Rotator Cuff Injury: How to Identify Rotator Cuff Symptoms

The rotator cuff is a group of muscles and tendons in the shoulder that work together to stabilize the shoulder joint and facilitate movement. The rotator cuff muscles include the supraspinatus, infraspinatus, teres minor, and subscapularis.

What is Rotator Cuff Injury?

A rotator cuff injury refers to damage or strain to the muscles or tendons of the rotator cuff in the shoulder. These injuries can range from mild inflammation to severe tears in the muscles or tendons.

Most common injuries to the Rotator Cuff are often referred to as:

• Rotator Cuff Tears (partial or full thichness of the muscles or tendons)
• Rotator Cuff Tendinitis (acute inflammation of the RC soft tissue)
• Rotator Cuff Tendinopathy (chronic irritation or degeneration of the RC soft tissue)
• Impingement Syndrome
• Calcific Tendinitis (deposition of calcium  in the tendons of the rotator cuff, leading to inflammation and pain)

Classification of Rotator Cuff Tear

Classification of tear is done on the basis of size, location and shape of tear. Cofield (1982) classified tear as following:

1. Small tear: less than 1 cm

2. Medium tear: 1–3 cm

3. Large tear: 3–5 cm

4. Massive tear: greater than 5 cm

Symptoms Of Rotator Cuff Injury

• Pain - usually over deltoid area
• Painful Range of Motion
• Painful arc - that is the pain occurs above shoulder height
• Muscle weakness (particularly during Abduction and External Rotation)
• Sleep Disturbances

 

Factors Causing Decreasing Sleep Quality

• functional limitation – which hinders tossing and turning throughout the night
• sleeping position - supine position causes significantly lower subacromial pressure as compared to prone or lateral decubitus position, and it leads to progression of degenerative changes and atrophy.
• shoulder stiffness
• Increased production of inflammatory cytokines

How does it affect sleep quality?

Rotator Cuff pain is correlated with sleep disorder or sleep patterns in various ways. It affects patients physical, social and emotional functioning  which includes mood disorders like depression and anxiety. Patients with RC tears seems to have more sleep disturbances compared with patients who have RC tendinopathies, or subacromial impingement

Plus many other factors have a profound effect on sleep quality such as hypertension, gender, low back pain, diabetes mellitus, body mass index (BMI), previous corticosteroid injection, and osteoarthritis. However, studies suggest that there is no statistically significant correlation  found between any of the features of the RC tear and sleep quality.

Frequently Asked Questions

How to heal a torn rotator cuff naturally?

Healing a torn rotator cuff naturally involves a combination of strategies which help in  reducing pain, inflammation, and promote tissue repair. Below are some natural approaches:

• Rest and Activity Modification
• Cryotherapy
• Heat Therapy
• Therapeutic Exercises
• Maintaining a balanced diet rich high in anti-inflammatory omega-3 fatty acids, such as salmon, flaxseeds, and walnuts
• Posture Correction - involve ergonomic adjustments at work, maintaining a neutral spine, and avoiding prolonged slouching or hunching
• Ensure adequate sleep and proper sleeping posture

What is rotator cuff surgery recovery process?

Recovering from rotator cuff surgery requires patience, commitment to rehabilitation exercises, and adherence to your surgeon's post-operative instructions.

Immediately Post-Surgery:

It involves immobilization of shoulder, pain management and initial rehabilitation exercises i.e. gentle range of motion exercises as directed by physical therapist.

Weeks 1-6:

It involves passive ROM exercises, gentle stretching, manual therapy techniques, and modalities like therapeutic ultrasound or transcutaneous electrical nerve stimulation. The sling is then gradually wean off and patient perform light activities of daily living.

Weeks 6-12:

It involves active ROM exercises, strengthening exercises and gradual return to activity.

Months 3-6:

It involves progressive strengthening exercises and functional training which focus on activities that mimic your daily tasks and recreational activities to improve overall shoulder function and endurance. 

Long-Term:

Continuing with a maintenance exercise program to preserve shoulder strength, flexibility, and function id prescribed.

 

 What rotator cuff stretches to relieve pain?

• Shoulder Pendulum Stretch
• Cross-Body Shoulder Stretch
• Sleeper Stretch
• Towel Stretch
• Doorway Stretch
• External Rotation Stretch
• Internal Rotation Stretch
• Wall Climbing Stretch
• Overhead Shoulder Stretch
• Arm Across Chest Stretch

How long does it take for a torn rotator cuff to heal without surgery?

The healing time for a torn rotator cuff without surgery can vary significantly depending on the severity of the tear, individual factors such as age and overall health, and the effectiveness of non-surgical treatments. In general, minor tears or strains may heal within a few weeks to a couple of months with conservative management. However, larger or more severe tears may take several months to a year or more to heal fully, and some tears may never completely heal without surgical intervention.

 

How to relieve rotator cuff pain at night?

Relieving rotator cuff pain at night can significantly improve sleep quality and overall comfort. Here are several strategies to help alleviate pain:

• Adjust Sleeping Position: Sleeping on your back with a pillow under your shoulder or on the unaffected side with a pillow between your arms can often provide relief
• Supportive Pillows: A contoured pillow or a body pillow can help maintain proper alignment and reduce strain on the rotator cuff
• Apply ice packs or a cold compress to the affected shoulder before bedtime to help reduce inflammation and numb pain
• Perform gentle stretching exercises for the shoulder before bedtime to help improve flexibility and reduce muscle tension
• Practice relaxation techniques such as deep breathing, progressive muscle relaxation, or guided imagery to promote relaxation and reduce tension in the muscles surrounding the shoulder
• Create a comfortable sleep environment. Ensure your mattress and pillows adequately support your body and minimize pressure points
• Avoid overuse or repetitive movements that may exacerbate rotator cuff pain

 

What are rotator cuff tear test that diagnose it?

• Drop Arm Test
• External Rotation Lag Sign
• Internal Rotation Lag Sign
• Belly Press Test
• Hornblower's Sign
• Lift-Off Test
• Empty Can Test
• Hawkins-Kennedy Test
• Neer Impingement Test
• Supraspinatus Strength Test