Although many people equate rotator cuff injuries with baseball players, they happen to occur fairly frequently in the general population. In my clinic, we’ve seen everyone from high school baseball pitchers to 85 year old never-athletes with this problem. There are many other shoulder injuries that could appear coincidentally or even mask a rotator cuff injury. These include bruises, separations, and bursitis, just name a few. If you have a shoulder pain or weakness that does not improve after a week, you should report it to a health care professional. Special tests are sometimes needed to confirm rotator cuff tears.
What is a rotator cuff, anyway? Rotator cuff refers to a group of four muscles in the shoulder which help to stabilize it and participate in almost all shoulder and upper arm movements. A loose or “subluxing” shoulder can irritate the rotator cuff, but not necessarily tear it. Sudden or violent movements of the arm, especially behind the back or overhead, can strain or tear it. That’s why baseball pitchers are among those who frequently injure their rotator cuff. Overuse, or repetitive “micro-trauma” can also build up to gradually cause a tear. This can occur by something as innocuous as simply moving ones arm repeatedly while sitting at a desk to something as vigorous as swinging a golf club. The movements affected by a rotator cuff strain can include inward and outward rotation of the arm, as well as lifting the arm forward or sideways. Often, lifting the arm out to the side is the most painful movement. In a severe injury, the person will barely be able to lift up his arm.
Treatment: Once a rotator cuff injury has been diagnosed, various things can be done. The physician may require you to wear a sling for a few weeks (if the injury is bad enough), to allow the injured tissues to rest and begin healing. You may also be referred to a physical therapist. Physical therapy can include therapeutic ultrasound, electrical muscle stimulation, infrared, cold laser, ice, and special rehabilitation exercises. It is essential that the exercises be specific to the injury, so as to strengthen what is weak, while not irritating what is already inflamed. In severe cases, surgery is performed by an orthopedic surgeon. After surgery, physical therapy is often prescribed, to help regain strength and range of motion in a safe and effective manner.
