What are the main causes of rotator cuff injuries. How can you recognize the symptoms of a rotator cuff tear. What treatment options are available for rotator cuff problems. When should you seek medical attention for shoulder pain.

Understanding the Rotator Cuff: Anatomy and Function

The rotator cuff is a crucial component of the shoulder joint, playing a vital role in both mobility and stability. But what exactly is the rotator cuff, and how does it function?

The rotator cuff consists of four muscles and their tendons that surround the shoulder joint. These muscles are:

• Supraspinatus
• Infraspinatus
• Teres minor
• Subscapularis

Together, these muscles form a “cuff” around the head of the humerus (upper arm bone), attaching it to the scapula (shoulder blade). This arrangement allows for a wide range of shoulder movements while keeping the joint stable.

The primary functions of the rotator cuff include:

1. Enabling shoulder rotation
2. Lifting the arm
3. Stabilizing the shoulder joint during movement

Given its complexity and frequent use, the rotator cuff is susceptible to various injuries and conditions that can significantly impact shoulder function and quality of life.

Common Causes of Rotator Cuff Injuries

Rotator cuff injuries can occur due to various factors, ranging from acute trauma to gradual wear and tear. Understanding these causes can help in prevention and early intervention. So, what are the primary culprits behind rotator cuff problems?

Acute Injuries

Sudden, traumatic events can lead to rotator cuff tears. These may include:

• Falling on an outstretched arm
• Lifting a heavy object with a jerking motion
• Sports-related injuries, particularly in contact sports

Repetitive Stress and Overuse

Many rotator cuff injuries develop over time due to repetitive motions or prolonged stress on the shoulder. Activities that can contribute to this include:

• Overhead sports (e.g., tennis, baseball, swimming)
• Occupations requiring frequent overhead work (e.g., painting, carpentry)
• Poor posture and ergonomics, especially during computer work
• Sleeping consistently on the same arm

Age-Related Degeneration

As we age, the tendons in our rotator cuff naturally weaken and become more susceptible to injury. This degeneration can lead to tears, even without significant trauma or overuse.

Anatomical Factors

Some individuals may be more prone to rotator cuff injuries due to their anatomy. For example, bone spurs (osteophytes) on the acromion can narrow the space for the rotator cuff tendons, increasing the risk of impingement and tears.

Types of Rotator Cuff Injuries: Tendinitis and Tears

Rotator cuff injuries primarily fall into two categories: tendinitis and tears. Each type has distinct characteristics and implications for treatment. What’s the difference between these two conditions?

Rotator Cuff Tendinitis

Tendinitis refers to inflammation of the rotator cuff tendons. It’s often associated with impingement syndrome, where the tendons become irritated as they pass through the narrow space under the acromion. Symptoms of tendinitis include:

• Pain during overhead activities
• Discomfort when lowering the arm from a raised position
• Mild weakness in the affected arm
• Pain that may extend from the front of the shoulder to the side of the arm

Rotator Cuff Tears

Rotator cuff tears occur when one or more of the tendons detach from the humerus. These tears can be partial or complete:

• Partial tears: The tendon is damaged but not completely severed
• Complete tears: The tendon is fully detached from the bone

Tears can result from acute injury or develop gradually over time. Symptoms of a rotator cuff tear may include:

• Severe pain, especially following a sudden injury
• Weakness in the affected arm
• Difficulty raising the arm or performing overhead activities
• A snapping sensation when moving the arm
• Pain that worsens at night, potentially disrupting sleep

Recognizing Rotator Cuff Injury Symptoms

Identifying the symptoms of a rotator cuff injury is crucial for timely diagnosis and treatment. How can you tell if you might have a rotator cuff problem?

Common Symptoms

While symptoms can vary depending on the type and severity of the injury, some common signs include:

• Pain in the shoulder, particularly during overhead movements
• Weakness in the affected arm
• Limited range of motion in the shoulder
• Clicking or popping sounds when moving the shoulder
• Difficulty sleeping on the affected side

Differentiating Acute vs. Chronic Injuries

The onset and progression of symptoms can provide clues about whether the injury is acute or chronic:

• Acute injuries: Sudden, intense pain following a traumatic event
• Chronic injuries: Gradual onset of pain and weakness that worsens over time

It’s important to note that some individuals with rotator cuff tears may not experience significant pain, especially if the tear develops slowly over time.

Diagnosis of Rotator Cuff Injuries: Medical Evaluation and Imaging

Accurate diagnosis of rotator cuff injuries is essential for appropriate treatment. How do healthcare providers assess and diagnose these conditions?

Physical Examination

The diagnostic process typically begins with a thorough physical examination. This may include:

• Assessing range of motion
• Testing shoulder strength
• Performing specific maneuvers to evaluate rotator cuff function
• Checking for tenderness or deformities

Imaging Studies

Various imaging techniques can provide detailed information about the condition of the rotator cuff:

• X-rays: While they don’t show soft tissues, x-rays can reveal bone spurs or arthritis that may contribute to rotator cuff problems
• Ultrasound: This non-invasive technique can visualize the rotator cuff tendons and identify tears
• MRI (Magnetic Resonance Imaging): Offers detailed images of soft tissues, allowing for precise evaluation of the rotator cuff
• Arthrogram: Involves injecting contrast material into the shoulder joint before imaging to enhance visibility of the structures

The choice of imaging study depends on various factors, including the suspected type of injury and the patient’s individual circumstances.

Treatment Options for Rotator Cuff Injuries

The approach to treating rotator cuff injuries depends on the type and severity of the condition. What are the primary treatment options available?

Conservative Treatment

Many rotator cuff injuries, particularly tendinitis and partial tears, can be managed with non-surgical approaches:

• Rest and activity modification
• Physical therapy to improve strength and flexibility
• Non-steroidal anti-inflammatory drugs (NSAIDs) for pain relief
• Corticosteroid injections to reduce inflammation
• Application of ice or heat

Surgical Intervention

Surgery may be recommended for complete tears or when conservative treatment fails to provide relief. Surgical options include:

• Arthroscopic repair: Minimally invasive procedure using small incisions
• Open repair: Traditional surgery for larger or more complex tears
• Tendon transfer: Used when the torn tendon is too damaged to be reattached

The choice of surgical technique depends on factors such as tear size, location, and the patient’s overall health and activity level.

Rehabilitation

Regardless of the treatment approach, rehabilitation plays a crucial role in recovery. This typically involves a structured physical therapy program to restore strength, flexibility, and function to the shoulder.

Prevention Strategies for Rotator Cuff Injuries

While not all rotator cuff injuries can be prevented, certain strategies can help reduce the risk. How can you protect your rotator cuff from injury?

Proper Technique and Form

When engaging in activities that involve repetitive shoulder movements:

• Learn and maintain proper form, especially in sports and exercise
• Use appropriate equipment and ensure it’s properly fitted
• Avoid overexertion and listen to your body’s signals

Strengthening Exercises

Regular exercises to strengthen the rotator cuff and surrounding muscles can improve shoulder stability and resilience. Key exercises include:

• External and internal rotation exercises
• Shoulder blade squeezes
• Wall pushups
• Pendulum swings

Workplace Ergonomics

If your job involves repetitive shoulder movements or prolonged periods in certain positions:

• Ensure your workstation is ergonomically optimized
• Take regular breaks to stretch and change positions
• Use assistive devices when appropriate to reduce strain on your shoulders

Lifestyle Factors

Certain lifestyle choices can contribute to overall shoulder health:

• Maintain good posture throughout the day
• Stay physically active and maintain a healthy weight
• Avoid sleeping on the same arm every night
• Quit smoking, as it can impair blood flow and healing

By incorporating these preventive measures into your daily routine, you can significantly reduce your risk of developing rotator cuff problems.

When to Seek Medical Attention for Shoulder Pain

While some shoulder discomfort may resolve on its own, certain symptoms warrant prompt medical evaluation. When should you consult a healthcare provider about shoulder pain?

Red Flags

Seek immediate medical attention if you experience:

• Sudden, severe pain following an injury
• Visible deformity of the shoulder
• Inability to move the arm
• Intense pain that doesn’t improve with rest or over-the-counter pain relievers
• Symptoms of infection, such as fever or redness and warmth around the shoulder

Persistent Symptoms

Consider scheduling an appointment with your healthcare provider if you have:

• Pain that persists for more than a few weeks despite home care measures
• Gradual loss of shoulder function or range of motion
• Weakness that interferes with daily activities
• Night pain that disrupts sleep

Impact on Quality of Life

Even if your symptoms are not severe, it’s advisable to seek medical evaluation if shoulder pain is:

• Interfering with work or leisure activities
• Causing you to modify your lifestyle significantly
• Leading to compensatory movements that may cause problems in other areas of your body

Remember, early intervention can often lead to better outcomes and may prevent the progression of rotator cuff injuries.

Understanding the complexities of rotator cuff injuries, from their causes and symptoms to diagnosis and treatment options, empowers individuals to take proactive steps in maintaining shoulder health. By recognizing the signs of rotator cuff problems and seeking timely medical attention when necessary, you can optimize your chances of a full recovery and maintain optimal shoulder function throughout your life.

Rotator cuff problems: MedlinePlus Medical Encyclopedia

The rotator cuff is a group of muscles and tendons that attach to the bones of the shoulder joint, allowing the shoulder to move and keep it stable.

• Rotator cuff tendinitis refers to irritation of these tendons and inflammation of the bursa (a normally smooth layer) lining these tendons.
• A rotator cuff tear occurs when one of the tendons is torn from the bone from overuse or injury.

The shoulder joint is a ball and socket type joint. The top part of the arm bone (humerus) forms a joint with the shoulder blade (scapula). The rotator cuff holds the head of the humerus into the scapula. It also controls movement of the shoulder joint.

TENDINITIS

The tendons of the rotator cuff pass underneath a bony area on their way to attaching the top part of the arm bone. When these tendons become inflamed, they can become more inflamed over this area during shoulder movements. Sometimes, a bone spur narrows the space even more.

Rotator cuff tendinitis is also called impingement syndrome. Causes of this condition include:

• Keeping the arm in the same position for long periods, such as doing computer work or hairstyling
• Sleeping on the same arm each night
• Playing sports requiring the arm to be moved overhead repeatedly such as in tennis, baseball (particularly pitching), swimming, and lifting weights overhead
• Working with the arm overhead for many hours or days, such as in painting and carpentry
• Poor posture over many years
• Aging
• Rotator cuff tears

TEARS

Rotator cuff tears may occur in two ways:

• A sudden acute tear may happen when you fall on your arm while it is stretched out. Or, it can occur after a sudden, jerking motion when you try to lift something heavy.
• A chronic tear of the rotator cuff tendon occurs slowly over time. It is more likely when you have chronic tendinitis or impingement syndrome. At some point, the tendon wears down and tears.

There are two types of rotator cuff tears:

• A partial tear occurs when a tear does not completely sever the attachments to the bone.
• A complete, full thickness tear means that the tear goes all the way through the tendon. It may be as small as a pinpoint, or the tear may involve the entire tendon. With complete tears, the tendon has come off (detached) from where it was attached to the bone. This kind of tear does not heal on its own.

TENDINITIS

Early on, pain is mild and occurs with overhead activities and lifting your arm to the side. Activities include brushing your hair, reaching for objects on shelves, or playing an overhead sport.

Pain is more likely in the front of the shoulder and may travel to the side of the arm. The pain always stops before the elbow. If the pain goes down the arm to the elbow and hand, this may indicate a pinched nerve in the neck.

There may also be pain when you lower the shoulder from a raised position.

Over time, there may be pain at rest or at night, such as when lying on the affected shoulder. You may have weakness and loss of motion when raising the arm above your head. Your shoulder can feel stiff with lifting or movement. It may become more difficult to place the arm behind your back.

ROTATOR CUFF TEARS

The pain with a sudden tear after a fall or injury is usually intense. Right after the injury, you will likely have weakness of the shoulder and arm. It may be hard to move your shoulder or raise your arm above the shoulder. You may also feel snapping when trying to move the arm.

With a chronic tear, you often do not notice when it began. This is because symptoms of pain, weakness, and stiffness or loss of motion worsen slowly over time.

Rotator cuff tendon tears often cause pain at night. The pain may even wake you. During the day, the pain is more tolerable, and usually only hurts with certain movements, such as overhead or reaching toward the back.

Over time, the symptoms become much worse and are not relieved by medicines, rest, or exercise.

A physical examination may reveal tenderness over the shoulder. Pain may occur when the shoulder is raised overhead. There is often weakness of the shoulder when it is placed in certain positions.

X-rays of the shoulder may show a bone spur or change in the position of the shoulder. It can also rule out other causes of shoulder pain, such as arthritis.

Your health care provider may order other tests:

• An ultrasound test uses sound waves to create an image of the shoulder joint. It can show a tear in the rotator cuff.
• MRI of the shoulder may show swelling or a tear in the rotator cuff.
• With a joint x-ray (arthrogram), the provider injects contrast material (dye) into the shoulder joint. Then an x-ray, CT scan, or MRI scan is used to take a picture of it. Contrast is usually used when your provider suspects a small rotator cuff tear.

Follow your provider’s instructions on how to take care of your rotator cuff problem at home. Doing so can help relieve your symptoms so that you can return to sports or other activities.

TENDINITIS

Your provider will likely advise you to rest your shoulder and avoid activities that cause pain. Other measures include:

• Ice packs applied 20 minutes at a time, 3 to 4 times a day to the shoulder (protect the skin by wrapping the ice pack in a clean towel before applying)
• Taking medicines, such as ibuprofen and naproxen, to help reduce swelling and pain
• Avoiding or reducing activities that cause or worsen your symptoms
• Physical therapy to stretch and strengthen the shoulder muscles
• Medicine (corticosteroid) injected into the shoulder to reduce pain and swelling
• Surgery (arthroscopy) to remove inflamed tissue and part of the bone over the rotator cuff to relieve pressure on the tendons

TEARS

Rest and physical therapy may help with a partial tear if you do not normally place a lot of demand on your shoulder.

Surgery to repair the tendon may be needed if the rotator cuff has a complete tear. Surgery may also be needed if the symptoms do not get better with other treatment. Most of the time, arthroscopic surgery can be used. Large tears may need open surgery (surgery with a larger incision) to repair the torn tendon or use other tissue to help the repair to heal.

With rotator cuff tendinitis, rest, exercise and other self-care measures often improve or even relieve symptoms. This may take weeks or months. Some people may need to change or reduce the amount of time they play certain sports to remain pain-free.

With rotator cuff tears, treatment often relieves symptoms. But outcome depends on the size of the tear and how long the tear has been present, the person’s age, and how active the person was before the injury.

Contact your provider for an appointment if you have ongoing shoulder pain. Also contact your provider if symptoms do not improve with treatment.

Avoid repetitive overhead movements. Exercises to strengthen shoulder and arm muscles can also help prevent rotator cuff problems. Practice good posture to keep your rotator cuff tendons and muscles in their right positions.

Swimmer’s shoulder; Pitcher’s shoulder; Shoulder impingement syndrome; Tennis shoulder; Tendinitis – rotator cuff; Rotator cuff tendinitis; Shoulder overuse syndrome

• Rotator cuff exercises
• Rotator cuff – self-care
• Shoulder surgery – discharge
• Using your shoulder after replacement surgery
• Using your shoulder after surgery

• Shoulder joint inflammation
• Inflamed shoulder tendons
• Normal rotator cuff
• Torn rotator cuff

Mosich GM, Yamaguchi KT, Petrigliano FA. Rotator cuff and impingement lesions. In: Miller MD, Thompson SR, eds. DeLee, Drez, & Miller’s Orthopaedic Sports Medicine: Principles and Practice. 5th ed. Philadelphia, PA: Elsevier; 2020:chap 47.

Ricchetti ET, Entezari V, Derwin KA. Structure and function of the rotator cuff. In: Matsen FA, Cordasco FA, Sperling JW, et al, eds. Rockwood and Matsen’s The Shoulder. 6th ed. Philadelphia, PA: Elsevier; 2022:chap 50.

Updated by: C. Benjamin Ma, MD, Professor, Chief, Sports Medicine and Shoulder Service, UCSF Department of Orthopaedic Surgery, San Francisco, CA. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.

Rotator Cuff Injuries | MedlinePlus

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What is a rotator cuff?

Your rotator cuff is part of your shoulder joint. It’s a group of muscles and tendons that holds the top part of your upper arm bone firmly in your shoulder socket. The rotator cuff keeps your shoulder stable when you move your arm in any direction.

What are rotator cuff injuries?

Rotator cuff injuries are common. Most of them are wear-and-tear injuries from doing the same arm movements over and over – especially reaching over your head. With time, the tissues in the rotator cuff break down, leading to these injuries:

• Tendinitis. The tendons in the rotator cuff connect your muscles to your shoulder bones. In tendinitis, the tendons become irritated and swollen from being pinched during shoulder movements.
• Bursitis. The bursa is a small, fluid-filled sac that pads the space between the rotator cuff and the bones of your shoulder. Bursitis happens when the muscle and bone rub the bursa too much. It swells with extra fluid, which causes pain
• Rotator cuff tears. Tears in a rotator cuff tendon can happen over time or suddenly from an injury, such as falling on an outstretched arm or lifting something heavy. A tear may go part way through a tendon (partial tear) or all the way through (full tear).

Who is more likely to develop a rotator cuff injury?

Anyone can develop a rotator cuff injury. But certain people are more likely to have one:

• People over age 40. Most rotator cuff injuries are from the wear and tear of aging. By age 80, most adults have tears.
• Athletes. Playing sports with repeated shoulder movements increases the risk of a rotator cuff injury, for example, tennis, swimming, and baseball – especially pitching.
• People in jobs that require a lot of reaching overhead or heavy lifting. Carpenters, construction workers, and painters are examples of workers who may be more likely to have rotator cuff problems.

What are the symptoms of rotator cuff injuries?

Rotator cuff injuries don’t always cause pain. But when they do, the pain is often in the top part of your arm or shoulder. You may feel more pain when you:

• Lie down, especially on the injured shoulder
• Lift your arm or lower it to the front or side
• Reach behind your back

Other symptoms from a torn rotator cuff may include:

• Loss of strength in the arm
• Clicking or popping sounds when you move your arm

How are rotator cuff injuries diagnosed?

To find out if you have a rotator cuff injury, your health care provider:

• Will examine your shoulder. This includes checking the range of motion and where the pain is.
• Will test your arm and shoulder strength.
• May order imaging tests, such as x-rays, an ultrasound, or an MRI scan.

What are the treatments for rotator cuff injuries?

The best treatment for you depends on your age, how much your injury bothers you, and whether your injury was sudden or happened from wear and tear.

Treatments for rotator cuff injuries often include:

• Rest
• Putting ice or a cold pack on the sore area
• Pain relievers to lessen pain and swelling, such as ibuprofen or aspirin
• Physical therapy exercises to strengthen your shoulder and improve movement
• A corticosteroid shot into your shoulder joint if other treatments don’t help with the pain

Treatments for rotator cuff tendinitis and bursitis may also include ultrasound therapy. Surgery may be an option if your shoulder doesn’t feel better in 6 to 12 months.

Treatments for a torn rotator cuff may also include heat to the sore area or electrical stimulation of the nerves and muscles (transcutaneous electrical nerve stimulation, TENS).

You provider may suggest surgery if your tear is large or is from a recent injury, or symptoms last for 6 to 12 months.

When should I see a health care provider for shoulder pain?

If certain activities bother your shoulder, it’s best to stop doing them and check with your provider. That’s because early treatment can prevent mild rotator cuff injuries from becoming more serious later on. If you your arm feels weak right after a sudden injury to your shoulder, see your provider as soon as possible.

• Direct Arthrography

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• Cortisone Shots

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• Rotator Cuff and Shoulder Rehabilitation Exercises

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• ClinicalTrials. gov: Rotator Cuff Injuries

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• Article: Preemptive middle glenohumeral ligament release in arthroscopic rotator cuff repair does. ..

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What is a rotator cuff tear?

The muscles of the rotator cuff or the so-called rotator cuff muscles are muscles located around the shoulder blade and their functions are similar to each other. The rotator muscles are known as the teres minor, subscapularis, infraspinatus, and supraspinatus. Rotator cuff tears most commonly occur in the tendons of these muscles. We have tried to answer many questions about a rotator cuff tear.

What is a rotator cuff?

The rotator cuff is a group of muscles that connects the shoulder to the scapula. Those who are looking for the answer to the question “What is a rotator cuff?” may come across a similar offer. 4 muscles of the rotator cuff that connect the shoulder to the scapula:

1. Subscapularis

2. Teres Minor

3. Infraspinatus

4. Supraspinatus

that our shoulder area is stable or balanced when performing various physical activities at work, in sports or in everyday life. Any tear or injury in this area will cause severe pain and weakness. The rotator cuff muscles, or rotator cuff muscles, stabilize the shoulder. This group of muscles or tendons work together. Stabilization in the shoulder joint is largely possible with the help of the rotator cuff muscles.

How does a cuff tear affect lifestyle?

In addition to holding the shoulder in place, the muscles that facilitate rotation cause pain even with the slightest movement. Cuff tear, which seriously reduces the quality of life, occurs more often in old age. Over time, muscle tendons wear out and this weakens the muscle. A cuff tear at a young age can occur in accidents, falls on the arm, or sports injuries. “What are the rotator cuff muscles?” We have tried to answer this question. Now, let’s look at the main symptoms of a rotator cuff tear.

Symptoms of a ruptured rotator cuff

Pain in the rotator cuff muscles is mainly concentrated in the lateral and anterior parts of the shoulder. Pain in the rotator cuff increases significantly at night. These symptoms raise the suspicion of rotator cuff syndrome.

On the other hand, limitation of movement in the shoulder and loss of strength in the arms may be among the symptoms of a rotator cuff tear. People with cuff tears have difficulty moving overhead. On the other hand, it can be very difficult for them to move their arms backwards. If the size of the gap is larger, it becomes very difficult to even raise your hand.

How is a rotator cuff tear diagnosed?

You will need the help of an orthopedic doctor to diagnose a rotator cuff tear. The orthopedic doctor checks the level of muscle strength and shoulder movements, in particular for diagnosis. Shoulder problems faced by the patient are identified. To clarify the articular problem in the shoulder area, an x-ray is first taken. All information about rotator cuff tendon injury is available after this x-ray. On the other hand, studies such as ultrasound and MRI are used to help repair the rotator cuff.

Treatment for a rotator cuff tear

Treatment for a rotator cuff tear is planned based on the level of the tear. These types of ruptures are mainly divided into two parts: ruptures are complete or partial ruptures. With partial ruptures, cold applications and painkillers are used. Right after that, various exercise applications and regenerative injections come to the fore. Surgery is recommended for patients who cannot benefit from this entire process. For cuff tears referred to as complete, alternative methods other than surgery should be monitored more closely due to risks such as tendon retraction or tear widening. It is impossible to be late in surgical interventions with complete ruptures.

Rotator cuff tear surgery

The surgical process uses the arthroscopic method, also known as the closed surgical method. During the operation, the patient under anesthesia should be in a sitting position. For this, it is preferable to use a special operating table. Additional problems other than shoulder cuff tear are also addressed during this operation. Compared to open surgeries, the patient does not feel much pain after the surgery. Physiotherapy after rotator cuff surgery is of great importance to restore the strength of the muscles that make up the cuff group and to restore balance between other muscles in the shoulder area.

Rotator cuff injury!

contents

1. What is a rotator cuff?
2. What causes damage to the rotator cuff of the shoulder?
3. Symptoms and diagnosis
4. Treatment

1. What is a rotator cuff?

The shoulder rotator is a bundle of tendons that connect the musculature that surrounds the bones of the shoulder. The shoulder rotator provides a coordinated movement of the muscles during rotational movements, lifting, turning, bending, abducting behind the back and moving the arm forward. A rotator cuff is a collection of interacting muscles and ligaments.

The shoulder joint is one of the most frequently used and mobile. Injury to the tissues around the bones of the shoulder leads to instability throughout the shoulder girdle, causes acute pain and carries the risk of even greater damage due to motor activity of the hands.

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2. Why is the rotator cuff damaged?

Any muscles and tendons are at risk of being damaged due to mechanical impact during injuries, accidents, traffic accidents. In relation to the rotator cuff of the shoulder, a number of factors can be identified that contribute to the weakening of its tissues. This leads to the fact that the cuff is damaged even with minor impacts, partial or complete rupture of the tendons occurs in situations that are not dangerous for a healthy shoulder. The strength of the tendons of the rotator cuff of the shoulder is reduced:

• With regular stress on the arms associated with movements of large amplitude;
• After 40 years as a result of normal wear and tear;
• Against the background of diseases that cause degenerative changes in connective muscle tissue;
• As a result of the individual anatomical features of the scapula, the processes of which can be shaped to injure the rotator cuff of the shoulder;
• For congenital dysplasia;
• Due to reduced blood supply in this area, due to an undeveloped network of blood vessels in the shoulder area;
• Due to side effects of certain medications (glucocorticosteroids).

One way or another, with age, muscles and tendons become thinner, lose elasticity and strength, and the risk of injury to the rotator cuff of the shoulder increases. Especially dangerous are sudden movements without prior training and a gradual increase in loads.

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3.Symptoms and Diagnosis

The first symptom that any person who has injured the rotator cuff of the shoulder will feel is a sharp pain that worsens with any movement of the arm. The pain syndrome is localized in the shoulder, but can also spread to the neck, shoulder blade and entire arm. Often the patient also complains of weakness in the hand. The maximum discomfort, as a rule, is caused by movements associated with raising the arm or moving it behind the back.

Damage to the rotator cuff due to degenerative and age-related changes is not so acutely felt. The following symptoms may gradually increase:

• Decreased range of motion of the arm;
• Cracking in the shoulder joint;
• Soreness while sleeping on side;
• Arthralgia after increased stress on the arms;
• Contracture, weakness.

Diagnosis in all cases includes history, identification of the traumatic component or episode, and physical examination. The diagnosis is specified by clinical tests and instrumental diagnostics, as well as by X-ray studies, magnetic resonance imaging.

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4. Treatment

First aid for torn muscles and tendons of the shoulder includes pain relief and prevention of possible inflammation. If the injury is associated with the formation of an open wound, it is necessary to take antiseptic measures. When bruised, cold is applied to stop internal bleeding.

In the acute period, the limb must be immobilized until the severity of the injury is determined. A complete torn ligament may require surgery.

Tears and sprains are treated conservatively. At the initial stage, the patient is shown complete rest of the limb until the pain syndrome disappears.

Then they move on to rehabilitation. Repair of a damaged rotator cuff includes:

• Physiotherapy;
• Passive training;
• Therapeutic exercise;
• Strength training.

Recovery of shoulder function after a rotator cuff injury can take 3 to 6 months.

If surgical treatment is required, operations are currently performed arthroscopically. The surgeon does not make a tissue incision, but acts through punctures in the skin of the shoulder. The arthroscope allows the specialist to see damage to the rotator cuff from the inside and perform the necessary minimum of precise surgical manipulations.