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Shoulder and Elbow - Rotator Cuff Injuries

Shoulder and Elbow - Rotator Cuff Injuries: What is it, Causes, Symptoms and More | Singapore General Hospital

Shoulder and Elbow - Rotator Cuff Injuries - What it is

The rotator cuff comprises a group of 4 muscles that function to stabilise and move our shoulders. Though the rotator cuff muscles are extremely important structures in the shoulder, they are also prone to tears and weakening.

A rotator cuff injury, which is fairly common, involves any type of irritation or damage to your rotator cuff muscles or tendons. The risk of injury increases with age, and is particularly common in middle-aged persons.

Shoulder and Elbow - Rotator Cuff Injuries - Symptoms

Symptoms of Rotator Cuff Injuries Singapore General HospitalIn many people with underlying rotator cuff injury, they can often have no pain or limitation of motion though they can have inflammation or early injury to their rotator cuff resulting from degeneration with chronic overuse from repeated usage. These patients often present only after an injury, like a fall which causes a tear in the already injured rotator cuff.

When there is a tear in the rotator cuff , the most common symptom is pain in the shoulder especially when lifting the arm. Pain may be experienced when you reach up to comb the hair, or bend the arm back to wear a piece of clothing.

You can also experience weakness, and tenderness in the shoulder and pain when sleeping on affected arm. The shoulder can also experience a loss of range of motion. With a large tear, there can be continuous pain and muscle weakness.

In cases of a complete tear of the rotator cuff, there is likelihood that you may completely be unable to lift the arm.

Shoulder and Elbow - Rotator Cuff Injuries - How to prevent?

Shoulder and Elbow - Rotator Cuff Injuries - Causes and Risk Factors

Causes of rotator cuff injury


Normal wear and tear

As the tendon of the rotator cuff has poor blood supply, it tends to be prone to degeneration due to ageing. The degeneration can be aggravated by repetitive shoulder movements. Hence this condition typically occurs if you are above 40.

Repetitive movements

Athletes who regularly use overhead repetitive movements such as swimmers, rowers or tennis players are at higher risk of rotator cuff injuries. However, the injury can also happen through seemingly trivial activities like carrying a heavy load, lifting things overhead or hanging the clothes out.

Trauma

The rotator cuff can also be damaged from a single traumatic injury such as a fall or a hard direct hit to the arm.

Heavy lifting or pulling

Lifting or pulling an object that is too heavy or lifting in the wrong way can cause the strain or a tear to the rotator cuff muscle or tendon.

Poor posture

Slouching forward of the head and neck can cause the muscle or tendon to be pinched leading to inflammation.

Shoulder and Elbow - Rotator Cuff Injuries - Diagnosis

Shoulder and Elbow - Rotator Cuff Injuries - Treatments

Minimally invasive surgery (MIS) involves using advanced techniques to make smaller surgical incisions, thereby leading to less post-surgery pain, shorter hospital stay and faster recovery from surgery. SGH Orthopaedics provides a comprehensive suite of MIS procedures to help our patients get back on their feet, covering surgeries involving the spine, shoulder, knee, hip, foot and ankle and sports-related injuries.

Common shoulder or joint injuries that we encounter include rotator cuff tears, shoulder impingement syndrome, shoulder instability, knee ligament and meniscal injuries, shoulder and knee cartilage wear, shoulder, knee and other sports injuries

Shoulder arthroscopy

is a form of MIS which involves the use of small keyhole incisions in the skin to perform surgery on a wide spectrum of shoulder conditions which previously were treated with open surgery. It has revolutionized the surgical treatment of shoulder conditions, allowing patients of all ages to return to an active and healthy lifestyle through faster and better recovery following surgery. Many patients are discharged home on the day of surgery. Patients benefit by having shorter recovery times, less post-surgical pain and better outcomes, thereby allowing for a return to a good quality of life.

Arthroscopic Superior Capsular Reconstruction

is a MIS procedure which involves placing a sheet of dermal graft into the shoulder joint through keyhole incisions to reconstruct the overlying shoulder capsule and improve shoulder function in patients with massive rotator cuff tears, obviating the need for shoulder replacement surgery in many of them. This procedure was introduced in the last 2 years and SGH is among the first hospitals in Asia to perform it. 

This treatment, like other MIS procedures, results in less post-surgery pain and faster recovery from surgery. In this instance, it allows patients an earlier return to improved shoulder function and quality of life through improving strength and reducing pain about the shoulder. It may be done as an outpatient procedure. It is available in other hospitals in Singapore.


Other recent advances in shoulder arthroscopy include joint preservation and restoration aimed at preventing or delaying the need for shoulder replacement surgery. SGH Orthopaedics also leads the region in other innovative orthopaedic treatments like hip and knee joint preservation, robotic surgery, enhanced recovery after surgery and the use of biologics, and is looking at AI, 3D printing, telemedicine, wearable technologies and other innovations to further enhance care of our patients.


Tips Include:


  • Always listen to your body: Refrain from aggravating activities if the shoulder hurts, and seek medical advice if the pain persists.
  • Always warm up before doing sports: Exercising cold muscles before doing overhead or throwing sports may lead to shoulder injuries. 
  • Always perform exercises in a stepwise manner: When working out in the gym, step up the exercises in a gradual manner, beginning with light weights before progressing to the heavy ones. This will allow the muscles to adapt and prevent injuries.
  • Avoid day-today activities involving carrying heavy loads above your shoulder or from overhead down: Doing so may lead to rotator cuff injuries, particularly in people above the age of 40 when rotator cuff degeneration has set it. Modify these activities eg by placing commonly used heavy items lower on the shelf, or standing on a stable platform to reach for heavy items.

Shoulder and Elbow - Rotator Cuff Injuries - Preparing for surgery

Shoulder and Elbow - Rotator Cuff Injuries - Post-surgery care

Shoulder and Elbow - Rotator Cuff Injuries - Other Information

The information provided is not intended as medical advice. Terms of use. Information provided by SingHealth

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