Rotator Cuff

Rotator cuff injuries are among the most common of all shoulder injuries, and they make up a significant portion of the 6 million shoulder injuries each year in the United States. Dr. Greg Nicholson, one of the leading shoulder surgeons in the country, is an innovator in shoulder and elbow care, treating patients with sports-related, traumatic, arthritic, and occupational conditions.

Causes of Injury

Wear and tear: As you age, especially those over the age of 40, 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.

Falling: Sudden trauma to the rotator cuff, such as that from using your arm to break a fall or during sports, can tear or bruise the rotator cuff tendon or muscles.

Repetitive stress: Repeated overhead motion of your arms can lead to inflammation and even tearing of the rotator cuff muscles and tendons. This often afflicts those in the building trades, such as painters and carpenters. Athletes are also vulnerable, especially swimmers, baseball players and tennis players. Dr. Greg Nicholson is expertly qualified to treat athletes’ injuries through his 15 years of experience treating professional baseball players and as a team physician for the Chicago White Sox organization.

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

Poor posture: If you slouch the shoulders and neck forward, the space where the rotator cuff muscles sit can become smaller. The can result in the muscle or tendon getting pinched beneath the shoulder bone. This is especially common for those doing overhead activities like throwing.


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

    The key to non-surgical treatments is patience. It can take anywhere from several weeks to several months to get desired results.

    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) and aspirin.
  • Physical therapy and exercise: Gentle exercises and stretches designed to strengthen the muscle can treat many rotator cuff injuries. Dr. Nicholson has found that beginning physical therapy is beneficial as soon after an injury as possible.
  • 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, and 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 that Dr. Nicholson has extensive experience performing include:

  • Impingement Surgery (also called Acromioplasty or Subacromial Decompression)
  • Arthroscopic Rotator CUFF Repair Surgery
  • How arthroscopic rotator cuff surgery is performed?

    Rather than making a large incision, Dr. Nicholson makes three small incisions.

    What type of anesthesia is required for arthroscopic surgery?

    Both general anesthesia and regional anesthesia can be given for this type of surgery.

    What are the advantages of arthroscopy for rotator cuff repair?

    Because arthroscopic surgery requires a smaller access point, the incisions are much smaller than in traditional open surgery, leading to shorter recovery time for the patient.

    Rotator Cuff 1

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