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Rotator Cuff Contusions of the Shoulder in Professional Football Players

Epidemiology and Magnetic Resonance Imaging Findings

Steven B. Cohen, MD^*, Jeffrey D. Towers, MD and James P. Bradley, MD^,

From the ^* Rothman Institute Orthopaedics, Thomas Jefferson University, Philadelphia, Pennsylvania, the Departments of Musculoskeletal Radiology and Orthopaedics, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, and Burke & Bradley Orthopedics, Pittsburgh, Pennsylvania

Address correspondence to James P. Bradley, MD, Burke & Bradley Orthopedics, 200 Medical Arts Building, 200 Delafield Road, Suite 4010, Pittsburgh, PA 15215 (e-mail: bradleyjp{at}upmc.edu).

Background: No published reports have studied the epidemiology and magnetic resonance imaging findings associated with rotator cuff contusions of the shoulder in professional football players.

Purpose: To determine a single professional football team’s incidence, treatment, and magnetic resonance imaging appearance of players sustaining rotator cuff contusions of the shoulder.

Study Design: Case series; Level of evidence, 4.

Methods: From 1999 to 2005, a North American professional football team’s injury records were retrospectively reviewed for athletes who had sustained a rotator cuff contusion of the shoulder during in-season participation. Those patients who had magnetic resonance imaging of the shoulder with a 1.5-Tesla magnet were reviewed by a musculoskeletal radiologist and graded according to the appearance and severity of clinical injury.

Results: Twenty-six players had a rotator cuff contusion. There was an average of 5.5 rotator cuff contusions per season (47% of all shoulder injuries). The predominant mechanism of injury was a direct blow in 70.3%. Magnetic resonance imaging findings included peritendon edema at the myotendinous junction, critical zone tendon edema, and subentheseal bone bruises. Treatment consisted of a protocol involving modalities and cuff rehabilitation in all patients. Six patients had persistent pain and weakness for a minimum of 3 days and were given a subacromial corticosteroid injection. Overall, 3 patients (11.4%) required later surgical treatment on the shoulder.

Conclusion: Rotator cuff contusions accounted for nearly half of all shoulder injuries in the football players in this study. Magnetic resonance imaging is an extremely useful tool in determining severity of injury and integrity of the rotator cuff. The majority of athletes are able to return to sports with conservative treatment; a minority of shoulders might progress to more severe injuries such as rotator cuff tears.

Key Words: rotator cuff contusion • magnetic resonance imaging • contact athletes • epidemiology