 The Rotator Cuff consists of four muscles
and their associated tendons that envelop the upper arm like
an upside down shoebox. These important muscles are responsible
for all the movements of the upper arm and shoulder. They
aid in raising your arm to comb your hair, scratching your
mid-back, swinging a golf club, carrying a suitcase and throwing
a ball overhand.
Rotator Cuff Injuries can result from several
sources. In younger individuals, they usually are the result
of a traumatic fall. In middle age individuals, they often
result from repeated overuse and end-stage impingement syndrome.
In the elderly, they usually result from attrition and thinning
of the rotator cuff over time. Small partial tears can cause
bleeding and deposits of calcium within the tendon.
Pain and weakness with shoulder use are
the primary symptoms. One of the hallmarks of rotator cuff
tears is pain even when lying down flat on your back. This
is because without gravity the ball of the upper arm presses
into the rotator cuff tear causing pain. The quality of the
pain is usually sharp. Early evaluation and initiation of a
treatment program is very important. Your physician will obtain
a detailed history of when your shoulder hurts. He then will
do a specific examination to find the location and cause of
your shoulder pain. An x-ray or MRI may be ordered to evaluate
your shoulder in greater detail.
Treatment initially is aimed at non-surgical
treatment. The rotator cuff has the capacity to repair itself
in certain situations. Resting your shoulder with a pillow
between your arm and your body when sitting or lying down can
help. Do not stop using your shoulder altogether as this can
cause a frozen shoulder. Gentle pendulum exercises (stir the
pot, bowling, rock the baby and saw wood) can keep your shoulder
active while resting it at the same time. Cold and heat can
sometimes help. Your physician may prescribe anti-inflammatory
medications to control the pain and inflammation. A formal
physical therapy program with ultrasound treatments and electrical
stimulation can reduce pain levels. If the pain is severe,
your physician may inject cortisone directly into the shoulder.
If conservative treatment fails, surgery may be needed. Today,
many rotator cuff injuries can be treated arthroscopically
through three tiny incisions as same-day surgery. Talk to your
doctor for more information.
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