“Is it my Rotator Cuff ?”
“Is it my Rotator Cuff ?”
Richard B Jones, M.D.
Sports Medicine Orthopaedic Surgeon
As a sports medicine orthopedist one of the most common things I see in my office is shoulder pain. Shoulder pain can come from a variety of causes, and is often very different depending on age. Patients less than age 40, and especially overhead or throwing athletes, usually have problems coming from looseness of the shoulder (instability), or injury to a structure deep in the shoulder joint called the labrum. Problems with the rotator cuff are rare in this group of patients.
On the other hand, rotator cuff problems are by far the most common cause of shoulder pain in patients over age 40. The rotator cuff is a series of four muscles that arise from the shoulder blade and form a large tendon surrounding the ball of the shoulder joint. They assist in raising and rotating the arm. Injuries to this tendon can range from tendonitis(inflammation of the tendon) to full tears. Pain from the rotator cuff is usually along the side or front of the shoulder and may radiate down the arm to the elbow. Reaching overhead or behind the back often causes pain. Patients may experience popping or catching in the shoulder and pain at night is extremely common. Injury to the rotator cuff is often caused by lifting heavy objects (especially overhead). Other common causes include falling directly on the shoulder or on an outstretched arm. Occasionally a tear may occur with no injury at all.
Treatments for mild rotator cuff problems include anti-inflammatory medications, physical therapy, and steroid injections. If this fails surgery may be indicated. Full thickness tears of the rotator cuff will not heal back to the bone unless repaired and usually require surgery by an orthopedist experienced in shoulder surgery. Arthroscopic repair of rotator cuff tears is becoming the state of the art repair technique. During the repair small “anchors” are placed in the bone with stitches attached to them. These stitches are passed though the torn tendon and allow reattachment of the tendon to the bone. This is a successful procedure about 85 to 90% of the time. Old large tears of the rotator cuff are much more difficult to treat and have a lower success rate. Therefore, it is not advised to ignore worsening or unresolved shoulder pain.
Richard B. Jones, M.D.
Southeastern Sports Medicine
828-274-4555