FAQs: Shoulder Injuries

Rotator Cuff Injuries

1. What is the rotator cuff?

The rotator cuff is composed of four muscles and its tendons that surround the shoulder joint. It is responsible for your shoulder’s strength and dynamic stability, permitting your arm to move in a vast arc of motion. The muscles of the rotator cuff help stabilize the shoulder and enable you to lift your arm, reach overhead, and take part in activities such as throwing, swimming and tennis.

2. How does the rotator cuff tear?

A tear may result suddenly from a single traumatic event or develop gradually because of repetitive overhead activities. Traumatic tears are sudden and weakness occurs immediately. Degenerative changes, as we age, can also contribute to rotator cuff tears, which often become painful over time. Common symptoms include recurrent pain with overhead activity, night pain that awakens you from sleep, weakness (especially when attempting to lift your arm), and possible catching and cracking sounds as the arm is moved. Not all rotator cuff tears require surgery. Sometimes, rehabilitation and time can allow the shoulder to return to normal, painless function. Tears that remain painful despite rehab and/or cause a functional deficit may benefit from surgery.

Other Conditions

3. What other conditions are common causes of pain in the shoulder?

The acromioclavicular joint (AC joint) can cause pain. This joint can be felt under the skin on the top of the shoulder (often a "bump" marks the joint). Trauma or arthritis can cause AC joint tenderness or pain. Occasionally, surgery may be required for a severe injury or for long-standing pain.

Adhesive capsulitis (frozen shoulder) can develop without trauma and most often affects females ages 40-60. There is a period of worsening once the onset of shoulder pain and stiffness begins. The pain and stiffness level off and then subsequently return to normal. The entire process can take up to two years to completely resolve, so it is important to know the correct diagnosis and understand the treatment plan.

Tendonitis (inflammation of the tendon): As there are many tendons in the shoulder, any of them can become inflamed and painful with chronic repetitive motions.

4. How are shoulder injuries treated?

Unless there is serious trauma associated with the pain, rehabilitation (consisting of motion and strengthening exercises) is often a starting point along with anti-inflammatory medications. If your surgeon is concerned about the possibility of requiring surgery, additional tests may be ordered to assess the injury and determine appropriate care.

Surgery

5. What is shoulder surgery like?

Advances in surgical technique and equipment now permit many shoulder disorders to be treated arthroscopically. These include many rotator cuff tears, labral tears, as well as shoulder instability. At times a combination of arthroscopy and open surgery is utilized, while at others, a formal open procedure is required to treat your injury.

Recovery

6. What is recovery like?

The first two days following surgery are the most painful. Ice cuffs are fitted to the shoulder and should be worn at all times for the first few days following surgery. Pain medication is prescribed and should be taken as needed. A sling is usually placed on the arm for comfort and protection. Activities permitted should be verified with your surgeon. Therapy and prevention of shoulder stiffness are very important post-operatively.