Overview

The rotator cuff is a group of muscles and tendons that stabilize the shoulder joint, keeping the head of the upper arm bone (humerus) firmly within the shallow socket of the shoulder blade. Injury to the rotator cuff can lead to shoulder pain, weakness, and restricted range of motion, often becoming worse while sleeping on the affected side.

Causes of Rotator Cuff Injuries

Rotator cuff injuries may result from:

• Acute trauma, such as a fall or sudden jerking movement

• Chronic wear and tear, often caused by repetitive stress over time

• Inflammation and tendon fraying, especially where tendons pass under the bony arch of the shoulder

When inflamed tendons rub against surrounding structures, the space narrows, leading to a condition called rotator cuff tendinitis or impingement syndrome.

Common contributing factors include:

• Holding arms in the same position for long durations (e.g., computer work, hairstyling)

• Sleeping on the same side consistently

• Repetitive overhead sports (e.g., tennis, baseball, swimming)

• Prolonged overhead manual work (e.g., painting, carpentry)

• Poor shoulder or scapular muscle control

• Long-term poor posture

Rotator Cuff Tears

Tears may occur in two forms:

• Acute Tear: Often caused by trauma, such as falling on an outstretched arm or lifting something heavy with a sudden jerk.

• Chronic Tear: Develops gradually due to untreated tendinitis or long-standing impingement. Over time, the tendon wears down and may eventually tear.

Signs and Symptoms

Tendinitis or Impingement Syndrome

• Pain with overhead movements (e.g., reaching for shelves, brushing hair)

• Discomfort in the front of the shoulder, radiating to the side of the arm

• Pain stops before reaching the elbow

• Increased pain while lowering the arm or lying on the affected shoulder

• Weakness and stiffness during shoulder movement

• Difficulty placing the hand behind the back

Rotator Cuff Tear

• Acute Tear: Sudden, severe pain with noticeable weakness or snapping sensation

• Chronic Tear: Persistent dull pain, especially at night, increasing over time and interfering with sleep or routine activities

If left untreated, symptoms may progress and significantly limit shoulder function.

PMC Diagnosis

At PMC Orthopedic Spine Center, diagnosis begins with a detailed medical history, physical examination, and 3D spinal X-rays to evaluate nerve involvement from spinal misalignment.

Additional diagnostic tools may include:

• Ultrasound: Detects tendon tears and inflammation

• MRI: Identifies rotator cuff swelling or full-thickness tears

• CT Scan: Less sensitive than MRI but helpful in specific cases

• X-rays: Used to rule out bone spurs or structural abnormalities

• Arthrography: Contrast-enhanced imaging (X-ray, CT, or MRI) to visualize internal joint structures

PMC Treatment Approach

PMC’s non-invasive treatment focuses on both the shoulder joint and the underlying spinal misalignment contributing to nerve dysfunction. Treatment includes:

• Repositioning spinal vertebrae to restore symmetrical alignment and improve nerve supply to the shoulder

• Stimulating connective tissue regeneration using acoustic technology

• Reducing inflammation and pain associated with impingement or tears

Rehabilitation and Lifestyle Modification

PMC promotes a comprehensive recovery plan including:

• Targeted physiotherapy exercises to strengthen the rotator cuff

• Postural correction strategies to prevent recurrence

• Modifications in sleep posture and ergonomic positioning

• Activity modifications to reduce strain on the shoulder joint