Your shoulder is a highly mobile ball-and-socket joint that’s a lot like a golf ball sitting on a tee. The rotator cuff is a group of muscles and tendons that stabilize the shoulder joint, keeping the ball of your upper arm bone firmly within its shallow socket; the entire joint is surrounded and held together by a flexible envelope of tissue called the joint capsule.
Traumatic injuries and repetitive strain can affect any part of the joint, leading to shoulder pain, stiffness, and reduced range of motion. Two of the most common shoulder injuries we see at Sports Medicine Oregon are rotator cuff tears and frozen shoulder, or joint capsule scarring and inflammation.
Here, our expert team of board-certified orthopedists discusses the ins and outs of rotator cuff and joint capsule injuries, two common — and commonly confused — causes of shoulder pain and immobility.
Understanding rotator cuff injuries
A torn rotator cuff is exactly what it sounds like: A partial or complete rip through one or more of the tendons that hold the ball of your arm bone firmly in the shallow socket of your shoulder joint. The rotator cuff allows you to lift and rotate your arm; a tear in any part of this complex can weaken and limit shoulder movement — and make it painful.
Although this common injury can happen instantly when lifting something heavy, during an accidental fall, on the sports field, or from some other forceful acute trauma, most rotator cuff tears are degenerative — meaning they develop progressively over time, usually because of repetitive action or overuse.
Degenerative rotator cuff tear injuries tend to be most painful when you try to lift or rotate your arm. Other symptoms include:
- Dull pain deep within your shoulder joint
- Weakness in your arm, especially when you try to lift it
- Noticeable crackling sensation during shoulder movement
If it’s ignored, a torn rotator cuff can fray even further over time, causing the tear to deepen — and the ensuing shoulder pain, stiffness, weakness, and immobility to worsen.
A short tutorial on frozen shoulder
Frozen shoulder occurs when the tough, flexible capsule that surrounds the shoulder joint becomes inflamed. This inflammation irritates the capsule and makes it swell, leading to the progressive development of stiff scars. As these adhesions build up over time, the capsule’s folds become increasingly rigid and tight — and eventually, immobile.
Also known as adhesive (scarring) capsulitis (inflammation of the capsule), frozen shoulder causes varying degrees of pain and joint immobility, depending on which stage it’s in:
- Phase 1 (freezing) causes the gradual onset of shoulder pain and stiffness
- Phase 2 (frozen) is characterized by total shoulder immobility, but often less pain
- Phase 3 (thawing) marks the gradual return of joint range of motion and mobility
It can take anywhere from one to three years to progress through the stages of a frozen shoulder injury; whether it resolves quickly or slowly often comes down to treatment.
Rotator cuff or joint capsule injury?
Shoulder pain and stiffness, arm weakness, and limited range of motion are symptoms that can occur with a rotator cuff tear as well as frozen shoulder. As similar as these injuries may seem, however, they have significant, telltale differences. Let’s take a closer look at both:
Degenerative rotator cuff tears and frozen shoulder are most common in adults aged 40 and older. Both these injuries develop gradually, too, which may help explain why many people aren’t sure whether their emerging shoulder pain and stiffness is a rotator cuff problem or a joint capsule injury.
Both these shoulder injuries tend to respond well to early intervention measures like physical therapy and anti-inflammatory pain medications. Both also tend to persist and worsen — often to the point of requiring arthroscopic surgical treatment — without proper care.
Frozen shoulder isn’t a result of degeneration; instead, it’s associated with a range of possible underlying factors that foster joint inflammation or stiffness, such as bursitis, prolonged joint immobilization following a shoulder injury or surgery, and chronic systemic conditions like diabetes, endocrine disorders, and heart disease.
Torn rotator cuffs, on the other hand, are typically a product of the combined effects of age-related degeneration and overuse — you’re more likely to develop this injury if you have a job that requires you to lift and rotate your arm repetitively (i.e., painter, carpenter).
Most importantly, someone with a torn rotator cuff can lift their arm by themselves, whereas people with frozen shoulders find it difficult or impossible to lift their arm without assistance.
Get to the bottom of shoulder pain
If shoulder pain and stiffness are interfering with your life, now’s the time to investigate the problem. Call your nearest Sports Medicine Oregon office in Tigard or Wilsonville, Oregon, today, or schedule an appointment online.