Rotator Cuff

September 12, 2022

At the top of our arm where it meets the shoulder, there is a group of 4 muscles collectively known as the rotator cuff (Supraspinatus, Infraspinatus, Subscapularis, Teres Minor). The rotator cuff muscles/tendons help to strengthen the joint, giving the shoulder the power and flexibility needed to participate in activities that require use of our arm, such as reaching. These muscles are prone to tearing, what is known as a torn rotator cuff.
Rotator cuff injuries are most common among sporting people, but they can happen to anyone. Rotator cuff tears can be painful and can cause other symptoms.
Depending on the severity of the tear, minimal tearing can be rehabilitated through physical/occupational therapy, with the patient learning how to strengthen specifically the rotator cuff muscles. Severe tears often require surgery intervention, followed with formal physical/occupational therapy to restore range of motion and strength.

Symptom #1: Pain When Reaching Overhead One symptom of a rotator cuff problem is you will feel discomfort or pain when reaching overhead, such as into overhead cabinets or putting on a shirt. You do not have to be holding anything heavy, it is the act of reaching itself that can be enough to cause discomfort or pain.

Symptom #2: Limited Range of Motion If you have a rotator cuff problem then it will be a lot more difficult for you to move the arm in its full range of motion, such as for reaching into a cabinet overhead or reaching out to your side. You may still be able to move your shoulder/arm, but you won't be able to move it to the same extent you could in the past. If you suffer from limitations in movement, then you should arrange to get your shoulder checked out by your orthopedist.

Symptom #3: Difficulty Sleeping On Shoulder
Most of us have a preferred position we tend to sleep in. The positions can vary considerably from person to person, each person will tend to sleep in the same position each night, although they will shift their position occasionally. We also tend to sleep on the same side, but we might be prevented from doing this at times.
Somebody with a torn rotator cuff will find they have difficulty sleeping on a particular side of the body. It can make it difficult to sleep, as you struggle to find a position that is comfortable.

Symptom #4: Pain
Pain is generally a response to damage to our bodies, or something that might be about to cause damage. It is perhaps the most unpleasant experience that we are likely to encounter, but we should hopefully not experience it too often. It can also be caused by various medical conditions, and a torn rotator cuff is one of them.
The pain is likely to be at its worst when we are moving our shoulder. However, it is not only when the shoulder is being used when the patient will feel pain, as it can cause pain even when the patient is at rest.

Symptom #5: Popping Sensation
We will often hear noises coming from our bodies, especially as we get older and things aren't running as smoothly as they once did. These creaks and groans come from our joints as different parts of the body rub together. People are also likely to experience these noises if they have sustained a torn rotator cuff.
When the rotator cuff is injured, the joint is not likely to be operating as smoothly as it usually would. This can cause parts to become slightly misplaced. This, in turn, can lead to a sensation that patients often describe as "popping." The patient might also sometimes hear an audible "popping" sound.

Symptom #6: Frozen Shoulder
The joints in our bodies, including those in our shoulders, work so smoothly that any engineer would be proud to call the work their own. Of course, the joints have not been "constructed" as such but are rather the result of many millions of years of evolution.

As impressive as these joints are, however, they are not immune from experiencing problems in their functionality. In the case of an injury such as a torn rotator cuff, the damage can prevent the joint from moving as required. This can cause it to lock up, leaving the patient unable to move the shoulder for functional activities.

Symptom #7: Pain Worse At Night
Most pain only lasts for a short period of time. The pain tends start off at their worst at the time the injury and gradually decreases in severity over time. Depending on the type of injury, the pain can be persistent and can linger. Some pain can also ebb and flow in terms of their severity.

In cases of a torn rotator cuff, the patient will often find pain will increase in severity at night time. This can be particularly inconvenient as it can prevent the you from getting enough sleep at night. If needed, a doctor may be able to prescribe something to help you feel more comfortable.

Symptom #8: Trouble Scratching Back
No part of our body is immune to feeling itchy from time to time, and this includes our backs. It is one of the most difficult parts to scratch because we have to reach behind to access it. We can still usually, just about make it, though, even if we have to use a back scratcher.

A torn rotator cuff, however, can limit mobility to the extent that the patient is unable to reach their back. This can be awkward if an itchy back occurs, limitations in motion can also make it difficult for the patient to wash thoroughly.

Symptom #9: Weakening Shoulder
Our shoulders are called do a lot of work and are one of the main power sources when it comes to heavy lifting. The rotator cuff area includes a number of strong muscles to help give us this strength. However, we can lose some of this strength if the rotator cuff is torn.

It's not necessarily that the muscles become weaker, but the tear means that the joint as a unit becomes weaker overall. In addition, the patient can find the shoulder gradually weakening as time goes by. Surgery should hopefully be able to restore the joint to its full strength.

Symptom #10: Weakness In Hands
Although a tear of the rotator cuff will not cause issues with the hand directly, however hand strength could be limited after a rotator cuff tear due to a certain type of pain response. This weakness is temporary and more neurological. Essentially it is our body's way of "shutting down" an area that is injured in order to avoid more injury.

Our ability to grip tightly onto objects has been a considerable evolutionary boon for us. The muscles that control the hand are not found in the hand itself, but in the arms. Muscles in the arms contract, pulling on tendons that then cause the fingers to close. The patient should hopefully recover to full strength after the injury has been treated.

This concludes our series on the Rotator Cuff Pathology and Symptoms. If you have any questions on please call our office at 307-472-3327.

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