Rotator cuff injury
Rotator cuff problems
The rotator cuff is a group of muscles and tendons that attach to the bones of the shoulder joint, allowing the shoulder to move and keeping it stable.
Rotator cuff tendinitis refers to irritation of these tendons and inflammation of the bursa (a normally smooth layer) lining these tendons. A rotator cuff tear occurs when one of the tendons is torn from the bone from overuse or injury
Each one of these muscles is part of the rotator cuff and plays an important role:
- Supraspinatus. This holds your humerus in place and keeps your upper arm stable. And helps lift your arm.
- Infraspinatus. This is the main muscle that lets you rotate and extend your shoulder.
- Teres Minor. This is the smallest rotator cuff muscle. Its main job is to assist with rotation of the arm away from the body.
- Subscapularis. This holds your upper arm bone to your shoulder blade and helps you rotate your arm, hold it straight out and lower it.
Both surgical and nonsurgical treatments are available when a person tears their rotator cuff.
Types of rotator cuff injury
There are a number of conditions that can affect your rotator cuff. The main ones are listed below.
- Rotator cuff tear. This is when one or more of the muscles and tendons that make up your rotator cuff tear. You can have a partial tear or a full-thickness tear. Tears can develop after an injury or if you dislocate your shoulder. Small tears can also develop in the tendon after general wear and tear over a long period of time.
- Tendinopathy. This is when you have pain in and around the tendons of your rotator cuff because they are no longer able to repair themselves properly. It’s usually because of wear
- Tendinopathy refers to pain and weakness, most commonly experienced with movements of the shoulder as a consequence of excessive load on the rotator cuff tissues”.
You can also have a combination of wear and tear with an injury, which is why shoulder injuries or pain can become more common over the age of 40.
Signs and symptoms
- Pain over the top of the shoulder and arm, pain can descend down the outside of the arm all the way to the elbow
- Difficulty lifting the arm up overhead or difficulty with activities such as reaching, getting dressed, or carrying objects
- A clicking or grating sound when you move your shoulder
Treatment options for rotator cuff injury
Most rotator cuff tears can be treated without surgery. In fact, only a small minority of patients end up undergoing surgical treatment for a rotator cuff tear.2
Non-operative rotator cuff treatments may include:
- Physical therapy for the rotator cuff
- Anti-Inflammatory medications
- Cortisone injections
Nonsurgical treatment should be attempted and most every situation of a rotator cuff injury. If nonsurgical treatments do not adequately alleviate symptoms or allow for normal function of the shoulder, then a surgical solution may be considered.
How can physiotherapy help?
- Reducing pain and muscle tension in the scapular and neck area in order to promote the motility of the scapula.
- Improving the wrong humeral head position in order to restore scapulo-humeral mobility.
- Regain proprioception and movement automatism by neuromotor rehabilitation
Physiotherapists will prescribe therapy exercises to stretch and strengthen the muscles around the shoulder and can help reduce the demands on the injured rotator cuff.