If you’ve ever suffered a rotator cuff injury, you know how painful and disabling it can be. Everyday tasks like combing your hair or reaching for a can on a high shelf cause pain in your upper arm and shoulder. Rotator cuff pain can become so severe that even sleeping through the night becomes a challenge.
But what’s the best way to manage the pain and weakness of a rotator cuff injury? Is surgery usually needed or could a non-surgical treatment like physical therapy put you on the road to recovery? We’re breaking it all down to help you—with guidance from your doctor—make the best decisions.
What Is the Rotator Cuff?
The rotator cuff is a group of tough, flexible tendons and muscles that attach to the bones of the shoulder joint. It keeps your arm in your shoulder socket. And as its name implies, the rotator cuff helps you lift and rotate your arm.
Causes of Rotator Cuff Injuries
Rotator cuff injuries are a leading cause of shoulder disability. The majority of these injuries are the result of repetitive motion, trauma, or changes associated with age. Injuries can cause inflammation of one or more of the rotator cuff muscles or an actual tear.
Sports injuries are a main source of rotator cuff injuries in young people. For older people, the trouble is often a result of wear and tear over time that can weaken shoulder tissues, making them more vulnerable to injury. This is especially true for people with occupations or hobbies that require repetitive or overhead motions—things like painting and playing tennis. To help prevent injuries, it’s helpful warm up with stretching and range-of-motion exercises (like shoulder circles).
Types of Rotator Cuff Injuries
There are two basic types of rotator cuff injuries: tendonitis (most common) and rotator cuff tears.
Rotator cuff tendonitis is an inflammation of the tendons in the shoulder. It usually begins as a dull ache on the outside tip of the shoulder and gets worse when you reach overhead or lift your arm up to the side. It can be painful to lie on that shoulder and simple tasks like getting dressed can be a challenge. Over time, the pain can become more severe and spread to the entire shoulder.
A partial or complete rotator cuff tear occurs when through overuse or an injury, you tear one of the tendons from the bone. Because rotator cuff tears are largely associated with the aging process, people 40 years of age and older face the greatest risk.
Treatment of Rotator Cuff Injuries
Depending on the type and severity of the injury, many patients can achieve improvement of rotator cuff conditions with physical therapy and it is often recommended as a first line of treatment. Physical therapy can:
- Improve range of motion, flexibility and strength
- Improve shoulder function, stability and posture control
- Decrease pain
- Reduce the risk of pain in the future
Penn Medicine Lancaster General Health outpatient physical therapists can develop individualized treatment plans to help manage rotator cuff injuries in patients who don’t require surgery, as well as part of post-surgery rehabilitation for patients with more severe injuries. The goal is to help manage pain and restore shoulder function.
There is some evidence that a single corticosteroid anti-inflammatory injection can improve shoulder pain and function in the short term. However, multiple steroid injections may negatively impact the integrity of the rotator cuff.
What Happens When a Rotator Cuff Injury Is Not Treated?
People who don’t get a rotator cuff injury treated face several risks:
- Increased shoulder, upper extremity, and neck pain
- Decreased shoulder range of motion and stiffness
- Upper extremity strength loss
- Limited ability to use the arm for functional tasks
Whatever type of rotator cuff injury you may be facing, it’s important to talk with your health-care provider about the best way to manage your pain and restore your shoulder function. Getting the appropriate treatment in a timely manner can help you get back to doing everyday tasks and other activities you enjoy without pain.