Rotator Cuff Injuries
Your rotator cuff is made up of the muscles and tendons in your shoulder below the deltoid muscle. These muscles and tendons connect your upper arm bone with your shoulder blade. They also help hold the ball of your upper arm bone firmly in your shoulder socket. The combination results in the greatest range of motion of any joint in your body.
A rotator cuff injury includes any type of irritation or damage to your rotator cuff muscles or tendons. Causes of a rotator cuff injury may include falling, lifting and repetitive arm activities, especially those done overhead, such as throwing a baseball or placing items on overhead shelves. Rotator cuff injuries usually improve with a physical therapy and a supervised exercise program.
Signs & Symptoms
- Pain and tenderness in your shoulder, especially when reaching overhead, reaching behind your back, lifting, pulling or sleeping on the affected side
- Shoulder weakness
- Loss of shoulder range of motion
- Inclination to keep your shoulder inactive
- You may experience pain when you reach up to comb your hair, bend your arm back to put on a jacket or carry something heavy. Lying on the affected shoulder also can be painful. If you have a severe injury, such as a large tear, you may experience continuous pain and muscle weakness.
Four major muscles (supraspinatus, infraspinatus, subscapularis and teres minor) and their tendons connect your upper arm bone (humerus) with your shoulder blade (scapula). A rotator cuff injury, which is fairly common, involves any type of irritation or damage to your rotator cuff muscles or tendons, including:
- Tendinitis. Tendons in your rotator cuff can become inflamed due to overuse or overload, especially if you're an athlete who performs a lot of overhead activities, such as in tennis or racquetball.
- Bursitis. The fluid-filled sac (bursa) between your shoulder joint and rotator cuff tendons can become irritated and inflamed.
- Strain or tear. Left untreated, tendinitis can weaken a tendon and lead to chronic tendon degeneration or to a tendon tear. Stress from overuse also can cause a shoulder tendon or muscle to tear.
- Normal wear and tear. Increasingly after age 40, normal wear and tear on your rotator cuff can cause a breakdown of fibrous protein (collagen) in the cuff's tendons and muscles. This makes them more prone to degeneration and injury. With age, you may also develop calcium deposits within the cuff or arthritic bone spurs that can pinch or irritate your rotator cuff.
- Repetitive stress. Repetitive overhead movement of your arms can stress your rotator cuff muscles and tendons, causing inflammation and eventually tearing. This occurs often in athletes, especially baseball pitchers, swimmers and tennis players. It's also common among people in the building trades, such as painters and carpenters.
- Poor posture. When you allow your neck and shoulders to slouch forward, the space where the rotator cuff muscles reside may become smaller. These muscles or tendons become pinched under your shoulder bones (including your collarbone), especially during overhead activities, such as throwing.
- Falling. Using your arm to break a fall or falling on your arm can bruise or tear a rotator cuff tendon or muscle.
- Lifting or pulling. Lifting heavy objects improperly can strain or tear your tendons or muscles. Likewise, pulling something heavy may cause an injury.
Your shoulders are your body's most mobile joints. But the ability to move in many directions can leave your shoulders prone to injury. A dislocated shoulder is an injury in which your upper arm bone pops out of the cup-shaped socket that's part of your shoulder blade.
A dislocated shoulder is a more extensive injury than a separated shoulder, which involves damage to ligaments of the joint where the top of your shoulder blade meets the end of your collarbone.
If you suspect a dislocated shoulder, seek prompt medical attention. Most people regain full shoulder function within a few weeks after experiencing a dislocated shoulder. However, once you've had a dislocated shoulder your joint may become unstable and be prone to repeat dislocations.
Signs & Symptoms
- A visibly deformed or out of place shoulder
- Swelling or discoloration (bruising)
- Intense pain
- Inability to move the joint
- Shoulder dislocation may also cause numbness, weakness or tingling near the injury, such as in your neck or down your arm. The muscles in your shoulder may spasm from the disruption, often increasing the intensity of your pain.
- Sports injuries. Shoulder dislocation is a common injury in contact sports, such as football and hockey, and in sports that may involve falls, such as downhill skiing, gymnastics and volleyball.
- Trauma not related to sports. A hard blow to your shoulder during a motor vehicle accident is a common source of dislocation.
- Falls. You may dislocate your shoulder during a fall, such as from a ladder or from tripping on a loose rug.