Rotator Cuff Injuries:Causes and Treatements

Wednesday, March 11, 2009

Doctor Ashish Anand, consultant, sports medicine and orthopedic surgeon, Wockhardt Hospitals, Talks to us about "Rotator Cuff Injuries" causes , treatments and preventing them

Dr Ashis Anand is a highly qualified Orthopedic Surgeon who has worked in India and US. His areas of interest include Arthroscopy and Joint Replacement (Hip, Knee and Shoulder). With more than 450 replacements (Primary and Revision). He has also excelled in Unicompartmental Knee Replacement which is done by very few centers in India.

Cardio workouts on the treadmill, elliptical trainers and stairclimbers or weight training with bench press, leg extensions, leg curls and hip adductor and abductor - they could all make you fit, but could also injure you if done improperly.

The increasing number of gym-related injuries is certified by many of the city’s orthopedics and sports medicine specialists. They say that gym-related injuries now constitute anywhere between 40 to 90 per cent of their cases.

Rotator cuff is made up of the muscles and tendons which connect your upper arm bone with your shoulder blade. They along with the Deltoid also help hold the ball of r upper arm bone firmly in your shoulder socket. The combination results in the greatest range of motion of any joint in your body.

A rotator cuff injury includes any type of irritation or damage to your rotator cuff muscles or tendons. Causes of a rotator cuff injury may include falling, lifting and repetitive arm activities — especially those done overhead, such as throwing a cricketball or placing items on overhead shelves.

Most of the time, a rotator cuff injury heal on its own with self-care measures or exercise therapy.

Main Causes of Rotator Cuff Injuries

Four major muscles (subscapularis, supraspinatus, infraspinatus and teres minor) and their tendons constitute the Rotator Cuff and connect the upper arm bone (humerus) with the shoulder blade (scapula). A rotator cuff injury, which is fairly common, involves any type of irritation or damage to your rotator cuff muscles or tendons, including:

Tendinitis: Tendons in your rotator cuff can become inflamed and irritated due to overuse or overload, especially in athletes involved in overhead activities, such as in tennis or racquetball.

Bursitis:The fluid-filled sac (bursa) between your shoulder joint and rotator cuff tendons can become irritated and inflamed.

Strain or tear: Left untreated, tendinitis can weaken a tendon and lead to chronic tendon degeneration or to a tendon tear. Stress from overuse also can cause a shoulder tendon or muscle to tear.

Common causes of rotator cuff injuries include:

1. Normal wear and tear:This is commonly seen in people who are less than 40 years and most often occurs due to repetitive damage to the tendons.Age related wear and tear on your rotator cuff can cause a breakdown of fibrous protein (collagen) in the cuff's tendons and muscles. This makes them more prone to degeneration and injury. With age, one may also develop calcium deposits within the cuff or arthritic bone spurs that can pinch or irritate your rotator cuff.

2. Lifting or pulling: Lifting an object that's too heavy or doing so improperly — especially overhead — can strain or tear your tendons or muscles.

3. Repetitive stress: Repetitive overhead movement of your arms can stress your rotator cuff muscles and tendons, causing inflammation and eventually tearing. This occurs often in athletes such as swimmers and tennis players. It's also common in painters and carpenters.

4. Faulty posture: When you slouch your neck and shoulders forward, the space where the rotator cuff muscles reside can become smaller. This can allow a muscle or tendon to become pinched under your shoulder bones (including your collarbone), especially during overhead activities, such as throwing.

5. Falling:Using your arm to break a fall or falling on your arm can bruise or tear a rotator cuff tendon or muscle.

Symptoms of Rotator Cuff Injury
Rotator cuff injury symptoms may include:
  • Pain and tenderness in your shoulder, especially when reaching overhead, reaching behind your back, lifting, pulling or sleeping on the affected side
  • Shoulder weakness
  • Loss of shoulder range of motion(stiffness)
  • You avoid using your shoulder
The most common symptom is pain. You may experience it when you reach up to comb your hair, bend your arm back to put on a shirt or carry something heavy. Lying on the affected shoulder also can be painful. If you have a severe injury, such as a large tear, you may experience continuous pain and muscle weakness.

If you answer 3 of the 5 questions below you need to see a Shoulder Specialist

1. When did you first begin experiencing shoulder pain?
2. Have you experienced any symptoms in addition to shoulder pain?
3. How severe is your pain?
4. What movements and activities aggravate and relieve your shoulder pain?
5. Do you have any weakness or numbness in your arm?


Self therapy
2.Local Ice Application.
3.Use medications such as Ibuproffen

Once you see the Shoulder Specialist and after a proper evaluation and investigations , you may be offered one or combination of treatments.

1.Use of pain killers with physiotherapy

2.Intrarticular injections of local anaesthetics

3.Surgery-Arthroscopic surgery to address the particular problem (Rotator cuff debridement,rotator Cuff repair,Labral repair, Acromioplasty)

4.Manipulation under Anaesthesia for frozen shoulder

Preventing Rotator Cuff Injuries

1. Do regular shoulder exercises to strengthen all muscles around the shoulder joint..
2. Take frequent breaks at work if your job requires repetitive arm and shoulder motions.
3.For sportspersons it is important to give adequate rest between games
4.At the first sign of pain apply ice packs.

Consult your Shoulder Specialist immediately.

To know more about Sports Injuries Centre at Wockhardt Hospitals,Please write to


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