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Swimming, throwing a ball and heavy lifting are among activities that can lead to a rotator cuff injury. The problem is stress placed on the joint by these activities. The muscles and tendons of the rotator cuff can also be torn by a fall onto the shoulder or arm.

The shoulder is a ball-and-socket joint with a wide range of motion. Because of this mobility, the shoulder can also be very unstable. The "rotator cuff" is actually a group of four muscles that help stabilize the shoulder joint. These muscles hold the ball-shaped top of the upper arm bone (humerus) in the socket-like area known as the glenoid. A rotator cuff injury occurs when the muscles and tendons, which connect muscle to bone, become overstretched or torn.

How Injury Occurs
The muscles and tendons of the rotator cuff can tear due to a fall onto the shoulder or onto an outstretched hand, or by slow wearing from repeated overhead arm movements, such as throwing a ball or swimming. Heavy lifting at home or at work can also overstress the shoulder joint.

Symptoms
A torn rotator cuff commonly causes weakness and pain in the shoulder. Arm movement may be uncomfortable and limited. Surprisingly, some patients with rotator cuff injuries have few symptoms.

Diagnosis
Your doctor will ask questions about your symptoms and the history of the condition, and will conduct a physical examination of the shoulder and upper arm. X-rays may be obtained to view the joint and rule out the possibility of broken bones. An MRI (magnetic resonance imaging) and arthrogram may be used to take a more in-depth look at your shoulder and surrounding soft tissues.

Treatment
Conservative treatment usually includes a period of rest and immobilization for the affected shoulder. Anti-inflammatory medications are useful for decreasing pain and swelling. Ice packs can also be applied to the area 3 to 4 times per day for 15 to 20 minutes until swelling disappears. Your doctor may have you participate in a rehabilitation program guided by a physical and/or occupational therapist. The goal of rehabilitation is to restore function in your shoulder and help you return to regular activities.

Surgery may be recommended if the tear is large, if the patient is young and very active or if the tear causes continued weakness or pain. Repairing damaged tissues helps restore function and reduce pain. A period of rest and rehabilitation will follow the surgery.

Long-term Outlook
Your recovery will depend on your age, overall health, the extent of the injury and the treatment recommended by your doctor. A mild injury may require just a few weeks to regain strength and flexibility. Patients who undergo surgery usually need approximately 6 to 8 months for complete recovery. Follow your rehabilitation program as closely as possible to promote healing and prevent re-injury.