Rotator Cuff Injury: Background, Epidemiology

Shoulder pain is the third most common reason for seeking a doctor’s help in Australia. Severe long term shoulder pain can have a huge impact on your range of motion and your ability to engage in various physical activities.
Background
Rotator Cuff is a group of muscle systems and tendons that gives firm support to your shoulder joint and the upper arm bone. The rotator cuff muscles associated with the rotator cuff helps in dynamic stabilization and movement of the shoulder joint to adjust its position with the scapula and the humeral head during a shoulder movement. Rotator Cuff muscles help in 600 to 1300 shoulder elevation and are widely responsible for your shoulder movement. Rotator Cuff injuries can be of various types, the most common ones being associated with the rotator cuff muscles:
  • Superior Subscapularis and Supraspinatus tears
  • Supraspinatus, Infraspinatus and Subscapularis tears
  • Supraspinatus and Infraspinatus tears, and
  • Supraspinatus, Infraspinatus and Teres Minor Tear
These rotator cuff tears can range from a diameter of 1cm to 4cm massive tears. While partial tears are caused by frayed or damaged tendons, complete tears affect both the tendons and the shoulder bones.
While younger individuals experience shoulder related problems due to repetitive usage of the rotator cuff muscles, aged people experience a gradual growing shoulder pain without a predisposed history of any traumatic injury.
Epidemiology
One of the most astonishing facts about rotator cuff injury is that, despite of being one of the leading causes of shoulder related disability, the pathogenesis of this condition still remains unknown. Traumatic injuries, atraumatic injuries, micro traumas and other secondary dysfunction are responsible for rotator cuff tears.
If a sudden force is applied while pushing or pulling an object, you may get traumatic rotator cuff injuries. Traumatic injuries can also be caused by falling or projecting excessive strain on an outstretched hand. On the other hand, atraumatic rotator cuff injuries are caused due to natural ageing and excessive repetitive motions. Tears can also be caused by repetitive overhead activity and heavy lifting.
Some other abnormal factors that can make you more prone to shoulder related problems include factors such as smoking, frozen shoulder (or, that which is caused by inflammation of the joint capsule), thyroid and other hormone related gynaecologic diseases, type 1 diabetes mellitus and other autoimmune related pathologies.
Ignoring rotator cuff injuries may lead to permanent weakness and stiffness of your shoulder and can slowly result in progressive degeneration of your shoulder joint. So it is best to see an orthopaedic surgeon at the earliest if you have a lingering shoulder pain that doesn’t go away.
In a recent survey, it was found that about 1% of adults who are more than 45 years, report a fresh incidence of shoulder pain every year. As reported by medical practitioners, shoulder related problems amount to 12% of their patients per week. The major reason for shoulder related problem is its overuse. Overall, there are about 36% cases related to shoulder pain in Australia, with a higher frequency in the females. Out of these, 70% cases are related to rotator cuff injuries, with 65% of these, specifically being rotator cuff lesions.
About 81% of these problems are managed by using diversified techniques and various soft tissues strategies. Rehabilitation strategies are also used by 89% of the practitioners.

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