The rotator cuff is a group of muscles and tendons around the shoulder joint that keep the arm centered in its socket. Four small muscles and their tendons make up the rotator cuff.
Injuries, whether they’re acute or degenerative, are common and risk increases with age, says Dr. Jeffrey Rossow, Marshfield Clinic Health System orthopedic surgeon.
How does injury happen?
If you fall on your arm or throw or lift anything suddenly with poor technique, you may experience an acute rotator cuff injury.
Rotator cuff tears are rare in young athletes, however can happen with high-energy injuries such as shoulder dislocations. Athletes who throw, row or lift weights are also prone to acute injuries.
People over 40 can experience rotator cuff injury over time, especially through repetitive use or working overhead.
What an injury feels like
Acute injuries often cause sharp, intense pain. You may even feel or hear a ‘snap.’ These injuries can lead to significant weakness and the inability to lift your arm. This would be an instance where you should seek medical evaluation within a week or two.
For degenerative injuries that develop over time, the pain is likely to be dull and achy. It can be worse with sleeping. You may also notice pain when you move your arm or use it to lift and lower objects.
How to prevent rotator cuff injuries
There are ‘on the body,’ ‘in the body’ and ‘around the body’ cues for preventing injuries.
- ‘On the body’ refers to protective equipment in sporting events and daily activity.
- ‘In the body’ refers to proper form, technique and posture when lifting or working overhead. It includes warming up properly, proper nutrition and hydration and getting enough rest between sets and proper sleep.
- ‘Around the body’ refers to just that: Be aware of your surroundings. This can help you prevent a fall or related impact.
You also can prevent rotator cuff injuries with exercises by strengthening the rotator cuff and the surrounding shoulder muscles.
Making small and large circles using a towel against a wall can help stretch and strengthen the shoulder area to prevent rotator cuff injuries. Exercises that strengthen both large and small muscles in the shoulders are most effective, as opposed to exercises that only focus on the major muscles.
Furthermore, consider making adjustments to your activity as you age.
“When you’re 20 years old and you lift 50 pounds slightly wrong, you’re probably going to be okay,” said Dr. Rossow. “If you do the same thing at 50 years old, you may not be so lucky. Ask for help lifting or reduce the weight.”
What to do if you’re worried
Contact your provider sooner than later if your shoulder is bothering you. Some injuries may respond to nonsurgical treatment. Surgery may be recommended depending on the severity of the injury and symptoms.
“A full tear or a partial tear causing significant pain that does not improve with therapy, may benefit from surgery,” said Dr. Rossow. “In most cases, we can fix things using a safe, minimally-invasive arthroscopic procedure that re-attaches the damaged tendon to the bone using anchors and sutures.”
Surgical patients often regain their strength and range of motion. On the other hand, people with untreated rotator cuffs may develop arthritis, in addition to the existing injury.
In terms of timeline, most people spend four-to-six weeks after surgery in a sling. They will then start physical therapy to restore range of motion and boost strength. Most people return to normal activities in three-to-six months, depending on the physical demands of their lifestyle and job. Mobility and strength gains continue for a year after surgery.
For rotator cuff pain, talk to a Marshfield Clinic Health System provider.
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