Rotator Cuff Problems of the Shoulder
The rotator cuff is a group of tendons and muscles that attach the bones of the shoulder joint, allowing the shoulder to move while keeping it stable.
Shoulder impingement is common in young athletes and those who are aged 50 and over. It occurs when the rotator cuff muscles around the shoulder become inflamed and it can be a result of falling onto the shoulder or even just overreaching for something. The result is a pain when raising the hand above shoulder height, and it can be difficult sleeping on the affected side.
Rotator cuff tears present similar symptoms as shoulder impingement and can occur without any history of injury to the shoulder. Small tears respond well to physiotherapy, but failure to regain a significant range of movement with physiotherapy may indicate a larger tear. Surgery, which would be an arthroscopic rotator cuff repair, may be required. Rehabilitation can take up to a year.
Rotator cuff injuries are common among young athletes, especially those who use their arms overhead for activities such as swimming, cricket, netball, and tennis. It’s also more common in people with jobs involving repetitive lifting or overhead activities using the arm, such as construction, stacking shelves or painting.
The condition can also be a result of a minor injury, or even with no apparent cause.
Local swelling, tenderness in the front of the shoulder and stiffness when lifting the arm are the main symptoms of an injury to the rotator cuff. Also, there may also be discomfort when the arm is lowered. As the condition progresses, the pain can become worse at night, with a loss of strength and motion, and difficulty doing everyday activities such getting dressed and reaching for items.
Treatment for this condition usually starts with physiotherapy and rest. Anti-inflammatory drugs can help, and physical therapy will contribute to restoring normal motion to the shoulder. Once the pain has improved, the patient can start strengthening exercises. If these don’t help, a cortisone injection to relieve pain may be required.
Some patients don’t respond well to conservative treatments so they may need a referral to a shoulder specialist for arthroscopic (keyhole) surgery. The recovery is around 8 to 12 weeks of recovery. Once the sling has been removed, a strengthening exercise programme is required.