Rotator Cuff Injury Treatment

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It can be frustrating and concerning to experience shoulder pain and weakness, especially when reaching overhead. This is especially true if the pain is accompanied by a sound, like a pop or click. If you're experiencing these symptoms, you may have a rotator cuff injury. 

Your shoulder's rotator cuff is made of muscles and tendons, that fuse together and surround your shoulder joint. Sometimes, an injury or overuse can cause your rotator cuff to be injured. The actual cause of injury could be anything from tendinitis to a rotator cuff tear. 

Rotator Cuff Injury Treatment at UVA Health

During your visit, your provider will ask you to move your shoulder in a variety of ways. As you do, they'll conduct a physical exam, feeling for points of resistance or pain. Depending on what they observe and your medical history, they may order imaging. 

Types of imaging they may request include: 

  • Ultrasound
  • Arthrogram
  • MRI
  • Arthroscopy

Rotator Cuff Injury Treatment Options 

Depending on what your doctor observes, your treatment plan may involve any of the following options. 

Medication 

  • Non-steroidal anti-inflammatory drugs (NSAIDs) can be used to help reduce inflammation and pain
  • Corticosteroids may be injected into the area to reduce inflammation 
  • Topical pain medications can help reduce pain 

Other Treatment Options 

Many effective treatments involve caution and observation. 

  • Rest Your provider may ask that you stop a certain activity or that you wear a sling to give the joint a chance to heal 
  • Physical therapy  A physical therapist can help you with exercises that strengthen supporting muscles in your shoulder
  • Ice can be used to reduce inflammation and pain 
  • Hot compresses can help relax overly tight muscles and reduce pain

Surgery

If your imaging tests show a rotator cuff tear, your doctor may recommend surgery. Unfortunately, tears can only very rarely heal on their own. 

There are several different surgical procedures depending on what caused your initial tear and how severe it is. 

Acromioplasty

The acromion is part of your shoulder bones. If your rotator cuff injury is caused by the ligaments or muscles of your rotator cuff being pulled on by this bone, it will need to be shaved down.
This surgery can be done arthroscopically or may require an open repair. 

Arthroscopy

Arthroscopy surgical procedures involve a small instrument being inserted into the shoulder. This technique can be used to remove pieces of bone, torn parts of the rotator cuff tendons, or even to repair small tears.

This surgical technique is designed to be less invasive for a quicker recovery time. 

Mini-Open Repair With Arthroscopy

If there's a larger tear in your rotator cuff's muscles or tendons, your doctor may recommend a mini-open repair. This technique uses arthroscopy as much as possible, but also involves an incisions the doctor can use for suturing. 

Open Surgery

In severe rotator cuff injuries, the injured tendon or muscle requires an open surgery. In an open surgery, a tissue transfer or tendon graft can be put in place to reconnect tears too large to be closed. If a serious shoulder injury was the initial cause, this is also how a shoulder joint replacement would be placed. 

Recovery 

Recovering from a shoulder injury can take up to 6 months, longer if you also need a joint replacement. For a quicker recovery, follow your doctor's suggestions for physical therapy, rest, and returning to normal activity. 

    Dr. Werner Explains Rotator Cuff Injuries

    The rotator cuff is made up of muscles and tendons to fuse together to surround the shoulder joint. Wear and tear over the years leads to rotator cuff injuries such as tendinitis, strains or tears. Most treatment is non-surgical, but surgery is available for more severe damage. View rotator cuff transcript

    What Causes a Rotator Cuff Injury? 

    Sometimes, the cause of a rotator cuff injury is obvious. Serious trauma, like a direct blow to the shoulder or a dislocation can cause a rotator cuff injury. But it can also be caused by degenerative wear overtime. Especially if there's repetitive overhead arm motion.

    Rotator cuff injuries are frequently seen in: 

    • Swimmers
    • Baseball players (mostly pitchers)
    • Tennis players
    • Carpenters
    • House painters

    Other Risk Factors

    In addition to activities or jobs, some other things that make rotator cuff injuries more likely are: 

    • Being over 40
    • Previous shoulder injuries
    • Shoulder instability
    • Heavy lifting
    • Arthritis

    Can You Prevent a Rotator Cuff Injury? 

    Unfortunately, many of the causes of rotator cuff injury aren't preventable. Arthritis, older age, and joint instability are factors that can affect anyone.
    And while some activities, like swimming, increase your risk it's also an activity that's great for staying active.
     

    You can reduce your chance of getting an injury though.

    • Take breaks if doing overhead repetitive work
    • Exercise regularly
    • Talk to a physical therapist early if you notice pain or loss of mobility

    Most people with a rotator cuff injury are able to recover well and resume their former activities.