Rotating Cuff Shoulder Injury

Some Shoulder Injuries Need Medical Attention - Wikimedia Rotator cuff injuries range in severity with the most severe injuries needing surgical treatment. Recovery timeframes can range from weeks to months.

The rotator cuff refers to a group of four muscles around the shoulder that stabilise and move the shoulder joint. The muscles that make up the rotator cuff are the supraspinatus, infraspinatus, teres minor and subscapularis.

Rotator cuff injuries can develop over time, as a result of repetitive overhead movements or overuse, for instance in occupations consisting of manual labour or certain sports. Acute injuries can also occur from a sudden, specific event, such as a fall or a sudden raising of the arm, against resistance.

Symptoms of a rotator cuff injury may include one or more of the following: pain (sometimes worse at night), weakness of the arm, reduced range of movement, popping or clicking sound when the arm is lifted, tenderness over the shoulder joint and muscle spasm.

The treatment of chronic shoulder injuries may include pain control by medication, the application of ice or heat (depending on what works for the patient) and shoulder exercises. It is also recommended that the patient avoids (at least temporarily) any activities that aggravate the injury, to allow the flare up of the injury to settle. If symptoms persist, the patient may be given a steroid injection into the shoulder and if this doesn’t help, shoulder surgery may need to be considered.

Acute injuries should be treated with ice to reduce the swelling, medication (such as an anti-inflammatory) and immobilisation of the arm by applying a sling. If the pain is severe and movement is very restricted, medical attention is recommended. Radiological investigations may be indicated to rule out a partial or complete rupture of the tendon(s). If the shoulder injury does not require surgical intervention, rehabilitation might be useful to optimise recovery timeframes and outcomes.

Recovery timeframes vary from person to person, depending on age, mechanism of injury, treatment and compliance with treatment. Generally speaking, a minor rotator cuff injury may only need a week or two to heal, if all treatment guidelines are adhered to. A more severe injury (not a rupture) may take longer to heal, possibly a couple of months.

If a tendon has been ruptured, surgical intervention is almost always required to repair the torn tendon. Following shoulder surgery, the arm is immobilised in a sling. For the first six weeks post surgery, generally only gentle, passive arm exercises are allowed. After the initial six weeks, a more active rehabilitation program is indicated, however the patient is not allowed to lift anything heavier than two kilograms. The weight restrictions are gradually increased over a number of months.

Full recovery – that is full return of function and power – may take up to 12 months post surgery. During the recovery period, the patient can expect to be reviewed several times by the surgeon and continue rehabilitation, such as physiotherapy until given the all clear by the surgeon.

Rotator cuff injuries vary in severity. Injuries where there is no tendon rupture are generally managed by a combination of rest, ice/heat, medication and rehabilitation. Severe shoulder injuries involving the rupture of muscle tendons require surgery, with a post-operative recovery time of up to 12 months.