Rotator Cuff Injury – Symptoms and Signs

Symptoms of a rotator cuff injury are due to the inflammation that accompanies the strain. This inflammation causes swelling, leading to the clinical picture of pain and decreased range of motion. Because the muscles and tendons of the rotator cuff are hidden well below skin level, it may be hard to feel the swelling that accompanies the injury, but that swelling within the small space that makes up the shoulder joint prevents the normal range of motion of the shoulder and causes the pain that occurs with movement.

  • Acute rotator cuff tear
    • Symptoms can be a sudden tearing sensation followed by severe pain shooting from the upper shoulder area (both in front and in back) down the arm toward the elbow. There is decreased range of motion of the shoulder because of pain and muscle spasm.
    • Acute pain from bleeding and muscle spasm: This may resolve in a few days.
    • Large tears may cause the inability abduct the arm (raise it away from the side of the body) due to significant pain and loss of muscle power.
  • Chronic rotator cuff tear
    • Pain usually is worse at night and may interfere with sleep.
    • Gradual weakness and decreased shoulder motion develop as the pain worsens.
    • Decrease in the ability to abduct the arm (move it out to the side). This allows the arm to be used for most activities but the affected person is unable to use the injured arm for activities that entail lifting the arm as high as or higher than the shoulder level to the front or side.
  • Rotator cuff tendinitis
    • More common in women 35-50 years of age
    • Deep ache in the shoulder also felt on the outside upper arm over the deltoid muscle
    • Point tenderness may be appreciated over the area that is injured
    • Pain comes on gradually and becomes worse with lifting the arm to the side (abduction) or turning it inward (internal rotation)
    • May lead to a chronic tear: When a rotator cuff tendon becomes inflamed (tend=tendon +itis=inflammation), it runs the risk of losing its blood supply, causing some tendon fibers to die. This increases the risk that the rotator cuff tendon can fray and partially or completely tear.

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