Facts

• The rotator cup is also known as the rotator cuff. The cup has grouped four tendons to give the shoulder stability. Each tendon is attached to a separate muscle, allowing the shoulder to move in different directions.
  
  

Cause of Injury and Pain

• The four muscles are prone to injury due to the location and movement they possess. Common injuries of the rotator cup are tendonitis, tears and impingement. Tendonitis is a condition also known as bursitis. The injury occurs when the bursa, a fluid balloon for cushion, becomes inflamed. Tears occur in the rotator cup due to an extreme cases of tendonitis, causing the tendons to wear out and tear. Shoulder impingement generally is caused by instability or dislocation where the shoulder pops out of the joint. Often impingement is sports related, while in some cases people have loose joints, making the injury easy to occur.
  
  

Symptoms

• The symptoms vary based on the cause and type of injury. Tendonitis is typically at the top of the shoulder and becomes worse with activity when the shoulder is raised. Tears in the rotator cup have similar symptoms to tendonitis. In cases where the tear is sudden due to lifting or exertion, a burst of pain will radiate the area. The shoulder will feel stiff and weak when a tear exists. The symptoms of shoulder impingement are felt immediately, as the shoulder will make a "pop" sound followed by pain. The shoulder pop is a dislocation that usually goes right back into the joint.
  
  

Diagosis

• A physician will diagnose a rotator cup injury based on pain symptoms. An injured rotator cup will show weakness when raised overhead. A final diagnosis is determined through an MRI, which shows images of the shoulder tissues. An X-ray or arthrogram may be conducted first; however there are limitations to the amount of information given from these tests.
  
  

Treatment

• Strengthening rotator cup muscles works to build stability in the shoulder and prevent injury. This treatment is recommended once the pain is gone. A tendonitis injury is treated by limiting activity to the shoulder area. Anti-inflammatory drugs may be prescribed, along with cold packs to the area. For mild tears, the treatment is the same as tendonitis. More severe tears may require surgery to repair. Rotator cup tears often are treated with physical therapy where a specialist works to strengthen the muscles and improve the motion of the shoulder and rotator cup. An impinged rotator cup requires strengthening to prevent future dislocation. If the tendons become stretched to the point they no longer prevent the shoulder from dislocating, surgery is the only treatment option available.