Shoulder pain can be more than just an inconvenience—it may signal a rotator cuff injury. Whether you’re an athlete, have a physically demanding job, or experience pain from everyday activities, understanding the diagnostic process is key to effective treatment. In this guide, we’ll walk you through the exact steps doctors take to diagnose rotator cuff injuries, from symptoms to imaging.
Recognizing Rotator Cuff Injury Symptoms
Before seeing a doctor, it’s important to identify common symptoms of a rotator cuff injury, including:
- Persistent shoulder pain, especially at night or when lifting your arm
- Weakness in the shoulder, making it difficult to lift objects
- Clicking or popping sounds when moving your shoulder
- Limited range of motion, such as trouble reaching behind your back
- Pain that worsens at night, a characteristic sign of a rotator cuff issue
If these symptoms sound familiar, it’s time to see a doctor for a professional evaluation and diagnosis.
What to Expect at Your Doctor’s Visit
1. Medical History
Your doctor will start by asking:
- When did the pain start?
- Was there a specific injury, or did it develop over time?
- What activities make it worse—exercise or rest?
- Have you had any past shoulder injuries?
- How is it affecting daily life (lifting, dressing, driving)?
Your answers help determine whether it’s a strain, tendonitis, or a partial/full tear.
2. Physical Examination
Next, your doctor will perform key shoulder movement tests to assess strength, flexibility, and pain response. These include:
- Drop Arm Test: Raising and slowly lowering your arm. If it drops suddenly, it may indicate a tear.
- Empty Can Test: Holding your arm up as if pouring from a can. Pain suggests a supraspinatus tendon issue.
- Hawkins-Kennedy Test: Rotating the arm internally to check for impingement syndrome.
- External Rotation Resistance Test: Testing the infraspinatus muscle for weakness.
These tests help determine whether the rotator cuff is inflamed or torn.
Imaging Tests: Do You Need an X-Ray, Ultrasound, or MRI?
Imaging helps confirm a rotator cuff injury. Here’s what doctors use:
- X-Ray: First-line imaging to rule out arthritis or bone injuries. Not effective for soft tissue damage.
- Ultrasound: A quick, non-invasive office procedure that detects tears and inflammation in real time.
- MRI: Provides the most detailed view of soft tissues, confirming full-thickness tears, labrum damage, and bone issues.
Most of the time, a diagnostic ultrasound is enough for an accurate rotator cuff injury diagnosis. However, your doctor must be skilled in performing ultrasound for reliable results.
Common Misconceptions About Rotator Cuff Injuries
- Does shoulder pain always mean a full tear? No. Even minor injuries can cause significant pain.
- Do all rotator cuff injuries require surgery? No. Most cases improve with physical therapy and regenerative medicine.
- Is an MRI always needed? No. Ultrasound and a proper physical exam are often sufficient.
How Long Does Diagnosis Take?
If you’re seeing a specialist, your history, physical exam, and ultrasound can typically be completed within 45 minutes, with immediate ultrasound results.
Why Early Diagnosis Matters
Ignoring shoulder pain can worsen injuries over time, delaying recovery. If you’re experiencing persistent pain, consult a specialist early for an accurate diagnosis and the right treatment plan.
Watch the full video for expert insights on diagnosing rotator cuff injuries.
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