How to Recognize if You Have a Rotator Cuff Injury

Rotator cuff injuries are becoming more common place in day-to-day life. This is not completely surprising as it is the most common type of shoulder-specific injury. But how do you recognize it as a rotator cuff issue, and what can you do about it to prevent further damage? That is what we’re here to discuss today.

Symptoms

          The symptoms of rotator cuff damage can range from a few different things including the following: difficulty or pain when lifting or reaching arm(s) overhead, general weakness in the affected arm, unnatural sounds coming from the affected area, or just persistent discomfort in the shoulder area.

            General shoulder pain isn’t always a rotator cuff injury specifically, but it is worth paying attention to, as it can be an early indicator of damage to the area. According to shoulder surgeon Eric L Giang, DO, “Shoulder pain that persists beyond the occasional twinge is like an off-key note that demands attention. It’s the most common early warning sign of a rotator cuff tear, often presenting as a dull ache deep within the shoulder. This pain may begin as mild discomfort during overhead activities, such as reaching into a cupboard, but it can advance into a sharp pain that intrudes upon your night’s rest, especially when you lie on the affected side." It is important to keep an eye on the pain and whether it is getting better or worse. Injuries that are only minor may be able to heal with only rest and over the counter pain reducers. Should the pain continue, or increase in intensity, this is a sign that you likely need to seek help from a medical professional.

Weakness in the affected arm will typically be instantly noticeable. You will pick up on it even with the most mundane of tasks and activities. Your arm will no longer feel it can lift as much weight or exert as much force as it used to be able to. Depending on the severity, you may even struggle to do things like reaching above head level, lifting lighter objects, and lying on the side of said arm. The sudden reduction in range of motion is a key indicator that there may be damage to the rotator cuff.

Hearing an unnatural sound like popping or clicking coming from the shoulder. As also mentioned by Dr. Eric Giang, “The soundtrack of a healthy shoulder should not include popping or clicking sounds. If you’re hearing a symphony of crackles and snaps during movement, it could be the telltale crepitus associated with a rotator cuff tear.” This noise can be a potential sign that you have caused some damage to the muscle stability of the joint in your shoulder. The specific reasons for this popping or clicking, per the Cleveland Shoulder Institute, are the following: “AC joint arthritis or a tear of the intra-articular disc, shoulder instability where the ball of the ball-and-socket joint dislocates or subluxes (meaning partially dislocates), and biceps dislocations or instability.”

Causes

In an article from AAOS, it is stated that “A rotator cuff tear may result from an acute injury, such as a fall, or may be caused by normal aging-related wear and tear with degeneration of the tendon. Typically, you will feel pain in the front or side of your shoulder that radiates (travels) down the side of your arm.” Tears can also occur more naturally, as well, due to the tendon wearing down. The Cleveland Clinic states that tears can also be caused by other injuries as a side effect, specifically “an accident, such as a fall, can cause a broken collarbone or dislocated shoulder that tears your rotator cuff.”

There are 2 types of rotator cuff injuries: Partial and complete. A partial tear means your tendon still maintains some level of attachment to your arm. A complete tear means that the tendon and bone are completely separated.

The Cleveland Clinic also lists several risk factors that can increase the chances of a rotator cuff injury. This list includes smoking, poor posture, being above the age of 40, and biological family history of shoulder problems.

Healing

            Per AAOS, “Rehabilitation plays a critical role in both the nonsurgical and surgical treatment of a rotator cuff tear. When a tear occurs, there is frequently atrophy (wasting or weakening) of the muscles around the arm and loss of motion of the shoulder. An exercise or physical therapy program is necessary to regain strength and improve function in the shoulder.” Most tears in the rotator cuff can potentially be healed non-surgically so long as the damage isn’t extensive. Resting the shoulder and using anti-inflammatory medication can be adequate to help. Sometimes if it’s slightly more intense, things like physical therapy or a form of steroid injection can be recommended. The area needs to be given proper time to heal, but also needs to rebuild strength to resume proper function. It is worth noting, however, that AAOS states “Even though most tears cannot heal on their own, you can often achieve good function without surgery. This is because there are many other muscles and tendons that help move the arm. If, however, you are active, relatively young, or use your arm for overhead work or sports, surgery is most often recommended because many tears will not heal without surgery.”

            If you notice your pain and range of motion is not improving, it may be time to enquire about surgical options. This is especially true if you work in a profession which requires you to have those muscles in constant use, as they will not have the proper circumstances to heal if they aren’t given the opportunity. Your tendon will need the proper time to either repair itself with rest, or surgically. It is best to carefully pay attention to all symptoms and their severity so that you and your doctor can properly determine a plan of care which will get you back to your best.