Rotator Cuff Injury

What is a rotator cuff?

The shoulder joint is the most mobile joint in the human body. This mobility is allowed, in part, by a group of four muscles and tendons called the rotator cuff. The rotator cuff covers the top part of the humerus (arm bone) and keeps the head of the bone firmly in place within the shallow socket of the shoulder. It attaches the humerus to the shoulder blade and is responsible for allowing the arm to bend, stretch and rotate. It also contributes to shoulder stability. The demands made on the rotator cuff are extensive, making it susceptible to injury. Dr. Benedict Nwachukwu, orthopedic shoulder specialist serving Manhattan, New York City and the surrounding New York boroughs is extremely skilled at diagnosing and repairing rotator cuff injuries and at getting patients back to their active lifestyles.

What is a rotator cuff injury?

Rotator cuff injuries are common, in fact over 2 million people a year are seen for an injury to their rotator cuff. Injuries to these muscles and tendons can occur in any age group and is most often seen in patients who perform continuous overhead arm movements. An injury occurs when one or more of the rotator cuff tendons become damaged or when they tear away, either partially or completely, from the humerus.

What types of shoulder injuries involve the rotator cuff?

Rotator cuff injuries can be acute (caused by a trauma or sudden event) or chronic (ongoing) injuries that happen over time. These injuries include:

• Wear and tear: Chronic injury that is caused by everyday use. Often seen in older individuals.
• Tendinitis: Inflammation of the tendons in the rotator cuff caused from overuse. Commonly seen in athletes who repeat overhead motions like tennis, volleyball or swimming.
• Tendon Tear: A partial tear (or strain) can occur from repetitive motions. If untreated a complete tear can occur. Complete tears are also seen in trauma such as a fall, sports injury or accident.
• Bursitis: Inflammation of the bursa (fluid-filled sacs) that cushion the shoulder joint and rotator cuff tendons. This condition is often caused by overuse.
• Shoulder Impingement: Caused by the rotator cuff tendons rubbing or catching on the bones of the shoulder. Shoulder impingement is a common cause of shoulder pain.

What causes a rotator cuff tear?

There are two main causes of a rotator cuff tear; degeneration and injury. Rotator cuff injuries occur most often from overuse with overhead activities and heavy lifting. They also occur from trauma, sports injuries, a fall or an automobile accident. Rotator cuff tears and rotator cuff tendonitis can also happen in patients who are not involved in sports or physical labor but can be an occurrence of the natural aging of the tendons. This type of injury is associated with degeneration or wear-and-tear of the muscles and tendons.

What are the types of rotator cuff tears?

Rotator cuff tears are classified by the amount of damage to the muscle tendon grouping. Most injuries occur in the supraspinatus tendon, but other parts of the tendon may also be involved. In many cases the tendon begins to fray, like a rope. As the damage continues, it can break or tear completely. The types of tears are:

• Partial Tear: Also called an incomplete tear. The tendon is damaged but is not completely torn from the humerus. Partial tears can show fraying.
• Full-thickness Tear: Also called a complete tear. The tendon separates completely from the bone. MRI Imaging will show a hole in the tendon where it has separated.

What are the symptoms of a rotator cuff injury?

Pain is the primary symptom of a rotator cuff injury. Some patients may also complain of weakness. Patients in New York often report the following symptoms:

• Pain at night, especially if sleeping on the affected shoulder
• Pain during specific movements: lifting and lowering the arm
• Cracking or popping with movement
• Decreased range of motion

How are rotator cuff injuries diagnosed?

Dr. Nwachukwu will obtain a thorough medical history and discuss symptoms as well as any events leading up to the symptoms of a rotator cuff injury. He will then examine the shoulder to check for tender areas, popping, range of motion, arm strength, or to see if there are any physical deformities. An x-ray and/or an MRI scan may be required to allow Dr. Nwachukwu to see if there is any bone damage and to visualize the soft tissue of the shoulder joint.

How is a rotator cuff injury treated?

The goal of any shoulder pain treatment is to reduce the painful symptoms and improve function.

Non-surgical treatment:

The majority of patients with a rotator cuff injury can find pain relief with the following:

• Rest
• Activity Modification
• Non-steroidal Anti-inflammatory medication (NSAIDs)
• Physical therapy
• Corticosteroid injection

Surgical Treatment:

Since no two rotator cuff injuries are alike there is not a “one size fits all” surgical treatment. The decision for surgical treatment is made between the patient and Dr. Nwachukwu. Dr. Nwachukwu will discuss the extent of the injury as well as different options for repair. If the rotator cuff is torn, surgery to reattach the tendon to the bone is usually the most beneficial course of action.

Arthroscopic rotator cuff repair is a minimally invasive treatment option offered to patients in New York. Dr. Nwachukwu has extensive training and experience in performing this surgery successfully.

For more information on rotator cuff injuries, or the treatment options available for your shoulder pain, please contact the office of Benedict Nwachukwu, MD, orthopedic shoulder specialist serving Manhattan, New York City and surrounding New York boroughs.  

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