Rotator Cuff Injury Health Article

Definition

A rotator cuff injury is a tear or inflammation of the rotator cuff tendons in the shoulder.

Description

Rotator cuff injury is known by several names, including pitcher's shoulder, swimmer's shoulder, and tennis shoulder. As these names imply, the injury occurs most frequently in athletes practicing sports that require the arm to be moved over the head repeatedly, such as pitching, swimming, tennis, and weight lifting. Rotator cuff tendonitis is an inflammation of the shoulder tendons while a rotator cuff tear is a ripping of one or more of the tendons.

The tendons of four muscles make up the rotator cuff. The muscles are the supraspinatus, infraspinatus, teres minor, and subscapularis. The tendons attach the muscles to four shoulder bones: the shoulder blade (scapula), the upper arm bone (humerus), and the collarbone (clavicles.) The rotator cuff tendons can also degenerate due to age, usually starting around age 40. Rotator cuff injury may also be caused by falling on the outstretched arm or joint of the elbow. Either of these may produce enough force to drive the humerus into the shoulder socket.

Causes and symptoms

Some areas of the rotator cuff tendons have poor blood supply. Thus, the tissue is very slow to heal and maintain itself during normal use. Tearing and inflammation in athletes is usually due to hard and repetitive use, especially in baseball pitchers. In non-athletes over age 40, the injuries usually occur as a result of lifting heavy objects. The two primary symptoms are pain and weakness in the shoulder or arm, especially with arm movement or at night. A partial tear may cause pain but still allow normal arm movement. A complete tear usually leaves the injured person unable to raise the arm away from the side.

Diagnosis

Diagnosis is usually made after a physical examination, often by a sports medicine physician. X rays are also sometimes used in diagnosis as well as an arthrogram. However, the arthrogram is an invasive procedure and may be painful afterwards. For this reason, magnetic resonance imaging (MRI) is preferred to determine tendon tears as it also show greater detail than the arthrogram.