What are Shoulder Rotator Cuff Disorders?

The rotator cuff is a group of muscles that support the shoulder. Rotator cuff disorders occur when these muscles and their tendons get irritated or damaged. Rotator cuff disorders include: tendon problems including tendinitis, tendinopathy, or tears, bursitis, impingement, or calcium deposits in the tendons. Most rotator cuff disorders are caused by a combination of: Normal wear and tear, overuse, and aging.

Symptoms of a rotator cuff disorder include shoulder pain and possibly weakness too. You may have difficulty with daily activities such as combing your hair, tucking in your shirt, or reaching for something. The range of movement may be limited due to pain. You may have pain at night especially lying on the affected side.

When to Seek Immediate Medical Attention

Seek immediate medical attention if you have an injury to your shoulder and your shoulder is severely painful, it appears deformed or has popped out of the joint, or if you have signs of injury to the nerves or blood vessels, such as numbness, tingling, a "pins-and-needles" sensation, or a pale, cold, or bluish skin colour after a shoulder injury.

What can you do?

Rest the injured shoulder. Limit repetitive movement and avoid strenuous or overhead activities. Avoid activities or positions that cause discomfort, such as playing golf or tennis or carrying heavy bags of groceries. Try applying ice to your shoulder for the first 48 hours after discomfort begins to relieve pain and reduce swelling. For an acute injury, do not use heat for the first 48 hours.

What can we do to help you?

Treatment for rotator cuff disorders focuses on relieving pain and inflammation and restoring shoulder strength, flexibility, and function. Treatment may help prevent further complications, such as loss of strength and motion in the shoulder or additional degeneration or tearing. Treatment considerations include your symptoms, age, and activity level. You and your doctor will decide together which treatment is best for you.

Most rotator cuff disorders are treated without surgery. Your treatment may include:

  • Rest from heavy lifting or overhead activities,
    although gentle movement of the shoulder is still recommended. Prolonged immobilization (holding the shoulder still), such as with slings or braces, may cause the shoulder joint to become stiff or lead to frozen shoulder.
  • Applying cold or heat, whichever helps more.
  • Taking over the counter pain medications.
  • Avoiding positions and activities that hurt your shoulder, such as overhead activities.
  • Physical therapy to strengthen your upper back and shoulder muscles

Most people with rotator cuff disorders recover without surgery. If symptoms do not improve after a few months of nonsurgical treatment, you and your doctor may consider imaging the shoulder. Your doctor may consider a corticosteroid injection if an inflamed tendon or bursa does not respond to nonsurgical treatments.

What does Surgery involves?

Surgery may successfully repair a torn tendon, but it cannot repair all the damage caused by age or degeneration. Surgery may be considered for people who have:

  • A complete rotator cuff tear caused by a severe injury.
  • Symptoms that do not respond well to 3 to 6 months of nonsurgical treatment.
    These symptoms might include severe pain or loss of shoulder strength and movement.