on the affected shoulder
- Make it difficult to comb your hair or reach behind your back (for ladies, wearing bra/undergarments can be difficult), wearing long pants, socks and shoes can be difficult too
- Be accompanied by arm weakness
When to see a doctor
Shoulder pain that is
short-lived may be evaluated by your family doctor. See your doctor
right away if you have immediate weakness in your arm after an injury.
If you need/want us to refer you to experienced shoulder orthopedic specialists, get in touch with us and we'll connect you as well as part of our value-added services to you.
Rotator Cuff Injury Causes
Rotator cuff disease may be the result of either
- a substantial injury to
- progressive degeneration
- wear and tear of the
- repetitive overhead activity or heavy lifting over a
prolonged period of time may irritate or damage the tendon too
Rotator Cuff Injury Risk factors
The following factors may increase your risk of having a rotator cuff injury:
As you get older, your risk of a rotator cuff muscle injury increases. Rotator cuff tears are most common in people older than 40 years old.
- Individuals who participate in certain sports
Athletes who regularly use
repetitive arm motions, such as badminton and squash players, baseball pitchers, archers and tennis
players, have a greater risk of having a rotator cuff injury (mainly due to the repeated overhand usage)
- Construction/carpentry/plumbing/electrical/highly manual repetitive jobs
Occupations such as
carpentry or house painting require repetitive arm motions, often
overhead, that can damage the rotator cuff over time.
- Family history
Unfortunately, there may be a genetic component involved with rotator cuff injuries as they appear to occur more commonly in certain families.
Rotator Cuff Injury Complications
Without proper treatment and/or physiotherapy, rotator cuff problems may lead to
- permanent loss of
motion or weakness
- and may result in progressive degeneration of the
Although resting your shoulder is necessary for your
recovery, keeping your shoulder immobilized for a prolonged time can
cause the connective tissue enclosing the joint to become thickened and
tight (frozen shoulder).
Rotator Cuff Injury Prevention
If you are at risk of rotator cuff injuries or if you've had a
rotator cuff injury in the past, daily shoulder stretches and
strengthening exercises can definitely help prevent future injury.
(If you prefer for a trained/experienced senior physiotherapist to help you work on your shoulder as opposed to you working on your shoulder yourself, then connect with us and we're more than happy to serve you.)
Most people exercise the front muscles of the chest, shoulder and
upper arm, but it is equally important to strengthen the muscles in the
back of the shoulder and around the shoulder blade to optimize shoulder
We can help you with that.
Rotator Cuff Injury Diagnosis
During the physical exam with the doctor, your doctor will press on different parts
of your shoulder and move your arm into different positions. He or she
will also test the strength of the muscles around your shoulder and in
In some cases, he or she may recommend imaging tests, such as:
Although a rotator cuff tear won't show
up on an X-ray, this test can visualize bone spurs or other potential
causes for your pain — such as arthritis.
- Ultrasound (diagnostic/imaging type, different from our applied therapeutics ultrasound therapy which is great for rotator cuff injury physiotherapy too)
This type of test uses sound waves
to produce images of structures within your body, particularly soft
tissues such as muscles and tendons. It allows dynamic testing,
assessing the structures of your shoulder as they move.
It also allows a
quick comparison between the affected shoulder and the healthy
- Magnetic resonance imaging (MRI)
technology uses radio waves and a strong magnet. MRI images that you will get will shoow all structures of the shoulder in great detail.
Rotator Cuff Injury Treatment
Conservative treatments — such as rest, cold therapy and physical therapy —
sometimes are all that a patient needs to recover from a rotator cuff injury...unless your injury is very severe and involves a complete tear of the muscle or
tendon, then you may need surgery.
(We can refer you to skilled shoulder specialists too, at no additional cost to you, as part of our value added services to you/loved ones).
If conservative treatments hadn't
worked to reduce your pain (or if it's taking more time), your doctor might recommend a steroid injection into
your shoulder joint, especially if the pain is interfering with your
sleep, daily activities or exercise.
While such shots are often
temporarily helpful, they should be used judiciously, as they can
contribute to weakening of the tendon if used multiple times at the same tendon/joints.
Physical therapy is usually one of the
first treatments your doctor may suggest.
Shoulder physiotherapy 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.
Physiotherapy may include:
Arthroscopic rotator cuff repair
Many different types of surgeries are available for rotator cuff injuries, including:
- Arthroscopic tendon repair
In this procedure,
surgeons insert a tiny camera (arthroscope) and tools through small
incisions to reattach the torn tendon to the bone. (This is very commonly done, with less scarring and quicker/better healing too).
- Open tendon repair
In some situations, an open
tendon repair may be a better option. In these types of surgeries, your
surgeon works through a larger incision to reattach the damaged tendon
to the bone. Compared to arthroscopic procedures, open tendon repairs
typically heal in the same length of time but recovery may be more
- Tendon transfer
If the torn tendon is too
damaged to be reattached to the arm bone, surgeons may decide to use a
nearby tendon as a replacement.
- Shoulder replacement
Extensive/massive rotator cuff
injuries may require a full or partial shoulder replacement surgery.
Rotator Cuff Injury Lifestyle and home remedies
Usually a minor rotator cuff injury often can heal on its own, with proper care and protection.
If you think you've injured your rotator cuff, try these steps:
- Rest your shoulder
Stop doing what caused/aggravates the
pain and avoid painful movements (especially movements that causes sharp pain). Limit all heavy lifting or overhead
activity until your shoulder pain subsides.
- Apply ice (cold therapy) and heat (heat therapy)
Putting ice on your
shoulder helps reduce inflammation and pain. Use a cold pack for 15 to
20 minutes every three or four hours. After a few days, when the pain
and inflammation have improved, hot packs or a heating pad may help
relax tightened and sore muscles.
- Take pain relievers/anti-inflammatories
relievers such as ibuprofen (Advil, Motrin IB)) may be helpful.
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At the first session, our specialist physiotherapists will carry out a thorough
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