Rotator Cuff Injuries

The four muscles of the rotator cuff include: 

• Supraspinatus: The supraspinatus muscle helps you lift your arm. 
• Infraspinatus: The infraspinatus helps with the external rotation (moving away from the body) of your shoulder.
• Teres minor: The teres minor muscle is just under the infraspinatus and assists with the external rotation of your shoulder. 
• Subscapularis: The subscapularis lies under the other three muscles and plays an important role in the internal rotation (moving towards the body) of your shoulder. 

Those with professions that require the use of upper body muscles are usually exposed to shoulder injuries, like painters and carpenters. In sports, rotator cuff injuries are common especially due to the repetitive movement of the shoulders like tennis, badminton, squash, cricket, and quite regularly, swimmers too.

Movements like lifting weights above shoulder height, swimming, throwing are some of the primary functions performed by the people who usually go on to have rotator cuff-related injuries due to the overuse and degeneration of the muscles and tissues. 

Because it is such a commonly used joint, strains, tendonitis, bursitis and other injuries are common to the rotator cuff. Overuse of the shoulders causes compression in the tendons and muscles. This leads to various injuries related to the rotator cuff, which vary in pain and severity. But there are also instances of patients suffering rotator cuff injuries despite no history of overuse.

There are three kinds of rotator cuff injuries that affect people:

Rotator Cuff Tendonitis: One of the common injuries that happen due to the overuse of the shoulder muscles, and is a common athletic injury. Like most tendonitis injuries, this too is aggravated due to overuse of the shoulder muscles like a fast bowler in cricket or a tennis player with an overhead serve. It is also more common among women after the age of 35.

Rotator Cuff Bursitis: Bursae are fluid-filled sacs that are located in the knees, elbows, hips and shoulders, cushioning the bones from the tendons because of the rotating movements they often employ. Bursitis occurs when the bursae get inflamed. It is also a common sports injury due to overuse of the rotator cuff.

Rotator Cuff Tear: Extreme use of the rotator cuff or even a single episode can cause a tear in the rotator cuff. A fall, car or motorbike accidents or a similar impact can cause the tendons in the rotator cuff to stretch more than they can take, and eventually tear. 

Injuries to the rotator cuff are usually pointed out immediately due to the limited range of movement in the affected shoulder, but here are a few tell-tale signs:

• Pain and tenderness in the shoulder
• Unable to lift the arm above a certain height
• Unable to sleep on the affected shoulder’s side
• Increased pain in the shoulder at night
• Unable to reach your back
• Low arm strength or grip
• You feel a click in the shoulder while lifting or rotating your arm

A doctor would usually begin with a physical exam to check for the nature of your injury and notice your shoulder movements. 

An x-ray is the first level of imaging that you will be asked to get to check for deformities in the bones that form your shoulder, as it is a degenerative injury. It is followed by an MRI which determines the damage caused in the tendons, muscles and ligaments in the rotator cuff.

An ultrasound is then performed to see the extent of swelling or accumulation of fluids in the soft tissues. Shoulder pain sometimes also turns out to be connected to heart conditions, which doctors usually check for as well.

Injuring your shoulder can be a very difficult phase to get out of because it disrupts your daily life and keeps you from performing the simplest of chores. But there are various ways to treat an injured rotator cuff depending on the severity and nurse it back to gain full range of motion in most cases. You doctor may advise one or more of the following:

• Rest and apply hot or cold compression to reduce swelling
• Anti-inflammatory over-the-counter medication
• Light exercises to regain strength and range of motion
• Restrict movement with a sling or support to prevent further aggravation
• Steroid injections applied directly to the injured area
• Physical therapy, before or after surgery
• Surgery, which is done in three different ways depending on the extent of damage

Whether you’re a professional athlete, in a field of work that requires physical labour or even someone living a sedentary lifestyle, problems like rotator cuff injuries can bring your regular functions to a halt. But here are a few factors that put one at risk of sustaining an injury like this:

• If you’re above the age of 40 you have a higher chance of injuring your rotator cuff due to degeneration
• People in professions that require repetitive lifting motions above the shoulder level, like painters and carpenters, and people pursuing sports such as tennis and cricket
• People who perform weightlifting exercises

While in a lot of cases a rotator cuff injury occurs suddenly, there are ways to mitigate that risk, even for people who are using their shoulder muscles all the time.

• Warm up and stretch before beginning a session of tennis or a gym workout as it helps mobilise the muscles and joints before increasing intensity
• Employ the right technique while performing physically demanding tasks that put a strain on your shoulder
• If you feel the slightest of pains in your shoulder joints, take a break and apply ice to treat the pain immediately

Being an important joint in the human body performing tasks constantly during the course of a day as well as being a ball-and-socket joint, the shoulder’s rotator cuff is constantly at work, and it is critical to look after them and not ignore the signals your body may be giving you. If you experience any kind of shoulder pain, it is important to check with a doctor before continuing with the task that triggered the pain in the first place.