Rotator Cuff Injury

Key Features

• Shoulder injuries are often a consequence of repetitive overuse and tissue failure

• Rotator cuff tendonitis and bursitis are the most commonly observed rotator cuff injuries in youth sports

• Rotator cuff tears in children and adolescents are exceedingly rare

• These overuse injuries typically occur in sports requiring repetitive overhead motions

  • Muscle imbalances and injury can cause the position of the humeral head to be abnormal, which may cause entrapment of the supraspinatus tendon under the acromial arch

  • Patients with nontraumatic shoulder instability due to ligamentous and capsular laxity (also known as multidirectional instability) are prone to overuse rotator cuff injury

Clinical Findings

• Injury can be acute or chronic

• Pain is described as diffuse or anterior and lateral

• Overhead activities exacerbate the pain

Diagnosis

• Diagnostic workup includes plain radiographs and an outlet view to look for anatomic variability

Treatment

• Rehabilitation of this injury is geared toward reduction of inflammation, improved flexibility, and core stabilization and strengthening of the scapular stabilizers and rotator cuff muscles

• A biomechanics evaluation can assist athletes in the recovery process by building sport-specific skills and eliminating substitution patterns

• Surgery is rarely indicated