By Yana Dellavedova, Physiotherapist
Rotator Cuff Injuries - How to diagnose, treat and prevent further injuries:
Shoulder pain - something that nobody wants to experience. Unfortunately, life requires us to use your shoulders and arms for activities every day. Picking up your children, combing your hair, putting those heavy files away in the cabinet, and before you know it - pain. What could this possibly be? Well read further to find out and put a stop to your pain.
What is THE ROTATOR CUFF?
I’m sure that we’ve all heard the term “rotator cuff” thrown around at least once when someone is talking about or referring to any type of shoulder pain, but what does it actually mean?
Well, there are actually 4 muscles that make up the rotator cuff muscles:
- Subscapularis muscle
- Supraspinatus muscle
- Infraspinatus muscle
- Teres minor muscle
WHY ARE THE ROTATOR CUFF MUSCLES SO IMPORTANT?
The shoulder joint is a very mobile joint and allows for us to move in very large ranges (think about how you can lift your arm right to the top, all the way to the side and still rotate it internally and externally. So many planes of motion! As great as this sounds, extra mobility comes with a catch - less stability.
That’s where our rotator cuff muscles come into play - the main role of the rotator cuff muscles, and the reason why they’re so important and often talked about, is that they stabilise the humeral head within the glenoid cavity, and therefore stabilise the ball-and-socket joint.
The rotator cuff muscles are also responsible for abducting (lifting sideways) the shoulder, as well as externally and internally rotating it.
The main role of the rotator cuff muscles, and the reason why they’re so important and often talked about, is that they stabilise the humeral head within the glenoid cavity, and therefore stabilise the ball-and-socket joint.
This is important because the shoulder has less stability than other joints in order to allow for a greater range of motion that can be achieved.
ROTATOR CUFF INJURIES
The rotator cuff muscles are used in almost every movement of the shoulder, making it pretty understandable injuries are relatively common. Rotator cuff injuries can also affect people of any age (the risk actually increases with age) and background, not only sports people.
Rotator cuff injuries can be complex, as there are 4 possible muscles where the injury can happen, and there are different types of injury that can happen. The most common types being:
- Rotator cuff tear.
- Rotator cuff impingement.
- Rotator cuff tendinitis (acute inflammation of the tendon).
- Rotator cuff tendinopathy (chronic inflammation).
- Bursitis (when the bursa sitting between the rotator cuff tendon and bone becomes inflamed).
WHAT CAUSES ROTATOR CUFF INJURIES?
There are many things which can cause an injury to occur to the rotator cuff muscles. Some studies suggest that genetics could play a role, and there are many other factors which can contribute to getting the injury, however there are 2 main causes:
- Overuse
This will often result in tendinitis, but can also cause rotator cuff tears, especially in sports such as tennis. Overuse is also more than just athletes over-training, and commonly also happens in people who work with their arms (especially in overhead positions) and lift heavy loads such as teachers, mechanics, engineers, gardeners etc.
- Trauma
This includes sports accidents, falls, car accidents and much more. The trauma can cause a rotator cuff tear.
WHAT CAUSES ROTATOR CUFF INJURIES?
Listed below are the most common signs and symptoms of rotator cuff injury, but it is important to note that the symptoms can vary greatly between individuals, which is why it’s so important to go to a qualified physiotherapist if you suspect that you may have an injury to your rotator cuff muscles.
- Pain
Usually in the shoulder joint that can refer down to the arm. Often described as a deep ache. It is also important to note that some people do not experience pain.
- Decreased range of motion (usually due to the pain and not stiffness)
Difficulty with movements such as putting on a jacket, reaching up to get things from high shelves, combing your hair.
- Pain at night
- Feeling of weakness
How to diagnose a rotator cuff injury?
If you have any of the symptoms listed above, it’s important to make an appointment with a physiotherapist who can help diagnose and treat you, as the symptoms above are also common for many other shoulder pathologies.
It is also important for us to clear other areas (we would need to assess your cervical spine to make sure the pain isn’t referred from your neck) and pathologies such as thoracic outlet syndrome and adhesive capsulitis.
This is achieved by doing a full assessment of your history, your general health and your daily activities, followed by evaluating your strength, range of motion and muscular control.
We also have many special tests that we can make use of which helps direct us to a possible diagnosis.
Diagnostic ultrasound and MRI are also ways in which we can determine a final diagnosis.
Treatment of Rotator Cuff Injuries:
Conservative treatment and physiotherapy for rotator cuff injuries is very successful and we have seen many patients return to their full working and sporting activities. Surgery is seldom needed and is only recommended for very serious rotator cuff injuries.
At first, our goal of treatment will be to help you manage the pain. This is achieved by activity modification, gentle movement exercises, thermal therapy (ice or heat) and electrotherapy such as TENS.
Physiotherapy for rotator cuff injuries will then include exercises to strengthen, improve and restore control and range of motion of the shoulder. This will be done alongside hands-on therapy such as mobilisations and electrotherapy.
The final stages of your rehabilitation and physiotherapy will focus on fine-tuning the specifics needed to get you back to doing what you love.
Prevention of Rotator Cuff Injuries:
During the rehabilitation of your shoulder, we will give you exercises to do at home and to continue doing once you are fully recovered in order to prevent re-injury.
Prevention of rotator cuff injury includes:
- Strengthening exercises
- Range of motion exercises
- Stability and control exercises
- Getting adequate rest
Think you have a rotator cuff injury? Make your appointment now so that you can get back to doing what you love.
How can we help you?
At Melbourne Sports Physiotherapy our goal is to get you moving pain free as soon as possible.
But, we also want you to actually move better and live a healthier, more active and fulfilling life!
If your sports, fitness training or work has been wearing your body down, book in with one of our expert massage therapists so we can help you reduce your pain or stiffness.
If you are showing some signs of this condition or simply want help prevent this from happening in the future then book in with one of our highly experienced Remedial Massage Therapists today!
You can make an appointment by calling or booking online.
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