If you have injured or damaged your rotator cuff, you may have the following signs and symptoms:
- Dull, deep pain in the front and lateral (outer) part of the shoulder that may radiate to the upper arm
- Weakness in the affected arm
- Difficulty performing tasks that require lifting, pushing, overhead movements, or reaching your hand behind your head (such as combing your hair, throwing a basketball, or slipping your arm into a sleeve)
- Disturbed sleep due to dull aching pain
- The pain worsens on rest
- A locking or catching sensation during shoulder movements
- Swelling in the affected shoulder
Many individuals with rotator cuff injuries, however, may not exhibit any signs and symptoms. The severity of symptoms, when present, greatly depends on the severity of rotator cuff damage.
What is the rotator cuff?
The rotator cuff refers to the group of four muscles—supraspinatus, infraspinatus, teres minor, and subscapularis—and their tendons that provide strength during various shoulder movements and ensure shoulder stability.
All of these muscles arise from the shoulder blade (scapula), get attached to the upper part of the arm bone (head of the humerus), and form a cuff around the joint between the shoulder blade and humerus bone (glenohumeral joint).
The rotator cuff facilitates various types of movements, such as:
- Abduction (movement of the arm away from the body including overhead arm movements)
- Lateral rotation (outward rotation of the arm)
- Medial rotation (inward rotation of the arm)
The rotator cuff ensures that various movements of the upper body occur smoothly without affecting shoulder stability by allowing “fine-tuning” movements of the head of the humerus within the glenohumeral joint.
What causes rotator cuff damage?
Injuries or damage to the rotator cuff can be seen at any age, although the risk increases as you get older. Rotator cuff tears are more common in individuals older than 40 years of age than in younger individuals. Moreover, people who have a family history of shoulder issues are more likely to have rotator cuff injuries. Other factors that may contribute to rotator cuff damage are poor posture and smoking.
In younger individuals, most rotator cuff injuries occur due to trauma, such as during sports (such as football and baseball), road traffic accidents, and falls.
Rotator cuff damage is commonly seen in individuals involved in occupations requiring repetitive movements at the shoulder joints, such as painters, carpenters, athletes, masons, and mechanics.
The rotator cuff may undergo various degenerative changes (wear and tear of muscle and tendon fibers) with age. Additionally, these changes may occur due to reduced blood supply to the rotator cuff with increasing age.
People with poor posture or those involved in repetitive shoulder movements may develop degenerative changes at a younger age. Sometimes, sharp bone growth or spur may form on top of the shoulder. Bone spur formation is usually seen in older individuals and may rub against the rotator cuff during shoulder movements leading to degenerative changes.
What are the various rotator cuff injuries?
Various injuries may affect the rotator cuff, with the most common including:
- Rotator cuff tears: Due to tearing of the muscle or tendon fibers in the rotator cuff
- Impingement syndrome: Occurs when the rotator cuff gets squeezed and rubbed against a bone
- Rotator cuff tendinitis: Irritation and inflammation of the rotator cuff tendon
- Rotator cuff tendinopathy: Chronic irritation or degeneration of the rotator cuff
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