#3 Rotator Cuff
The rotator cuff is a group of muscles and tendons around the shoulder joint that keep the upper arm bone in the shoulder socket. 16 Various levels of injury can occur to the rotator cuff, including tendonitis, chronic tendinopathy, partial tears, and full-thickness tears. Tendonitis commonly occurs due to trauma or overuse and can progress to a chronic state of tendinopathy. Once in this chronic stage, the rotator cuff may become weak and can lead to further tearing. 17 Rotator cuff tears are extremely common, affecting at least 10% of those over the age of 60 in the United States, which equates to over six million cases per year. 9 It has been shown that 23% of asymptomatic shoulders have tears with the percentages increasing each decade after 50 years of age. 18 Cuff pathology is considered a progressive disorder. Twenty percent of asymptomatic tears are progressive, and do not get smaller with time. 9 Industry estimates suggest rotator cuff surgeries are performed in the US on 75,000–250,000 patients per year and the failure rate for surgical repair of rotator cuff tears is between 25 and 90%. 9 Fortunately, patients with failed repairs report satisfaction levels and outcome scores that are nearly indistinguishable from those whose repairs are intact. 9 A number of retrospective case series and one randomized controlled trial have suggested that nonoperative treatment of full thickness rotator cuff tears may be successful in some patients. 9
COMMON CAUSES OF ROTATOR CUFF INJURIES INCLUDE
Rotator cuff injury symptoms
A dull deep shoulder ache
• Repetitive overhead movements making rotator cuff injuries common across a diverse patient population. 16 • Trauma such as falls, rapid humeral deceleration with throwers, or high resistive forces applied through the shoulder. 16 • Individuals over the age of 60 are more prone to rotator cuff injury. 16 • Subacromial bone spurs can contribute to impingement, leading to an increased likelihood of rotator cuff pathology. 11 • Weakness or imbalance of muscles surrounding the shoulder joint. 16
Pain that disturbs sleep
Discomfort with overhead movement and with moving the arm behind the back
Arm weakness
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