Shoulder Pain and Rotator Cuff Injuries: What You Should Know

Rotator cuff injuries are extremely common in athletes, especially basketball and tennis players. In the past recent years, many celebrity athletes, such as Kobe Bryan – a basketball luminary – as well as Maria Sharapova – a tennis superstar – have all suffered what is known as a rotator cuff injury. However, the thing to note is that it is not only athletes that get this kind of injury, as it is something that is a very common cause of shoulder and upper arm pain amongst normal people as well. (1) The American Academy of Orthopaedic Surgeons has reported that as many as two million people tend to visit the doctors’ offices for rotator cuff problems every year.

Definition of the Rotator Cuff

This is made up of four small muscles and tendons that are bunched together close to the shoulder blade. These groups of muscles as well as tendons, connect the top of the shoulder and the head of the upper arm bone to the shoulder, the head being the round globular part in the ball-and-socket joint of the shoulder. The thing to note is that it is the rotator cuff that is responsible for providing the strength and stability in the shoulder and it is also responsible for keeping the head of the upper arm bone centered and locked in the socket.

Reasons for Rotator Cuff Injuries

The main reason why the rotator gets injured is because of the wear and tear that occurs in the tendons. This wear and tear can be because of old age, as the tendons start to get thin and they are easily torn as the person gets older. (2) Other than that, injury to the rotator cuff – such as because of a car accident, or by falling – can also result in the tendons to get torn.

Furthermore, we find that overusing the rotator cuff can also cause injury to it, and this is the most common reason why athletes tend to injure this part of the body.

Athletes often stretch out their arms and overuse their muscles and joints, which is why they can tear the tendons and get hurt, just like such athletes are also prone towards other similar injuries, such as tendinitis, which is the inflammation of the tendons. Other professionals that tend to overuse their shoulders and arms, such as electricians, painters, carpenters, and construction workers, etc. are also very likely to get such injuries.

Moreover, we find that many people with inactive jobs, such as desk jobs, also tend to get rotator cuff injuries, as they can be sitting with poor posture and not follow proper ergonomics. This can also result in shoulder and upper arm pain.

Signs and Symptoms of Rotator Cuff Injury

The main symptoms of a rotator cuff injury include shoulder pain along the side as well as upper arm pain. It has to be noted that even though the pain might also be there below the elbow, it is very rarely so. This shoulder and upper arm pain can be quite problematic as it can interfere with the person’s normal daily routines.

People suffering from such pain tend to have problems with lifting heavy objects, putting on clothes, reaching up high, and conducting other activities that involve the use of their arms. Patients are also likely to feel a lot of pain while sleeping, especially if they put their weight on the injured shoulder.

Several things can be done to help relieve the symptoms and alleviate the upper arm pain and shoulder pain. Many people tend to find relief by resting the arm and also by putting ice packs on the affected areas. Certain medications, such as non-steroid anti-inflammatory drugs – like aspirin, naproxen, and ibuprofen – can also help reduce the pain and swelling. Opiates and other narcotic medicines, such as Vicodin, are not recommended, except the patient has undergone surgery and is in severe pain.

Initial Treatment:

Doctors can diagnose rotator cuff injuries through physically examining the shoulder and can also follow up with imaging, such as X-ray, ultrasound, or MRI. Physical therapy is initially suggested for pain relief, as well as several other non-surgical techniques. (2)

Physical therapy:

Physical therapy can take the form of a supervised step-by-step program that would work to exercise the shoulder and to strengthen the muscles. The main idea is to have the muscles and joint becoming more efficient.

Cortisone shots:

If the pain is too much and the person is not able to handle it even after physical therapy, an injection of cortisone can be used along with some numbing medication, such as novocaine, to reduce the pain and inflammation.

Platelet-rich plasma injections:

This is a new form of treatment in which the doctors extract the cells from the patients’ own blood and this blood is then injected back into the patient to stimulate the healing process. (3) Even though there is no scientific evidence to depict that this works, it is nevertheless quite popular, especially amongst professional athletes.

Debridement:

If there is no tear in the tendon, it is very much likely that the patient is going to heal on his or her own. (5) In case that does not happen, debridement might be conducted, which is a minor and minimally invasive procedure that works to remove the damaged tissue from the joint. (4)

Surgical Repair of Rotator Cuff Tears:

In case the tear is very large and the condition is severe, surgery of the rotator cuff is required. (5) One type of surgery that is very common because it is minimally invasive is arthroscopy, in which miniature instruments are inserted through small incisions and the tear is taken care of.

Another technique is called interscalene block (6), in which medication used to numb the nerves is administered directly. This is continued for a few days after the surgery to reduce the post-surgery pain and quicker recovery. In either case, the recovery time after surgery can be quite large, ranging from four to six weeks with the patient having to wear the arm in a sling to prevent further injury.

Prevention:

Rotator Cuff Injury can be easily avoided by maintaining good posture as well as by regularly exercising. (7) It is also important to not overuse the shoulder and those people who tend to overuse their shoulders must also conduct regular exercises to help them prevent the injuries from happening. It is also important to have an ergonomic desk and workplace for office workers to avoid this type of injury and pain.

References: