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Dr. Shiel received a Bachelor of Science degree with honors from the University of Notre Dame. There he was involved in research in radiation biology and received the Huisking Scholarship. After graduating from St. Louis University School of Medicine, he completed his Internal Medicine residency and Rheumatology fellowship at the University of California, Irvine. He is board-certified in Internal Medicine and Rheumatology.
The rotator cuff is the group of four tendons that stabilize the shoulder joint. The tendons hook up to the four muscles that move the shoulder in various directions.
There are four muscles whose tendons form the rotator cuff: the subscapularis muscle, which moves the arm by turning it inward (internal rotation); the supraspinatus muscle, which is responsible for elevating the arm and moving it away from the body; the infraspinatus muscle, which assists the lifting of the arm during turning the arm outward (external rotation); and the teres minor muscle, which also helps in the outward turning of the arm.
Rotator cuff disease is damage to the rotator cuff from any cause. This condition is one of the most common causes of shoulder pain.
The rotator cuff can be injured because of degeneration with aging or inflammation due to tendinitis, bursitis, or arthritis of the shoulder. The rotator cuff is commonly injured by trauma (such as from falling and injuring the shoulder or overuse in sports). Rotator cuff injury is particularly common in people who perform repetitive overhead motions that can stress the rotator cuff. These motions are frequently associated with muscle fatigue.
The most common symptom of rotator cuff disease is shoulder pain. The pain is often noticed gradually and may be first noticed even a day after the actual event which may have caused the injury. Sometimes, a sudden pain occurs during a sport activity. The pain is usually located to the front and side of the shoulder and is increased when the shoulder is moved away from the body. The pain is usually noted to be more intense at nighttime and sometimes increases when lying on the affected shoulder. The pain can diminish and result in a frozen shoulder. There can also be tenderness in the area of the inflamed tendons of the injured rotator cuff.
People with rotator cuff disease usually find it difficult to lift the arm away from the body fully. If the rotator cuff disease involves severe tears of the rotator cuff tendons, it can be impossible for the patient to hold the arm up because of pain.
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