Symptoms of Rotator Cuff Injuries

What are the symptoms and signs of a Rotator Cuff injury?

To begin with, let’s distinguish the difference between a Rotator Cuff symptom and a Rotator Cuff sign.

A symptom is an abnormality that a person recognizes themselves, for example pain or numbness in your shoulder. Everyone’s experience is different; therefore symptoms are subjective and based on an individual basis.

A sign is an abnormality that is recognized by a health care professional during an examination. For example, a doctor will palpate your shoulder to feel for any bone abnormalities or inflammation. Signs are more objective and normally confirm your symptoms.

If you have early stage Rotator Cuff inflammation or tendonitis you may only experience pain and other symptoms with strenuous activity. However, if you have a Rotator Cuff tear you may experience more weakness and targeted pain, which interferes with your ability to sleep at night and greatly affects your mobility. If you allow your pain to persist, you will eventually experience pain at rest or with no activity at all.

The most common Rotator Cuff symptoms:

Pain in your Rotator Cuff may happen gradually and is normally associated with movement from repetitive activities, overstraining, or from degeneration of the tendon. It can also occur immediately following a trauma, such as a fall onto your arm or a lifting injury. It is most aggravated and intensifies when doing overhead or forward reaching activities (throwing motions or reaching for objects).

You will often feel Rotator Cuff pain on top of and in front of your shoulder which radiates down the outside of your upper arm (near the deltoid area). People generally find it worse at night, especially when lying on the affected shoulder. This pain can range from mild, to moderate, to sharp, although it can be difficult to pinpoint. Generally the amount of pain you experience will depend on the extent of your injury.

Weakness in your Rotator Cuff makes it difficult for you to raise your arm above your head, or extend your arm in front or to the side of you. You will often find it difficult to complete routine tasks such as reaching behind your back or combing your hair. This is frequently noticed with complete rotator cuff tears.

The loss of mobility and/or decreased range of movement in your shoulder area can indicate a Rotator Cuff injury. This is often accompanied by stiffness in the joint area, which is sometimes referred to as “frozen shoulder”.

Another key symptom of a Rotator Cuff injury is Crepitus (the clicking, grating, crackling or popping sounds heard and experienced in your shoulder joint when you move your upper arm around). This tends to result from two rough services coming in contact and grinding against one another, especially where cartilage has worn away. These noises tend to occur when you are overexerting yourself, such as pushing a heavy object.

Recurring or constant inflammation and swelling around the Rotator Cuff or near a bone spur on your shoulder blade will also indicate an injury. Often this will be a result of tissue catching on the bone or being pinched between the bones.

If you have Rotator Cuff Tendinitis and Bursitis you will generally experience some of the above symptoms as well as red, sore, and swollen tendons or bursa. There is generally a gradual onset of pain, which flares up when you move your shoulder in any direction, especially overhead or out to the side.

Your ache will often originate from deep inside your shoulder and you will feel tenderness in a general area; this pain will often be worse at night. A mild popping or crackling in your shoulder joint often indicates rotator cuff bursitis. As mentioned previously, if left untreated this can lead to a chronic tear. Rotator Cuff tendonitis and bursitis are very common in women 35 – 50 years of age.

If you have Rotator Cuff Instability you may feel your arm slipping in and out of your shoulder socket, and/or you may experience a “dead arm” feeling when you raise your arm over your head or move it away from your body. This Rotator Cuff instability may cause you to experience pain and unsteadiness. If you have a dislocation, your arm bone will slip or be forced out of the socket, resulting in immediate inflammation, loss of mobility, and a possible tear. This is very painful.

If you have a chronic or acute Rotator Cuff Strain or Tear you will experience most of the above symptoms. You will notice that your pain will be targeted in specific areas, especially when you lift your arm overhead or away from your body. You will also not be able to sleep on your injured shoulder. A strong crackling or popping sensation in your shoulder often indicates a tear.

If the tear occurs with a traumatic injury you may experience a sharp and sudden pain, a snapping sensation and an immediate weakness in your arm. This is known as an Acute Rotator Cuff tear. You will experience specific tenderness over the point of the tear and your range of motion will decrease immediately, as a result of muscle spasm, bleeding, or pain. You will also not be able to raise your arm out to your side without assistance. This sharp pain will generally last for a few days; however the other symptoms may carry on indefinitely. Rotator Cuff strains or tears occur most often in athletes and people over 50 years of age.

A Chronic Rotator Cuff tear is usually found on your dominant side and is worse at night, which will interrupt your sleep. You will notice that your shoulder muscles will weaken and atrophy (decrease in muscle mass), and the stiffness and pain in your shoulder will get worse over time. Your range of motion will also decrease until you are unable to lift your arm out to the side or over your head without assistance. This condition is very common in women, and generally affects people over the age of 40 years.

Should You Seek Medical Attention?

This is up to your discretion; however any continued discomfort in your shoulder should be investigated, as it can lead to long term damage. If you experience any of the symptoms below, it is recommended that you seek professional medical attention:

• You are unable to work due to the pain or limited range of motion
• You are unable to move your shoulder or arm at all
• You are unable to reach to the side or overhead after 2-3 days
• Your pain and/or inflammation lasts for more than 2-3 days