Rotator Cuff Injury

A rotator cuff injury is a common musculoskeletal condition that affects the shoulder, causing pain and limiting movement. Rotator cuff injuries can result from acute trauma, such as lifting a heavy object or falling, or from chronic overuse, commonly seen in activities involving repetitive movements. Untreated injuries can lead to persistent pain, reduced mobility, and further complications.

Suffering from a rotator cuff injury? Consult our rotator cuff specialist for an accurate diagnosis & personalised treatment plan today.

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Dr Dennis Ng Zhaowen
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Causes of Rotator Cuff Injury

Several factors can cause acute or degenerative rotator cuff injury. Understanding these causes aids in preventing and managing the injury.

Acute Injuries

Acute injuries occur suddenly due to a specific event or trauma. Common causes include:

  • Lifting Heavy Objects: Attempting to lift heavy objects, especially with improper technique, can strain or tear the rotator cuff tendons.
  • Falls: Falling onto an outstretched arm or directly on the shoulder can result in a sudden tear or strain.
  • Sudden Movements: Quick, forceful movements, such as those experienced during sports activities or accidents, can lead to acute injuries. This includes throwing a ball, swinging a racket, or lifting heavy weights.
Degenerative Injuries

Degenerative injuries develop over time due to gradual wear and tear on the tendons. Factors contributing to degenerative injuries include:

  • Repetitive Stress: Repetitive overhead activities, such as those involved in certain sports like baseball, tennis, and swimming or occupations like painting or carpentry, can wear down the rotator cuff over time.
  • Ageing: As people age, the tendons of the rotator cuff naturally degenerate and become more susceptible to injury. The blood supply to the tendons decreases with age, which impairs the body’s ability to repair minor injuries.
  • Bone Spurs: Bone spurs, which are bony growths that can form on the edges of bones, particularly in the shoulder, can rub against the rotator cuff tendons and cause damage over time.
  • Poor Posture: Chronic poor posture, such as rounded shoulders or forward head posture, can place additional stress on the rotator cuff tendons, leading to injury.

Symptoms of Rotator Cuff Injury

Rotator cuff injury symptoms must be identified for prompt diagnosis and treatment. While symptoms vary by injury severity and type, common signs include:

  • Shoulder Pain
    This happens during specific movements, such as lifting or reaching, and can also be present at rest. It often causes shoulder pain at night due to resting on the shoulder, disrupting sleep and leading to further discomfort. Pain may also radiate from the shoulder down the arm, making it difficult to locate the injury.
  • Limited Movement
    Rotator cuff injuries can cause shoulder stiffness, limiting arm movement. People with rotator cuff injuries often struggle with movements that require reaching behind the back, such as fastening a bra or tucking in a shirt.
  • Clicking or Popping Sounds
    Some people may hear or feel clicking or popping sounds when moving their shoulders. These sounds can indicate tendon damage or impingement within the shoulder joint.
  • Swelling and Tenderness
    Swelling around the shoulder joint can occur due to inflammation or fluid buildup in response to the injury. The shoulder may be tender to the touch, especially when the tendons are damaged or inflamed.

Diagnosis of Rotator Cuff Injury

Diagnosing rotator cuff injuries requires a medical history, physical examination, and imaging. This helps determine injury severity and suitable treatment for patients.

Medical History

The shoulder specialist starts by obtaining a thorough medical history before diagnosing. This includes asking about the patient’s symptoms, when they first appeared, and any activities that might have caused or worsened the pain. The shoulder specialist will also ask about past shoulder injuries or conditions that could be relevant to the current issue.

Physical Examination

During the physical examination, the shoulder specialist will assess the shoulder’s range of motion by asking the patient to move the arm in various directions. Resistance workouts will be used to test the shoulder and arm muscles’ strength and find any weak spots. The shoulder specialist will also feel for tenderness in certain parts of the shoulder to figure out exactly where the pain is.

Imaging Tests

Imaging tests are used to provide a clearer view of the structures inside the shoulder. Common imaging tests include:

  • X-rays: While X-rays do not show tendons, they can reveal bone spurs or other bone issues that might be causing symptoms.
  • Ultrasound: This test uses sound waves to create images of the soft tissues in the shoulder, helping to identify tears or inflammation.
  • Magnetic Resonance Imaging (MRI): MRI scans provide detailed images of both bones and soft tissues, making it easier to see the extent of tendon damage or tears.

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Treatment Options for Rotator Cuff Injury

Rotator cuff injuries are treated according to severity, age, activity level, and health. Treatment options include non-surgical and surgical.

Non-Surgical Treatment

Non-surgical treatments are often effective for mild to moderate rotator cuff injuries and are typically the first line of treatment. Among these treatments are:

  • Physical Therapy: Patients follow a tailored exercise program to improve shoulder flexibility, strength, and range of motion. Manual therapy techniques, such as massage or joint mobilisation, may also be used to relieve pain and improve function.
  • Medications: Various medications can help manage the symptoms of rotator cuff injuries. Over-the-counter pain relievers like ibuprofen or acetaminophen can reduce pain and inflammation.
  • Ice and Heat Therapy: Applying ice packs to the shoulder can help reduce inflammation and numb the pain, while using heat packs can relax and loosen tissues and stimulate blood flow to the area.
  • Steroid Injections: Corticosteroid injections may be recommended to reduce inflammation and pain. These injections are typically administered directly into the shoulder joint or the surrounding area, and they work by reducing inflammation, which in turn alleviates pain and swelling.
Surgical Treatment

Surgical treatment may be needed if non-surgical treatments are ineffective or if the rotator cuff injury is severe.

  • Arthroscopic Rotator Cuff Repair: Arthroscopic surgery is a minimally invasive procedure that involves making small incisions and using a tiny camera (arthroscope) to guide the surgery. This procedure typically has a shorter recovery time. Torn tendons are reattached to the bone during arthroscopic surgery using sutures or anchors.
  • Open Surgery: Open surgery is sometimes required for large or complex tears. This traditional method involves a larger incision to repair the damaged tendons. In cases where the rotator cuff tendons are too damaged to be repaired, a tendon transfer may be performed. This involves using a nearby tendon to replace the damaged one.
  • Shoulder Replacement Surgery: Shoulder replacement surgery may be considered in severe rotator cuff damage cases. This procedure involves replacing the damaged parts of the shoulder with artificial components.

Rehabilitation and Recovery

Rotator cuff injuries require rehabilitation and recuperation. Shoulder therapy reduces discomfort, restores strength and flexibility, and prevents further injury.

  • Early Recovery Phase - During the initial phase of recovery, the focus is on reducing pain and inflammation. This may involve rest, ice application, and taking prescribed medications. Gentle stretching exercises may be introduced to maintain a range of motion without putting too much strain on the injured shoulder.
  • Intermediate Recovery Phase - As pain and inflammation decrease, rehabilitation will include more active exercises. Physical therapy becomes more intensive, focusing on strengthening the muscles around the shoulder and improving flexibility. Exercises are tailored to the person’s condition and recovery progress. This phase may include the use of resistance bands, light weights, and specific stretching routines designed to improve shoulder stability and function.
  • Progressive Recovery Phase - The progressive recovery phase focuses on shoulder strength and function. This includes more challenging exercises that stimulate daily tasks or sports movements. The patient and shoulder specialist will work together to perform exercises safely. The patient will gradually resume normal activities, avoiding movements that could lead to re-injury.
  • Monitoring and Follow-Up - Regular follow-up appointments with the shoulder specialist are important to monitor progress and make any adjustments needed to the rehabilitation program. This ensures that recovery is on track and addresses any issues that may arise during rehabilitation.

Prevention Strategies

Rotator cuff injuries can be prevented by avoiding shoulder muscle and tendon injuries. These techniques help all activity levels, especially those who lift heavy objects.

  • Exercise Regularly and Use Proper Techniques
    Daily shoulder-strengthening exercises like shoulder rotations, arm raises, and resistance band workouts enhance joint support and stability, reducing injury risk. Additionally, always use proper techniques in activities, such as lifting objects by bending at the knees and maintaining correct form in sports, to avoid unnecessary shoulder stress.
  • Warm-Up and Stretching
    Before engaging in physical activities, warming up and stretching the shoulder muscles is important. A proper warm-up increases blood flow to the muscles and prepares them for the activity while stretching improves flexibility and lowers their risk of strains and tears.
  • Limit Repetitive Stress
    Limiting repetitive stress on the shoulder is key to preventing injuries. This can be as simple as switching up your work to prevent always using the same muscles, taking regular pauses from jobs requiring repeated shoulder motions, and utilising technologies that make some tasks easier.
  • Maintain a Healthy Lifestyle
    Maintaining a healthy lifestyle, including a balanced diet and avoiding smoking, can also contribute to the prevention of rotator cuff injuries. A healthy diet supports muscle and tendon health, while quitting smoking improves blood flow and healing capacity in the body.
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Our Patients' Feedback

Learn what our patients have to say about our treatments and services.

Jeremy Teo
Jeremy Teo
2024-05-16
I tore my left pec muscle after a bench press accident and had the fortune of getting help from Dr Dennis. He is a very caring and helpful individual that you can tell wants the best healing progress for you and actively follows up with you sincerely. I initially had a two month delay and misdiagnosis at Ktph and it caused my tendon to retract. Should have went to Dr Dennis from the start.. 5/5
Emily Loo
Emily Loo
2024-05-16
I felt that doctor Dennis is very experienced and he skilfully aligned my fractured toe after my accident so that I didn’t need to do a minor surgery. He was friendly and professional and I felt his fees were reasonable without additional overselling of tests, supplements etc. that I have experienced elsewhere. Overall it was a smooth and effective experience and I would highly recommend doctor Dennis.
Ming W
Ming W
2024-04-20
Wonderful experience with Dr. Dennis and his team. The staff were attentive and efficient. Dr. Dennis is professional, caring and knowledgeable. I had a shoulder injury and knee injury that required surgery. The whole journey, including pre and post surgery, Dr. Dennis and his team made sure I received the best treatment possible. Really thankful for the team and I definitely will recommend this place to others.
Jermy Tan
Jermy Tan
2024-04-02
Saw Dr Dennis for my lumbar slipped disc. Great doctor and he explained clearly the different options available. Went with surgery and have been recovering well since then.
Amanda Seah
Amanda Seah
2024-03-02
I came in with a shoulder injury that meds from a GP did not relieve one month ago. Dr Dennis and his team were great in diagnosing the exact injury with an mri, and he prescribed physio. My shoulder condition has greatly improved and I can now move my arm almost completely! Thank you Dr Dennis!
Jaslyn HENG (Kenrick)
Jaslyn HENG (Kenrick)
2024-02-19
A very friendly and nice doctor who manage to cure my elbow issue whjch has been bothering me for more than 6 months! Thank you Doctor Dennis!
Xianmin Jiang
Xianmin Jiang
2024-02-07
I had severe left shoulder pain due to exercise. After MRI checking , it was shown high-grade tendon tearing. Dr Dennis did the surgery for my left should calf repair. After surgery, I strictly follow what he suggested. The recovery was really amazing and fast. I was curious about what happened to my shoulder, he explained in details and with great patience. Now, I am fully recovered in a very fast speed and come back to my loved sports and exercises. I definitely recommend Dr Dennis for his profession, patience and delicate skills. Last not the least, thank for his medical team. The nurses are always prompt to reply when I need help and message them.
Omar Lechuga
Omar Lechuga
2023-12-27
Dr. Dennis helped me with an elbow pinch coming from a trauma. His attention to detail confidence and great empathy really helped me to fully recover. Thank you Dr. Dennis.
Benjamin Mah
Benjamin Mah
2023-12-09
Dr Dennis has been helpful in the diagnosis and explanation of my injury

Dr Dennis Ng Zhaowen
Mount Elizabeth Novena Specialist Centre
38 Irrawaddy Road #08-41,Singapore 329563

Dr Dennis Ng Zhaowen

  • Senior Consultant Orthopaedic Specialist
MBBS (Singapore)
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MRCSEd
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MMED
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FRCSEdOrth (Gold Medal Award)

Before private practice, Dr Dennis Ng was the former Deputy Head of the Shoulder & Elbow Division and Sports Knee Division in National University Hospital.

He completed his fellowship at the prestigious Fowler Kennedy Sports Medicine Centre in London, Ontario, Canada, and has rich experience treating professional athletes and returning them to sports. 

Special Areas of interests include keyhole and reconstructive procedures of the shoulder and elbow. 

Common procedures include frozen shoulder release, rotator cuff repair, SLAP/Labrum repair, shoulder stabilization, tennis elbow release etc.

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    Visit Us Today

    Mount Elizabeth Novena Specialist Centre

    38 Irrawaddy Road #08-41
    Singapore 329563

    Monday – Friday: 9am – 1pm; 2pm – 5pm
    Saturday: 9am – 1pm
    Sunday & PH: CLOSED

    Other Clinic Location

    Gleneagles Medical Center

    6 Napier Road #07-15
    Singapore 258499

    Monday – Friday: 9am – 1pm; 2pm – 5pm
    Saturday: 9am – 1pm
    Sunday & PH: CLOSED

    Frequently Asked Questions (FAQs)

    Can a rotator cuff injury recur after treatment?

    Yes, there is a possibility of recurrence, especially if the original injury was not fully healed or if preventive measures are not followed. Strengthening the shoulder muscles, avoiding repetitive stress, and following your physical therapist’s recommendations can reduce the risk of recurrence.

    What types of exercises can help prevent rotator cuff injuries?

    Exercises that strengthen the rotator cuff muscles and improve shoulder flexibility can help prevent injuries. These include shoulder rotations, arm raises, and resistance band exercises. It is important to perform these exercises properly and under the guidance of a physical therapist if possible.

    What are the potential complications of untreated rotator cuff injuries?

    Untreated rotator cuff injuries can lead to chronic pain, persistent weakness, and reduced shoulder mobility. Over time, this can result in further degeneration of the tendons, making the injury more difficult to treat and potentially leading to permanent loss of shoulder function.

    What should I do if my rotator cuff injury symptoms worsen?

    If your symptoms worsen, it’s important to contact a shoulder specialist. Your treatment plan may need to be adjusted and your condition reexamined. Ignoring symptoms that get worse can result in more serious issues.

    +65 9751 1486