Rotator cuff injury

Rotator cuff injuries are a common cause of shoulder pain.

The rotator cuff is the group of four muscles and their tendons at your shoulder joint. They form a cuff around the head of your upper arm bone (the humerus). They keep your shoulder stable and help it move.

Rotator cuff injuries can range from minor strains to complete tears of the muscles or tendons. They are sometimes called or are related to:

• rotator cuff tears
• rotator cuff tendonitis
• shoulder impingement syndrome

Rotator cuff injuries are common in older people and active people. They can happen suddenly or develop over time.

Symptoms of rotator cuff injury can include:

• pain in your shoulder and upper arm
• weakness of your shoulder
• pain when sleeping on the affected side
• limited shoulder movement

You may notice pain or limited shoulder movement during activities where you lift your hands above your head, such as washing or brushing your hair.

It's common for older people with rotator cuff injuries to not have any symptoms.

Rotator cuff injuries can be due to

• an accident — such as a fall
• repetitive lifting or overhead activities — from sports like tennis or swimming and jobs like painting
• general wear and tear with age

Smoking and being overweight can increase your risk of rotator cuff problems.

You should see your doctor if you have:

• injured your shoulder
• pain in your shoulder and arm that doesn't go away after a few weeks
• problems moving your shoulder

Your doctor will ask you about your symptoms and what makes them better or worse. They will also ask about your general health and activity level.

Your doctor will examine your shoulder. They may ask you to do certain arm movements to see if these cause any difficulty or pain.

In many cases, further tests are not needed to make the diagnosis.

In some cases, imaging tests may be recommended. These may include:

• x-rays — to make sure you don't have any other reason for your shoulder pain
• an ultrasound scan
• an MRI scan — to examine your rotator cuff in detail if you are not getting better with treatment

The aim of treatment is to ease the pain and bring back strength and motion to your shoulder joint.

Your doctor may recommend different treatment options, depending on:

• your age
• your level of activity
• the extent of your injury
• how long ago the injury happened

Physiotherapy

Physiotherapy is often the first treatment approach used. Your physiotherapist may recommend:

• applying cold packs
• resting from activities that make your shoulder pain worse
• stretching
• rehabilitation and strengthening exercises

Medicines

Pain-relief medicines and anti-inflammatory medicines can be helpful in managing shoulder pain.

If the pain continues, your doctor may suggest a corticosteroid injection.

Surgery

In some cases, surgery may be recommended.

Surgery may be suggested if your injury does not get better other treatments. Your doctor will consider your age and level of activity.

After surgery, most people will need rehabilitation with exercises and physiotherapy for several months.

Partial-thickness rotator cuff tears can progress to full-thickness tears over time. It's also possible to re-tear your rotator cuff after it has been repaired.

Sometimes, rotator cuff problems can lead to osteoarthritis of the shoulder, or a frozen shoulder.

Preventing rotator cuff injuries and problems from happening may not be possible.

But there are some things that may lower your chance of having rotator cuff problems.

• Avoid repetitive overhead activities.
• Avoid lifting heavy objects above the height of your shoulder.
• Quit smoking.
• Maintain a healthy weight.

The Australian Physiotherapy Association (Opens in new tab) has information on rotator cuff tears (Opens in new tab) and injuries.

You can also call the healthdirect helpline on 1800 022 222 (known as NURSE-ON-CALL in Victoria). A registered nurse is available to speak with 24 hours a day, 7 days a week.