Rotator Cuff

Causes of Injury

Rotator cuff injuries make up a significant portion of the 6 million shoulder injuries each year in the United States.

Wear and tear: As you age, everyday activities begin to take a toll on the rotator cuff. Gradually, the collagen (fibrous protein) in the rotator cuff muscles and tendons begins to break down, leading to a greater chance of injury.

Trauma: Sudden trauma to the rotator cuff from using your arm to break a fall or during a collision on the field can tear or bruise the rotator cuff tendon or muscles.

Repetitive stress: Repeated overhead motion of your arms can lead to inflammation and even tear the rotator cuff. This often afflicts those in building trades, such as painters, carpenters, and construction workers. Athletes are also vulnerable, especially swimmers, baseball players, and tennis players.

Pulling and lifting: Straining and tearing the rotator cuff tendons and muscles can occur if you lift an object that is too heavy or if you improperly lift an overhead object.

Poor posture: Slouching of the shoulders and neck can cause the space where the rotator cuff muscles sit to become smaller. The muscle or tendon then gets pinched beneath the shoulder bone.


Diagnosis may come in any combination of the following:

  • Magnetic Resonance Imaging (MRI)
  • X-rays
  • Arthrogram with CT Scan
  • Ultrasound
  • Diagnostic Arthroscopy
  • Non-Surgical Treatments

    Non-surgical treatments require a lot of patience. It can take anywhere from several weeks to several months to get back to full strength or range of motion.

    Rest: Resting the injured joint is the first step to reduce swelling and pain. Be sure to keep using the arm gently. Keeping it immobilized can lead to a painful condition called frozen shoulder.

    Ice: In the first 24 hours of an injury, ice it to reduce swelling and pain.

    Heat: After 24 hours have passed, a heating pad or hot compress can help.

    NSAIDS (non-steroidal anti-inflammatory drugs): Reduce pain and swelling through NSAIDS such as ibuprofen (Advil), naproxen (Aleve), or aspirin.

    Physical therapy and exercise: Gentle exercises and stretches designed to strengthen the muscle can treat many rotator cuff injuries.

    Steroids: Cortisone can be injected directly into the rotator cuff to reduce inflammation and pain, but steroid injection should be used under the careful direction of a doctor. Multiple injections should be avoided.

    Surgical Treatments

    Most rotator cuff injuries are treated non-surgically, but Dr. Nicholson may do surgery if a rotator cuff is torn or if months of physical therapy and other treatments have not helped.

    Common surgeries to correct rotator cuff include:

  • Impingement Surgery (also called Acromioplasty or Subacromial Decompression)
  • Arthroscopic Rotator CUFF Repair Surgery
  • For more information about rotator cuff diagnosis and treatment, please contact our office.

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