The rotator cuff consists of four key tendons that work together to stabilize the shoulder joint and facilitate the lifting of arms overhead. These tendons are connected to four muscles responsible for moving the shoulder. Damage to the rotator cuff can result from an acute injury or stem from repetitive strains and gradual wear and tear on the tendons. This is especially common in individuals who engage in work or sports that involve repetitive overhead movements, such as tennis. Minor strain injuries have the potential to progress into a partial tendon tear or even a complete muscle rupture, leading to a loss of shoulder joint function. Interestingly, a complete tear can sometimes occur without any noticeable symptoms, which is often the case in older adults who maintain a less active lifestyle.
Gradual Emergence of Pain
A rotator cuff injury can cause pain that develops gradually, starting at the time of the injury or even days later. As time passes, the pain intensifies, eventually leading to extreme discomfort when attempting to move the shoulder joint.
Sudden, Intense Pain in Shoulder and Arm
Rotator cuff injuries can cause pain in the front and side of the shoulder, as you might expect. This discomfort often becomes more intense when lifting the arms above the shoulders or out to the side, and can be particularly noticeable during activities like swimming, golf, or tennis. In some cases, the pain may even radiate from the shoulder down to the upper arm and possibly even the elbow.
Challenges in Lifting the Arm and Reduced Arm Movement
Individuals suffering from rotator cuff disease often struggle to lift their arms overhead or away from their bodies, leading to a reduced range of motion. In cases where the rotator cuff tendons are severely torn, it may be nearly impossible for a person to keep their arm raised. Typically, they may be able to lift their arm slightly, but not as high as their shoulder. This limitation can make everyday tasks, such as brushing one’s hair or reaching for an item on a high shelf, increasingly difficult or even unachievable.
Audible Clicking Sounds
Individuals suffering from rotator cuff injuries may experience loud clicking, popping, or cracking sounds, known as crepitus, when lifting their affected arm. These sounds tend to worsen over time and become more pronounced during specific arm or shoulder movements.
Rotator cuff disease often causes pain that worsens in the evening and becomes most severe at night, particularly when resting or lying on the affected shoulder. As the disease progresses, individuals may experience such intense pain that they require painkillers to sleep comfortably.
Stiffness and Sensitivity
Rotator cuff disease can gradually lead to a stiffer shoulder as a result of inflammation and persistent immobility. In some cases, individuals may develop a condition known as frozen shoulder, which can persist for months or even years after the initial rotator cuff injury has been treated. Typically, those with frozen shoulder experience moderate to severe pain during the first two to nine months. Although the pain may eventually subside, an increase in stiffness often follows, accompanied by tenderness around the affected tendons. Engaging in physical therapy is crucial for regaining complete mobility in the impacted shoulder.
Bruising and Shoulder Weakness
While relatively rare, some individuals with severe rotator cuff disease, particularly those with a torn rotator cuff, may experience bruising and swelling in the shoulder and surrounding tissues. This inflammation can further aggravate muscle weakness, which may worsen over time if the shoulder remains too painful or stiff to achieve its full range of motion. This can result in a debilitating cycle, making it essential to seek medical attention and address the issue promptly.
While a rotator cuff injury can present various symptoms, it is sometimes asymptomatic, meaning individuals may be unaware of the injury until they undergo medical imaging or another diagnostic procedure for unrelated issues. It’s important to consult a physician if even mild shoulder pain persists or fails to improve within a few weeks, as it could be indicative of an underlying issue such as rotator cuff disease.