​How to Know If You Might Have a Rotator Cuff Issue

Rotator cuff issues are a common culprit of shoulder pain. Four muscles make up the rotator cuff and keep the head of the upper arm bone in its socket, enabling it to work. Those muscles turn into tendons that attach near the head, which is the ball of your shoulder, a ball-and-socket joint.

You may not know it, but you use your shoulder almost constantly. The shoulder is the most mobile joint in the body, and prolonged pain in your shoulder should not be ignored. Most tears to the rotator cuff happen from degeneration, though they can happen from an acute injury. Here are some signs you might have a rotator cuff issue:

1. Pain. One of the surest signs of a rotator cuff injury, you may feel pain or weakness over the outside of the shoulder and upper arm, or occasionally down the arm. Sometimes pain may be present while performing overhead activities (with your arm elevated above your head). You may also experience pain at night, especially when sleeping on the affected side.
2. You perform activities that require overhead repetitive motions. Baseball and tennis players are at risk of rotator cuff problems, as are painters, electricians or even NASCAR pit crew who work on a specific position on a race car. We also see rotator cuff injuries in people who perform repetitive lifting of weights, do CrossFit activities, and we’ve even seen them from lifting a gallon of milk!
3. You have a hard time doing daily activities. If you have difficulty raising your arm overhead or in front of you, reaching behind you or doing things you do every day without pain or weakness, it may be a sign of a rotator cuff tear.
4. You’re older. The risk of rotator cuff injuries increases as you age, when your tendons aren’t as strong. We see more full thickness tears when people are in their 50s than at younger ages.

Rotator cuff injuries vary in severity and don’t always necessitate surgery; many patients are able to recover with rest and anti-inflammatory medications. Physical therapy can also help and focuses on strengthening the shoulder blade muscles and other areas that support the shoulders and upper back. A partial tear may require only a débridement (smoothing procedure), though a full thickness tear in the tendon will need to be repaired and can involve transplantation of tendons or joint replacement, depending on the case.

It’s best to see a doctor as soon as possible if you are having signs of rotator cuff issues as early diagnosis and treatment can keep you from losing strength and range of motion.

Adam Fosnaugh MD is a fellowship-trained sports medicine physician with OrthoCarolina Monroe.