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Is Your Rotator Cuff Causing Your Shoulder Pain?

April 18, 2024

About 70% of people experiencing shoulder pain can trace the problem to the rotator cuff, a collection of four tendons anchoring the upper arm bone in the socket.

Are you one of them?

Here’s how the rotator cuff works and why it might be giving you problems, according to Derek Shia, MD, a specialist with the Connecticut Orthopaedic Institute at MidState Medical Center.

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The rotator cuff helps the arm move around.

The layer of tendons that make up the rotator cuff are responsible for controlling the movements of the shoulder joint and positioning the arm in space, Dr. Shia explains.

“This is what allows us to reach out to the side, behind the back and over our head,” he says.

That job leaves the rotator cuff vulnerable to injury.

Because of the movement it helps us perform daily, the rotator cuff can be injured in several ways, Dr. Shia continues.

Potential injuries include:

  • Tendonitis. This can stem from overuse, particularly when performing repetitive overhead activities.
  • Partial tear. Likening this to fraying, he says it involves injury to less than the full thickness of the tendon. An MRI can determine the extent of the tear.
  • Full tear. This occurs when the entire attachment point of a rotator cuff tendon becomes completely detached.

> Related: What Different Types of Shoulder Pain Could Mean

How to know the rotator cuff is causing your shoulder pain

Typically, Dr. Shia says an injury to the rotator cuff causes pain in the arm between the shoulder and elbow.

Other symptoms to look for include:

  • Pain when reaching overhead, out to the side or behind your back
  • Trouble sleeping
  • Significant bruising
  • Swelling in the area

“Anyone experiencing a trauma like a fall or lifting injury that keeps them from raising the arm above shoulder height should see a specialist,” he adds.

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There’s many ways to treat a rotator cuff that aren’t surgery

Surgery is not always the answer for treating rotator cuff injuries, Dr. Shia stresses.

First, your provider might suggest:

  • Physical therapy
  • Over-the-counter anti-inflammatory medication
  • Activity modification
  • Corticosteroid or platelet rich plasma (PRP) injections

“If these options don’t work, we would then consider surgery,” he says, adding the procedure is typically outpatient and done arthroscopically through small incisions.

Patients wear a sling for four weeks. Work to strengthen the repaired rotator cuff begins about 10 weeks after surgery, with patients returning to full activities in about six months, he says.