Rotator Cuff Disorders

Rotator cuff location

Last Updated December 20th, 2021

Overview of rotator cuff disorders

The World Health Organisation (WHO) reveals that nearly 50% of the current global population suffers from musculoskeletal injuries of some form or the other. These injuries are more widespread among professional athletes. The main parts of the musculoskeletal system that suffer the injury in such cases are the muscles, tendons, ligaments and soft tissues. The reports of the Center for Disease Control and Prevention show that nearly 22% of the general population suffer from rotator cuff disorders. Nearly 20% of them have high risks of a re-tear injury. Proper treatment is necessary in such cases in order to reduce the global health burden due to rotator cuff disorders.

 

What is rotator cuff disorder?

Rotator cuff disordersRotator cuff disorder refers to an injury to any of the four small muscles that comprise the rotator cuff. The main function of the rotator cuff is to support the upper arm bone (humerus) within the scapula (socket of the shoulder blade). The constituent muscles of the rotator cuff are- supraspinatus, infraspinatus, teres minor and subscapularis. The supraspinatus initiates the shoulder motion and maintains the balance of the shoulder throughout the range of motion. The infraspinatus and the teres minor help in the external rotation of the shoulder. The subscapularis facilitates the internal rotation of the shoulder. All these muscles function synchronously to provide stability to the shoulder joints and bones. They also maintain the range of motion of the shoulders. Injury to any of these muscles leads to rotator cuff disorders of various types. Incidences of rotator cuff disorders are more prevalent in old people. But children and teens who actively take part in sports and athletic activities are also the vulnerable groups of this disease.

 

What are the causes of rotator cuff disorders?

An overuse injury is a primary factor behind rotator cuff disorders. But there are other precipitating factors as well. Following is a list of the common causes of rotator cuff disorders-

  • Repetitive stress on the tendons and the rotator cuff muscles due to similar movements of the shoulder
  • Overuse injuries of the tendons, ligaments due to occupational stress
  • The repetitive overhead motion of the arms during sports such as basketball, badminton, tennis, weightlifting
  • Sudden lifting of a heavy load
  • Reduced blood supply to the rotator cuff tendons (impedes the proper healing of the wounds and injuries)
  • Degeneration of tendons, rotator cuff muscles, and ligaments due to aging
  • An occurrence of bony outgrowths that causes friction with the rotator cuff tendon
  • Performing exercise without sufficient warm up
  • Sports injuries
  • Damages resulting from proximal humerus fractures, bicep tendon ruptures or shoulder dislocations
  • Constriction of the supraspinatus opening that lies below the coracoacromial arch
  • Incorrect sports techniques such as improper angle of serving, an incorrect angle of strike
  • Accidental trapping of the tendon between the glenoid fossa and the humerus
  • Alterations in structures and properties of the rotator cuff
  • Stress on the articular and bursal portions of the tendon
  • Trapping of the rotator cuff between the postero-superior labrum and the tip of the humerus
  • Defective movements or poor postures
  • Poor vascular functions or anatomical defects of the rotator cuff that are present from birth
  • Tendon inflammation and tendon fibrosis
  • Loss of scapular stability and scapular rotations
  • Overuse of broad-spectrum medications that can affect the health of the rotator cuff muscles
  • Certain diseases like Arthritis, Diabetes, and Gout
  • Loosening of joints and muscles of the shoulder (due to aging or existing medical illnesses)
  • Deposition of calcium along the tendons close to the rotator cuff muscles
  • Rigorous physical activities

 

What are the different types of rotator cuff disorders?

Rotator cuff locationGiven below is the common classification of rotator cuff disorders-

  • Partial rotator cuff tear: The soft tissue suffers considerable damage in this case, but does not become completely non-functional.
  • Full-thickness rotator cuff tear: A hole in the tendon usually occurs in this case. The soft tissues are completely split. The tendons dislocate at the point of junction with the humerus.

Based on the intensity of tear, rotator cuff disorders can be categorized into the following types-

  • Acute rotator cuff tear: It usually follows some accidental injuries that lead to shoulder dislocation or a broken collarbone.
  • Degenerative rotator cuff tear: It occurs due to the degeneration of the tendons. It is typically a feature of old age. It is usually symmetric in nature, that is, if one shoulder develops a tear, the other shoulder also develops a tear, even if there is no occurrence of pain.

 

What are the symptoms of rotator cuff disorders?

Following are the common warning signs of rotator cuff disorders-

  • Pain and inflammation in the shoulders
  • Pain during normal shoulder movements such as lifting the arms
  • Weakness and heaviness of shoulder and arm muscles
  • Generation of crackling or popping noise during shoulder movements (Crepitus)
  • Limited movements of the shoulder
  • Frozen shoulder syndrome
  • Sharp pinching pain that radiates to the arms and neck

 

What diagnostic tests are necessary?

The following diagnostic tests are critical to determining the root cause of rotator cuff disorders-

  • X-rays (to detect the presence of bone spurs)
  • Ultrasound scan (to detect soft tissue injuries)
  • MRI scan (to determine the age of the injuries)

 

Treatment

  • Rotator cuff disorders painConservative therapies– These include proper rest, cold packs (ice application) and physical therapy. In case of minor injuries, conservative treatment methods are sufficient for the injury to heal. However, in case of major injuries involving a muscle or tendon tear, surgeries might be required.
  • Physical therapy– It is one of the first lines of treatment suggested by the doctor. The patient is taught exercises based on the location of the rotator cuff injury. This therapy aims at reinstating flexibility and strength to the affected shoulder. Physical therapy is also recommended after the surgeries performed for the rotator cuff injuries.
  • Injections- If the conservative therapy fails to relieve the pain and the pain starts interfering with sleep, exercise or daily activities, a steroid injection is given in the shoulder joint. These are transient methods of pain relieving. These injections should be used cautiously as they might cause the weakening of the tendon.

Surgical intervention– There are several methods for operating and surgically treating the rotator cuff injuries. Some of them are as follows:

  • Arthroscopic tendon repair– This method employs an arthroscope which has fine surgical tools and a video camera attached to it. The arthroscope helps in reattaching the tendon to the bone with the use of few small incisions.
  • Open tendon repair– In some cases, an open surgery is performed. In these types of surgeries, a larger incision is given in order to access the detached tendon. Recovery after these surgeries is more uncomfortable as compared to the arthroscopic surgeries.
  • Tendon transfer– These surgeries are performed when the tendon is too damaged to be reattached to the bone. The damaged tendon is replaced by a healthy tendon from a nearby tissue.
  • Shoulder replacement- These surgeries are performed in case of massive rotator cuff injuries.

 

 

Dos and Don'ts

Dos
  • Follow an exercise routine. Regular physical activity helps in strengthening the muscles. It also maintains the elasticity of the muscles and tendons.
  • Take rest. Avoid activities and movements that hurt your shoulder. Refrain from lifting heavy weights or overhead activities until the shoulder pain goes off.
  • Use cold and hot packs. After the injury, an ice pack can be used for the shoulder for 15 to 20 minutes after every 3 to 4 hours. After the pain and inflammation subside, hot packs can be applied with the aim to relax tightened and sore muscles.
Don'ts
  • Ignore symptoms such as a dull pain deep in the shoulder, difficult to sleep on the affected side, weakness of the arm, difficulty in reaching behind the back etc.
  • Take steroid injections without the advice of your doctor. Use the steroid injection judiciously as it might cause tendon damage. You can take OTC pain medications such as ibuprofen, naproxen sodium etc.

 

 

 

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Psyllium Husk: More than just an effective natural laxative Psyllium husk, or isabgol, is a popular natural laxative . But did you in addition to regulating bowels,…
Miracle extract from the root of maca: 10 ways it can help you! Maca root has been used for years in herbal medicine. Today scientific research is unearthing fresh evidence in…
Lauric Acid: 8 health benefits you can derive from coconuts Appropriate use of saturated fats containing lauric acid can provide you numerous health benefits. This is the main…
kshar sutra
Kshar sutra treatment for piles, fissures and fistula Read to know the benefits and side effects of kshar sutra to treat anal piles, fissures, and fistula…
Cordyceps: How the Caterpillar fungus works as a proven cancer-shield Strange as it may sound, but cordyceps or "caterpillar fungus", a fungus variety native to the Himalayas may…
GGt test
GGT – Gamma-Glutamyl Transferase Test GGT or gammaglutamyl transferase test is a liver function test that is used to detect the extent of…
green poop causes
Green poop : What are the reasons and how can you correct it Ever sneak a peek down the toilet only to shockingly find green poop? Why does our poop turn…
hYdroxycut pills
Hydroxycut: How safe are these so-called weight loss supplements? Hydroxycut is a blend of several different ingredients formulated to promote weight loss; powered by a key weight…
superfoods quinoa probiotics
10 fantastic Superfoods you need to include in your diet from today! What exactly are superfoods and how do they battle diseases? From losing weight to looking ravishing- these superfoods…
thyroid_scan
Thyroid Scan Thyroid scan is a diagnostic procedure that aims to view the thyroid gland and detect any growths or…
creatinine
Creatinine Test The level of creatinine in the blood is a significant indicator of the health of your kidneys. This…
Pelvic_ultrasound
Pelvic Ultrasound Pelvic ultrasound is a process where sound waves are used to create image of your pelvic region organs…
Mood swings
The real reasons for your mood swings and how to overcome them Are you prone to heated moods frequently? Do you also feel bouts of depressive feeling creeping up on…
Find all the instant ways to get rid of blackheads Blackheads - Not only are they aesthetically unappealing but if left untreated these can cause bacterial overgrowth on…
Did you know drinking alkaline water could be the healthier choice for you? Ever wondered how safe is your drinking water in terms of pH? Recent studies have revealed that Alkaline…
Ultrasound
Abdominal Ultrasound An abdominal ultrasound is used to visualize the organs inside your abdominal cavity including the liver, spleen, gall…
Crossfit with rope
CrossFit: Now get the perfectly sculpted body with this explosive gym routine CrossFit is a fitness regimen that makes use of high-intensity exercises in a shorter period to achieve muscle…
Is it possible to achieve full body detox with Master Cleanse? Master cleanse is a diet consisting of a lemonade based beverage, a salt water drink and a herbal…
Optavia diet
The features of an Optavia diet The Optavia diet endorses pre-packaged meals and snacks called "fuelings" that are tasty, low in calorie, and incorporates…
Tart Cherry: The healthiest excuse for taking that second serving of pie Tart cherry has been traditionally used in delectable desserts such as pies. Recent studies have revealed that its…
Hot cups for detox? Read all about the ancient technique of cupping Did you know inverted hot cups on your back can squeeze out and eject toxins from your body?…
carbamazepine
Carbamazepine / Tegretol test The carbamazepine is a drug that is used to treat epilepsy and the carbamazepine test is performed to…
Bromelain: 11 reasons why you should start adding pineapple to your pizza! If you didn't love pineapples already, here are some of the top health benefits that bromelain can bring…
Electric toothbrush vs manual toothbrush: Who wins the dental war? Manual brushes are ideal for kids as it is important to start slowly unlike the electric brushes which…
Chlorella: Therapeutic powers of the billion-year-old algae now within your reach Chlorella - A billion year old nutrient-rich algae that can potentially ward off cancers and high cholesterol; the…
How to correctly perform nasal irrigation using a Neti Pot? Neti pot has been a part of Ayurveda since centuries. This ancient tool is extremely effective in treating…
leptospira Igm test
Leptospira-IgM Test A Leptospira-IgM test is a blood test which is carried out to detect anti-Leptospira IgM antibody. Leptospirosis is…
Coffee Enema: Turn your favorite morning beverage into a powerful colon cleanser The wonders of coffee are not just limited to waking you up every morning. You can now use…
Helicobacter pylori IGA
Helicobacter Pylori – IgA Test The H.pylori IgA test is a blood test used to identify the level of IgA antigen in the…
Milk Thistle skin
Milk Thistle: Find possible cures for fatal diseases in these purple blooms Milk thistle is well-known for treating liver conditions. However, did you know that it comes with a plethora…
sleep deprivation
Don’t let your sleep deficit grow into memory loss or heart attack Why is sleep important for us? How could sleep deprivation harm you? We bet you didn't know about…
piles fissure fistula
Allopathy vs homeopathy vs ayurveda treatment for piles, fissures, and fistula Read to know the best form of treatment among allopathy, homeopathy,or ayurveda for piles, fissures, and fistula
myelogram
Myelography Myelography is an important diagnostic tool that is used to investigate and identify abnormalities in the spine and…
cytomegalovirus igm test
Cytomegalo Virus (CMV) – IgM Test The CMV antibodies include both IgM and IgG antibodies which are the immune system's response to a CMV…
glucose-tolerance
Oral Glucose Tolerance Test – GTT Glucose tolerance test (or Oral GTT) is used to detect the onset of diabetes or prediabetes conditions. It…
The right way to prepare Alfalfa sprouts at home Alfalfa or lusan ghas is not just a nutritious animal fodder. This flavonoid-rich herb has some amazing health…
woman with abdominal pain holding ovulation calendar
Ovulation – facts to know about ovulation Learn how and when ovulation occurs, demystify common misconceptions, identify symptoms, methods of detection and right period for…

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