What is a rotator cuff injury?

Rotator cuff injuries include inflammation, or partial or complete damage of the tendons of the shoulder. The rotator cuff is a group of four tendons that converge and surround the front, back, and top of the head of the humerus. These tendons are individually connected to very important muscles that cover the shoulder blade (scapula). When these muscles contract, they stimulate the rotator cuff tendons, causing the movements of elevation, separation, and internal and external rotation, hence the name "rotator cuff”.

The main injuries to the rotator cuff are tendonitis and tears:

• Tendonitis of the rotator cuff : occurs when the tendons of the joint become inflamed.
• Tears of the rotator cuff : when one of the tendons detaches from the bone. The tear may be partial or complete, and may occur suddenly or slowly over time.

Prognosis:

Rotator cuff injuries are painful and can impede mobility, which has an impact on the patient's quality of life.

If the injured rotator cuff is not treated properly, it can cause chronic stiffness and weakness, and can progressively wear away the shoulder joint.

Symptoms of rotator cuff injuries:

The main symptoms of rotator cuff injuries are:

• Pain and tenderness in the shoulder, which may extend to the arm.
• Severe pain when lifting the arm sideways, lifting weight, or trying to reach behind oneself.
• Pain when sleeping on the affected shoulder.
• Mobility problems in the shoulder.

Medical tests for rotator cuff injuries:

The orthopaedic surgeon will begin with a physical examination in which he or she will press on different points of the shoulder and move the patient's arm, as well as examining the strength of the arms.

If the physical examination is not conclusive, imaging tests such as an ultrasound, X-ray or MRI may be used.

Can rotator cuff injuries be prevented?

Rotator cuff injuries can be prevented by avoiding activities that cause them, such as certain sports that involve arm movements (e.g. tennis or cricket). Also, certain jobs that require use of the arms for several hours, such as carpentry or painting. Exercising and strengthening the shoulders and arms is also a good way to prevent injuries.

Treatments for rotator cuff injuries:

In some cases, conservative treatment with rest, physical therapy exercises, and the application of ice is enough to treat a rotator cuff injury. In cases where conservative treatment is not enough, pain injections, physical therapy sessions, or surgery to repair the tendon or even a tendon transplant may be prescribed. This intervention can be done either by open surgery or laparoscopy.

Which specialist treats rotator cuff injuries?

An orthopaedic surgeon is the ideal specialist to diagnose and treat rotator cuff injuries. A physiotherapist will also be involved in the treatment and rehabilitation of the injury.