What Is Rotator Cuff Syndrome?

Rotator cuff syndrome is an umbrella term for injuries and conditions involving the shoulder joint. The rotator cuff is a group of tough, flexible fibers (tendons) and muscles in the shoulder, and injuries can encompass a range of issues, including tendonitis, bursitis, tears in the tendons or ligaments, dislocations and frozen shoulders.

Types of Rotator Cuff Syndrome

Rotator cuff syndrome includes a range of conditions that can cause pain or require physical therapy or surgery:

  • Irritation or damage to the tendons (tendinopathy, sometimes called tendonitis)
  • Inflammation or irritation of a bursa (bursitis), a small, fluid-filled sac in the shoulder that cushions between the tendons and the bones
  • Impingement, the result of a tendon being squeezed or rubbed against bone
  • Calcium buildup in the tendons, which can cause a painful condition called calcific tendinopathy
  • Partial or complete tears of the rotator cuff tendons

Causes of Rotator Cuff Syndrome

The most common cause of rotator cuff syndrome is overuse due to repetitive motions, such as those associated with manual labor or athletic activities. Other risk factors include age-related degeneration, direct trauma to the shoulder joint and a previous shoulder injury.

It requires significant force to tear a healthy rotator cuff tendon. This injury can occur during sports, due to an accident or as a result of a severe fall. However, even a simple action like lifting a suitcase can lead to a rotator cuff tear in an older adult or someone with preexisting shoulder damage.

Risk Factors for Rotator Cuff Syndrome

Circumstances that may increase the risk of rotator cuff disorders include:

  • Aging
  • Holding or moving your arm overhead often is necessary for many jobs, including painting, a vocation requiring carrying heavy trays (such as waiting tables or working in a bar), or playing tennis, baseball and other throwing sports
  • Previous shoulder injuries, which may include dislocations and broken bones
  • A rotator cuff tear in the other shoulder
  • Irregularities of the muscles, tendons and bones in the shoulder, which may increase wear on the rotator cuff tendons
  • Having received multiple corticosteroid injections in the shoulder, which may weaken tendons and increase risk
  • Smoking, which decreases the blood supply and slows healing
  • Shoulder instability

Screening for & Preventing Rotator Cuff Syndrome

To prevent rotator cuff syndrome, it is important to perform stretching and strengthening exercises regularly and to avoid activities that place excessive strain on the shoulder joint. Maintaining proper posture while sitting or standing is also beneficial, as poor posture can lead to additional tension in the shoulder muscles.

Signs & Symptoms of Rotator Cuff Syndrome

Symptoms include pain when lifting your arm above your head, difficulty reaching behind your back, a dull ache in the shoulder, particularly at night, and reduced range of motion.

Diagnosing Rotator Cuff Syndrome

Diagnosing rotator cuff syndrome typically includes a physical exam and imaging tests, such as an X-ray, computed tomography (CT) or magnetic resonance imaging (MRI) scans. Your doctor may also order blood tests to rule out other possible causes of shoulder pain. Based on the results of these tests and your symptoms, your doctor can confidently diagnose rotator cuff syndrome.

Treating Rotator Cuff Syndrome

Your treatment will depend on the severity of your injury and whether other parts of your shoulder are injured. Your doctor may recommend physical therapy to increase your range of motion and strengthen your muscles. The experts at the Montefiore Einstein Department of Physical Medicine and Rehabilitation will create an individualized treatment plan to help with recovery, symptoms and repair. 

Our team often recommends the following for recovery: 

  • Physical therapy
  • Non-opioid-based pain management 
  • Ultrasound-guided cortisone injections
  • Development of a home exercise program  

Exercises play a crucial role in the treatment of rotator cuff syndrome. If you experience pain, weakness and stiffness in your shoulder due to a rotator cuff issue, your doctor will likely recommend that you try exercises along with other at-home treatments. Additionally, it is essential to perform exercises if you undergo rotator cuff surgery. You will collaborate with your doctor and physical therapist to design a personalized exercise plan to help you regain as much strength, muscle mass and flexibility in your shoulder as possible. These exercises typically involve stretching and strengthening the muscles in your shoulder, back, chest and arms.

Before starting the exercises, consult your doctor or physical therapist. It is vital to perform them correctly each time. Stop the exercises and reach out to your doctor or therapist if you are unsure about your technique. Any discomfort experienced during exercise should not persist for more than two hours after completion. If your shoulder feels sore after exercising, apply ice to it.

Be sure to keep your care team informed of any changes in your injury.