Types of rotator cuff injuries
In addition to a rotator cuff tear (LINK), shoulder pain can be caused by rotator cuff tendinitis, bursitis, or impingement. The rotator cuff is comprised of four muscles that stabilize the shoulder joint and move the arm up and down. Between the rotator cuff and the bone on the top of the shoulder (the acromion) is the bursa, which is a sac that allows the tendons of the rotator cuff to move freely as the arm moves. Rotator cuff tendinitis is caused when the rotator cuff tendons are irritated or damaged. Bursitis occurs when the bursa is inflamed and/or swollen. Impingement is when there is decreased space under the acromion or acromioclavicular joint and the tendons and the bursa rub against the undersurface causing irritation.
Causes and symptoms of rotator cuff injuries
Rotator cuff injuries are common in athletes who use their arms overhead, as well as in middle-aged people who do repetitive lifting motions overhead. Rotator cuff injuries can also be caused by minor injuries. Rotator cuff pain presents as pain and stiffness when lifting and/or lowering the arm, pain radiating from the front of the shoulder to the side of the arm, pain at night, or loss of strength.
Diagnosing rotator cuff injuries
It’s best to seek treatment earlier rather than later, as many rotator cuff injuries worsen with time. We will check for tenderness, identify mobility issues, and test arm strength. After ruling out other conditions such as arthritis or a pinched nerve, we may recommend imaging tests to identify excess fluid, inflammation, or tearing.
Treating rotator cuff tendinitis, bursitis, and impingement
In most cases where the rotator cuff is not torn, surgery is not necessary. Treatment may take several weeks, but typically results in a full recovery. We recommend rest and NSAID medications, and sometimes physical therapy and steroid injections. If surgery is necessary, we offer arthroscopic surgery to increase the subacromial space, remove painful bursa and address rotator cuff issues.
