A rotator cuff injury is inflammation or damage to the muscles and tendons in your shoulder.
Rotator cuff injuries are the most common cause of shoulder pain in the UK. Shoulder pain affects up to a quarter of the UK population, with seven in 10 of these being caused by a rotator cuff injury.
Your rotator cuff is made up of a group of four muscles (the subscapularis, supraspinatus, infraspinatus and teres minor) and their tendons. They help keep your shoulder joint stable and also help with shoulder joint movement.
Your shoulder joint (also known as your glenohumeral joint) is a ball and socket joint made up of two bones. The ball-shaped end of your upper arm bone (humerus) joins with a shallow socket on the edge of your shoulder blade (scapula).
On top of your shoulder joint is a bone called the acromion. In the gap between your shoulder joint and the acromion is a narrow space called the subacromial space. This is where your rotator cuff tendons pass through. In this space is a fluid-filled pad called the subacromial bursa, which cushions your tendons.
Rotator cuff injury is a general term. It describes inflammation (soreness and swelling) or damage to one or more of the muscles, tendons or bursa that make up your rotator cuff.
There are a number of conditions that can affect your rotator cuff. The most common are inflammation of your rotator cuff tendons and tearing of your muscles or tendons.
The tendons of your rotator cuff can become pinched against one of the other structures that make up your shoulder joint. This can cause your tendons to become inflamed and is known as tendinopathy. Rotator cuff tendinopathy most often affects the tendons that pass through your subacromial space. When a tendon becomes trapped or squeezed, it's known as rotator cuff impingement.
Your subacromial bursa can also become inflamed – this is called bursitis.
This is when one or more of the muscles and tendons that make up your rotator cuff tear. You can have a partial tear or a full-thickness tear. It may be as a result of trauma, such as a fall. Or because of tiny tears in the tendon caused over time by overuse and wear.
Symptoms of a rotator cuff injury include:
The pain may come on gradually if you have tendinopathy. But your pain may be severe and sudden if you tear your rotator cuff because of an accident or fall.
These symptoms may be caused by problems other than rotator cuff injuries. If you have any of these symptoms, see your GP for advice.
Rotator cuff injuries may occur for a specific reason. Some examples are listed below.
There are some things that increase the likelihood of you getting a rotator cuff injury, including the following.
Your GP will ask about your symptoms and examine you. They may ask about your medical history and any activities that may be causing your condition.
Your GP may refer you to an orthopaedic surgeon, a sports physician or a hospital clinic for tests to look at your shoulder. This may include one or more of the following tests.
Treatment of a rotator cuff injury depends on the type of injury you have and how severe it is.
The following measures may help.
Your GP may refer you to a physiotherapist (a health professional who specialises in maintaining and improving movement and mobility). They will show you suitable exercises to help stretch your shoulder muscles and improve the strength and movement of your shoulder. The exercises will be tailored to your specific injury.
If your rotator cuff tear isn’t getting better after trying other types of treatment, your GP may recommend that you have a steroid injection into your shoulder joint. See our frequently asked questions for more information.
Your orthopaedic surgeon or sports physician may recommend surgery if your rotator cuff is torn and other types of treatment haven’t worked for you.
There are several types of surgery that may be used to repair a rotator cuff injury.
Your surgeon will be able to give you advice on which type of surgery is best for you. See our frequently asked questions for more information about how to speed up your recovery after surgery.
Produced by Dylan Merkett, Bupa Health Information Team, August 2014.
For answers to frequently asked questions on this topic, see FAQs.
For sources and links to further information, see Resources.
This information was published by Bupa's Health Information Team and is based on reputable sources of medical evidence. It has been reviewed by appropriate medical or clinical professionals. Photos are only for illustrative purposes and do not reflect every presentation of a condition. The content is intended only for general information and does not replace the need for personal advice from a qualified health professional. For more details on how we produce our content and its sources, visit the about our health information page.
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