Rotator Cuff Injuries: 10 Terms to Know

The rotator cuff is comprised of four different muscles and corresponding tendons that hold the arm into the shoulder joint. There are several different types of rotator cuff injuries, largely resulting from overuse of the shoulder (throwing a baseball, heavy lifting, painting, etc). Here are ten terms to help you get familiar with rotator cuff injuries.

1. Rotator Cuff Tendonitis: Tendonitis creeps up slowly over long periods of overuse of the shoulder. In a nutshell, the tendons in the rotator cuff become inflamed. In addition to extensive movement of the arm over the head (thus the nicknames of baseball, tennis, and swimmer’s shoulder), this tendonitis can also get worse from sleeping positions or lack of shoulder movement. 
2. Impingement Syndrome: Rotator cuff impingement occurs when the acromion (a bone in the shoulder) “impinges” on the tendons and bursa positioned between it and the rotator cuff. Many sources use tendonitis and impingement interchangeably, as the treatment and symptoms are largely indistinguishable with only minor anatomical causational differences. The resulting pain is generally continuous, growing worse at night (particularly if the shoulder is slept on).  
3. Subacromial Bursitis: Bursae (plural of bursa) are the thick cushions between bones and tissue that protect structures from friction. As the largest bursa in the body, the one located in the shoulder is particularly susceptible to bursitis—an inflammation of the bursa. Symptoms include pain and tenderness in the shoulder and arm, often exacerbated by repetitive movement. While it may radiate down the arm, pain reaching the elbow or farther is usually indicative of a different issue. Because the tissues in the shoulder are so closely positioned, additional problems often follow bursitis. 
4. Rotator Cuff Tear: Injury or extensive overuse of the shoulder can eventually lead to an actual fissure in the tendons or muscles of the rotator cuff. As the most extreme of the rotator cuff injuries, a tear may develop because of previous strains or injuries. Shoulder pain, weakness, and limited mobility can all be indicative of a rotator cuff tear. It’s important to seek medical care immediately, as speedy treatment often carries a better outlook. 
5. Adhesive Capsulitis: Also referred to as “frozen shoulder,” adhesive capsulitis is a potential complication of a rotator cuff injury—even of the treatment intended to heal the issue at hand. Insufficient movement causes the tissues in the area to grow thicker, causing stiffness and pain. Frozen shoulder progresses over three stages: freezing (shoulder pain develops as motion slowly becomes limited), frozen (pain increases as motion becomes more difficult), and thawing (range of motion begins to return). It can take several months for this condition to develop and disappear. 
6. Arthrogram: An arthrogram is part of the array of image testing that can be used to diagnose a rotator cuff injury. While a standard x-ray is used largely as a means of ruling out other issues that could be causing shoulder pain, an arthrogram is designed specifically for joints. Dye is injected into the shoulder before the radiograph is taken. If the film shows dye leaking, a rotator cuff tear is likely present. 
7. Painful Arc Test: Part of the physical exam performed for diagnosing a rotator cuff injury involves investigating the centralization of pain, how this is affected by arm motions, and if range of movement is inhibited. The patient is instructed to stand with their arm flat against their side, then slowly lift it until it’s raised above the head, indicating where it becomes painful and where pain diminishes. 
8. Occupational Therapy: It can take quite some time to recover from rotator cuff injuries, as there is no magic cure-all. Physical therapy is often useful to develop strength and flexibility to help prevent future injury and compensate for current discomfort through specially designed exercises and techniques. Occupational therapy is similar, but specifically designed to manage everyday activities that have become difficult or impossible because of the rotator cuff injury. 
9. Arthroscopic Surgery: An arthroscope is a tiny camera used for surgical repairs. Similar to a laparoscopic surgery, very small incisions are made for tools and the arthroscope. This provides the benefits of surgical recovery with relatively minimal pain and a faster recovery time. 
10. Rotator Cuff Degeneration: Rotator cuff injuries can go unnoticed for years before they become progressed sufficiently to cause noticeable pain. Without treatment, serious injuries to the area can eventually result in rotator cuff degeneration. Age decreases the plasticity and strength of the musculoskeletal system, increasing the likelihood of degenerative changes, such as the detachment of tendons. This can cause serious shoulder dysfunctions—although the initial degeneration may not be especially problematic, it increases the likelihood of future injuries that can be especially damaging.