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Rotator Cuff Injury

Rotator cuff injuries range from tendon inflammation to complete tears, causing shoulder pain and weakness; most improve with physical therapy, anti-inflammatory medication, and activity changes.

Musculoskeletal
The rotator cuff is a group of four muscles and tendons that surrounds the shoulder joint, holding the ball of the upper arm bone in its shallow socket and powering lifting and rotation. Rotator cuff injuries range from tendon irritation (tendinopathy) and bursitis to partial and complete tears. They are among the most common causes of shoulder pain, and the risk rises steadily with age as the tendons naturally wear. Because the shoulder trades stability for mobility — it is the most mobile joint in the body — the cuff works constantly, and problems with it are very common in adults over 40. Causes and Risk Factors: Most rotator cuff problems develop gradually, though some occur suddenly:
  • Age-related degeneration: The most common cause — tendon tissue slowly frays over decades, which is why tears become increasingly common after age 60, often with surprisingly little pain at first.
  • Repetitive overhead activity: Tennis, swimming, baseball, painting, and carpentry repeatedly stress the cuff.
  • Acute injury: A fall onto an outstretched arm or lifting something too heavy can tear a tendon suddenly.
  • Impingement: Bone spurs on the shoulder blade can rub the tendons with each arm raise, gradually wearing them down.
Symptoms: Rotator cuff problems produce a characteristic set of complaints, usually beginning gradually and worsening over months:
  • Dull, deep shoulder ache: Often worse with overhead reaching or reaching behind the back, such as fastening a seatbelt or a bra.
  • Night pain: Difficulty sleeping on the affected shoulder is one of the most consistent features.
  • Weakness: Trouble lifting the arm, combing hair, or carrying groceries; sudden marked weakness after an injury suggests an acute tear and deserves prompt evaluation.
  • Crackling or catching: Grinding sensations with certain movements.
Diagnosis: Your physician will examine the shoulder's range of motion and test the strength of each cuff muscle. Shoulder pain in adults has several look-alikes — osteoarthritis of the shoulder, frozen shoulder, neck-related nerve pain, and, in older adults with stiffness on both sides, polymyalgia rheumatica — so the exam matters. X-rays show bone problems and arthritis, while ultrasound or MRI shows the tendons themselves and whether a tear is partial or complete. Not every tear seen on imaging needs fixing: many adults have painless cuff tears discovered incidentally, so imaging results are always interpreted alongside the examination. Treatment: Most rotator cuff injuries — including many confirmed tears — improve without surgery, and most people regain a comfortable, functional shoulder with a structured program:
  • Physical therapy: The cornerstone of treatment. Progressive exercises strengthen the intact cuff muscles and the muscles that stabilize the shoulder blade, restoring pain-free motion over weeks to months.
  • Relative rest: Avoiding aggravating overhead activity while staying generally active — complete immobilization stiffens the shoulder and slows recovery.
  • Anti-inflammatory medication: NSAIDs such as naproxen or meloxicam reduce pain enough to participate fully in therapy.
  • Corticosteroid injection: An injection into the bursa can calm severe pain, used selectively because repeated injections may weaken tendon tissue.
  • Surgery: Repair is considered for acute full-thickness tears in active people, and for persistent pain and weakness despite several months of good conservative care.
Shoulder pain that lingers beyond a few weeks, disturbs sleep, or comes with real weakness should be examined rather than pushed through. The internal-medicine team at Zimmer Medical Group can evaluate your shoulder, start a treatment plan, and coordinate imaging or orthopedic referral when it is needed.

Related Medications

Commonly prescribed medications for this condition

NaproxenMeloxicam

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