Rotator Cuff Injuries

Most commonly, rotator cuff injuries are associated with situations of overuse in athletes such as swimmers and tennis players. However, this is also a common injury in car accidents. In the case of athletes, the injury to the rotator cuff is a slow, progressive injury. In car accidents, the impact causes a sudden tear of the tendon, usually requiring surgery to repair.



It is important to understand the workings of the shoulder to grasp the depth of the injury. The rotator cuff is comprised of four muscles that attach to the shoulder joint or humeral head just behind the shoulder blade. These muscles are attached by a tough piece of tissue called a tendon. Combined, these muscles allow the shoulder to have its great range of motion. Notably, the shoulder has the widest range of motion of any joint in the body. However, when these tendons become inflamed or torn, the ability to move the shoulder becomes severely restrained.



The force of a car accident, especially when combined with certain movements of the body, is enough to completely tear these tendons. The most likely incident to cause a rotator cuff tear is a rear-ended crash. In this case, a vehicle strikes yours from behind with little or no anticipation. If you do see it coming, you might check your rear-view mirror and see the car approaching too quickly. The natural reaction is then to brace yourself against the steering wheel. This combination of twisting and bracing plus the impact of the other car is perfect for damaging the rotator cuff. Another series of events that sometimes injures the rotator cuff is a rear-end collision where the victim's car is spun off to the side. The driver tries to recover control and stay on the road, overstressing the shoulder muscles.



Symptoms of an acute, complete tear of the rotator cuff are usually immediate and severe. Although there are exceptions, typically within 24 to 48 hours there is sharp pain in the shoulder and arm. This is accompanied by a reduced range of motion, especially in the inability to lift the arm over the head. Most patients complain of sleeping problems due to the pressure applied to the shoulder while lying in bed. Symptoms of non-acute rotator cuff injuries are more gradual, however similar pain is felt.



There are a variety of treatment methods for rotator cuff injuries. Surgery is not always the right option, but is usually recommended in cases of acute tears. Most doctors recommend trying a conservative (non-surgical) treatment option first to see if the injury will heal on its own. These include resting, medication, icing, and physical therapy exercises. These treatments, though, may not restore full strength or range of motion. Surgery can provide a more complete recovery, but it may not be as effective if it is delayed significantly. It is best to discuss all of your options with your physician before beginning a treatment plan.





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