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Rotator cuff problems


Alternative Names:

Swimmer's shoulder; Pitcher's shoulder; Shoulder impingement syndrome; Tennis shoulder; Tendinitis - rotator cuff; Rotator cuff tendinitis; Shoulder overuse syndrome

Exams and Tests:

A physical examination may reveal tenderness over the shoulder. Pain may occur when the shoulder is raised overhead. There is usually 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.

Your doctor 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 doctor 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 doctor suspects a small rotator cuff tear.
Treatment:

Follow your doctor'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 doctor 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.

Outlook (Prognosis):

With rotator cuff tendinitis, rest, exercise and other self-care measures often improve or even relieve symptoms. This may take weeks or months. Some persons 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.

When to Contact a Medical Professional:

Call for an appointment with your health care provider if you have ongoing shoulder pain. Also call if symptoms do not improve with treatment.

Prevention:

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.

References:

Miller RH III, Azar FM, Throckmorton TW. Shoulder and elbow injuries. In: Canale ST, Beaty JH, eds. Campbell's Operative Orthopaedics. 12th ed. Philadelphia, PA: Elsevier Mosby; 2013:chap 46.

Rudolph GH, Moen T, Garofalo R, Krishnan SG. Rotator cuff and impingement lesions. In: Miller MD, Thompson SR, eds. DeLee and Drez's Orthopaedic Sports Medicine: Principles and Practice. 4th ed. Philadelphia, PA: Elsevier Saunders; 2015:chap 52.


Review Date: 7/13/2015
Reviewed 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, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team.

The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed physician should be consulted for diagnosis and treatment of any and all medical conditions. Call 911 for all medical emergencies. Links to other sites are provided for information only -- they do not constitute endorsements of those other sites. Copyright 2002 A.D.A.M., Inc. Any duplication or distribution of the information contained herein is strictly prohibited.

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