Rotator cuff injury

It's a type of shoulder injury to the rotator cuff; a group of four muscles and tendons around the shoulder joint. They support the shoulder and help it to move. Problems with the rotator cuff are a common cause of shoulder pain.

It can cause a dull ache that's often worse when you try to sleep on the affected side.

Symptoms of a rotator cuff injury include:

• Intense pain when you raise your arm above your shoulder
• Pain in and around your shoulder joint
• Reduced movement in your shoulder
• Weakness in your shoulder and arm
• Pain may be chronic (long-term), which sometimes gets worse at night, or acute – a sudden tearing sensation

Sometimes pain in your arm can be a sign of a heart condition or heart attack. If shoulder pain doesn’t get worse when you raise your arm or you feel unwell, you should contact A&E.

Your doctor will discuss how you’re feeling and examine your shoulders for pain and movement.

Your neck will also be checked to make sure your shoulder pain isn't referred pain (pain that's felt in another part of the body than its actual source) from conditions affecting your spine.

Your doctor may also ask you about any recent chest pains to rule out a possible heart condition.

Your doctor may recommend some other tests to rule out a broken bone or another condition:

• MRI scan
• Ultrasound scan
• X-ray

The causes of a rotator cuff injury include the following:

A rotator cuff tear following an injury

Tears caused by an injury, such as a fall or a dislocated shoulder.

A rotator cuff tear following long-term (chronic) overuse

Repetitive overhead use of your arm at work or sport increases the risk of a rotator cuff injury. For this reason, it often affects painters, carpenters, cricketers and racket players.

Subacromial impingement

Also known as shoulder impingement, tendonitis, bursitis and trapped tendon. This is when the tendons press against the bones in your shoulder. It can be caused by arthritis and bone spurs on the bone at the top of your shoulder (acromion).

Calcific tendonitis

This is when calcium builds up in the rotator cuff tendon, increasing pressure in the tendon and causing irritation and pain. It isn’t known what causes it. The calcium can affect how the rotator cuff functions and cause subacromial impingement.

Degenerative wear and tear

Degeneration of the muscles and tendons is known as tendonitis and is more common in women aged 35–50. Bony overgrowths, also associated with ageing, can weaken the tendon and cause tears.

Treatments for rotator cuff injury include:

• Resting your shoulder
• Applying an ice pack
• Rotator cuff exercises
• A sling may also be useful to help rest your shoulder
• Anti-inflammatories, such as ibuprofen may also help, but ask your doctor about using them first

Steroid injections may help in the case of a chronic (long-term) injury.

In more serious cases, you may require rotator cuff surgery. This could involve:

• Open tendon repair
• Rotator cuff repair using arthroscopy, a type of keyhole surgery
• The transfer and use of tendons from another part of your body
• In extreme cases, full shoulder joint replacement