Rotator Cuff Injuries
“The Rotator Cuff” is the system the body uses to keep your arm secure when you are moving it. The shoulder joint is a ball and socket joint. The top of your upper arm bone is the ball, and there is a socket on the outer edge of your shoulder blade. Whenever your arm has to move, your body pulls the ball tighter into the socket. This makes it much more stable to do the things for which we need our arms and hands, like pushing and pulling and lifting, throwing, waving and reaching, especially overhead. As you can imagine, this is damaged a lot in people who work with their arms overhead (like painters, electricians, teachers, etc). There are some sports and activities that can be a greater stress for your shoulders, like swimming, baseball, basketball, football, tennis, bicycling, mountain biking, climbing, riding a motorcycle, etc)
Again, whenever your arm moves, your body pulls the ball of the upper arm bone tighter into the socket of the shoulder blade. There are 4 main muscles that do this, but there are 17 muscles that are attached to the shoulder blade, and they attach to other points as high on your body as the back of your head, and they touch every part of your back, all the way down to your pelvis!
Most rotator cuff disorders are caused by wear and tear due to overuse, and unbalanced use.
What this means is that it’s not normally the shoulder, the shoulder blade, or even the rotator cuff: it’s how you’ve been using them! Using your shoulder in an unbalanced way, for many years, slowly damages the rotator cuff.
The pain could be due to a mild strain, and the resulting inflammation, of the muscle or tendon, which leads to no permanent damage. It could also be due to a tearing of one of the muscles or other soft tissues. This may require surgery for repair, depending on how badly it is torn. This uneven wear and tear can lead to “impingement,” which means that there is less room for you to move, and soft tissue can rub against hard bone, in the area. This causes a pinching (impingement) which causes damage & irritation of the soft tissue, which then causes bleeding and inflammation. And that is painful!
What does a rotator cuff injury feel like?
The damage that comes from your uneven use of the shoulder causes inflammation. Inflammation causes swelling, swelling causes pain that gets worse when you move your arm.
Most of the time, you will feel the pain on front and side of the upper arm and shoulder.
A deep dull ache in the shoulder
You can’t sleep well, especially if you are laying on that side
Getting dressed gets difficult (combing your hair, lifting your arm to put on a shirt, reaching behind your back to put on a bra or belt, etc)
Weakness in your arm
Pain from a rotator cuff injury gets worse when you move your shoulder. If your shoulder pain is not affected by movement, seek immediate medical care. There could be something more serious going on, and you want to make sure! If your shoulder pain is accompanied by crushing chest pain, like an elephant is sitting on your chest, or there is concern that the pain is coming from the heart, this is not a drill, seek emergency care: call 911 right now!
Traditional Treatment for a Rotator Cuff Injury
If your medical doctor suspects a rotator cuff injury, they will often order an x-ray to check the bones of the shoulder, first. In many cases, another imaging test, like an ultrasound or an MRI, may also be needed to get an accurate diagnosis.
Once diagnosed, what you do next, will determine how you heal.
Do not ignore it. Without the right kind of treatment, your shoulder will most likely get weaker, as you avoid the pain, and develop habits of accomplishing your tasks in a different way. You will then develop further complications, like Frozen Shoulder (link), as you use your shoulder blade, instead of your shoulder joint to get through your days.
For most rotator cuff disorders, your medical doctor will recommend rest and reduced activity, ice or heat on the shoulder, and anti-inflammatory drugs. Steroid injections into the shoulder may be recommended if pain is bad enough. Your doctor may also suggest physical therapy to reduce pain and increase your shoulder strength. Also depending on the severity of the injury, you may be referred to an orthopedic surgeon to discuss a surgical repair.
How long does it take for a Rotator Cuff Injury
In most cases, the damage is to a tendon, which will heal over time. The older you are, the longer it takes to heal. Traditional treatment may take several months to resolve the pain, depending on the severity of your injury, and the treatment you chose. Without proper treatment, you may have developed bad movement habits by the time it healed, and may be on track for another injury.