Rotator Cuff Syndrome
What is your Rotator Cuff?
Rotator cuff syndrome is a prevalent shoulder injury. Your shoulder joint is a relatively unstable ball and socket joint that is moved and controlled by a small group of four muscles known as the rotator cuff.
The subscapularis, supraspinatus, infraspinatus and teres minor are your small rotator cuff muscles. These muscles stabilise and control your shoulder movement on your shoulder blade (scapula). As the name suggests, the rotator cuff muscles are responsible for shoulder rotation and form a cuff around the head of the humerus (shoulder ball).
Rotator Cuff Injury
Your rotator cuff muscles and tendons are vulnerable to rotator cuff tears, rotator cuff tendonitis and rotator cuff impingement and related rotator cuff injuries.
Rotator cuff injuries vary from mild tendon inflammation (rotator cuff tendonitis), shoulder bursitis (inflamed bursa), and calcific tendinopathy (bone-forming within the rotator cuff tendon). More significant injuries include partial and full-thickness rotator cuff tears, which may require rotator cuff surgery.
Some shoulder rotator cuff injuries are more common than others.
- Shoulder Impingement
- Shoulder Tendinopathy
- Shoulder Bursitis (a fluid-filled sac that provides a cushion between a bone and tissues)
- Calcific Tendonitis
- Rotator Cuff Tear
- Bicipital Tendinopathy
Where are your Rotator Cuff Muscles?
Your rotator cuff muscles hold your arm (humerus) onto your shoulder blade (scapula). Most of the rotator cuff tendons hide under the bony point of your shoulder (acromion), which as well as protecting your rotator cuff can also impinge on your rotator cuff structures.
What Causes a Rotator Cuff Injury?
Your rotator cuff tendons protect themselves, from simple knocks and bumps, by overlaying bones (mainly the acromion).
In between the rotator cuff tendons and the bony arch is the subacromial bursa (a lubricating sack), which helps to protect the tendons from touching the bone and provide a smooth surface for the tendons to glide over.
However, nothing is fool-proof. Any of these structures can be injured – whether they be your bones, muscles, tendons, ligaments or bursas.
Rotator cuff impingement syndrome is a condition where your rotator cuff tendons are intermittently trapped and compressed during shoulder movements. Impingement causes injury to the shoulder tendons and bursa, resulting in painful shoulder movements.
What are the Symptoms of Rotator Cuff Injury?
While each specific rotator cuff injury has its particular symptoms and signs, you can suspect a rotator cuff injury if you have:
- an arc of shoulder pain or clicking when your arm is at shoulder height or when your arm is overhead.
- Shoulder pain that can extend from the top of your shoulder to your elbow.
- Shoulder pain when lying on your sore shoulder.
- Shoulder pain at rest (with more severe rotator cuff injuries).
- Shoulder muscle weakness or pain when attempting to reach or lift.
- Shoulder pain when putting your hand behind your back or head.
- Shoulder pain reaching for a seat-belt.
How is a Rotator Cuff Injury Diagnosed?
Your physiotherapist or sports doctor will suspect a rotator cuff injury based on your clinical history and the findings from a series of clinical tests.
A diagnostic ultrasound scan is the most accurate method to diagnose the specific rotator cuff injury pathology. MRI’s may show a rotator cuff injury but can miss them. X-rays are of little diagnostic value when a rotator cuff injury is suspected.
How to Treat a Rotator Cuff Injury?
Once you suspect a rotator cuff injury, it is crucial to confirm the exact type of your rotator cuff injury since treatment does vary depending on the specific or combination of rotator cuff injuries.
Your rotator cuff is an essential group of control and stability muscles that maintain “centralisation” of your shoulder joint. In other words, it keeps the shoulder ball centred over the small socket. This centralisation prevents injuries such as impingement, subluxations and dislocations.
We also know that your rotator cuff provides subtle glides and slides off the ball joint on the socket to allow full shoulder movement. Plus, your shoulder blade (scapula) has a vital role as the main dynamically stable base plate that attaches your arm to your chest wall.
Researchers have concluded that there are mostly seven stages that need to be covered to rehabilitate these injuries and prevent recurrence effectively.
- Early Injury Protection: Pain Relief & Anti-inflammatory Tips
- Regain Full Range of Motion
- Restore Scapular Control
- Restore Normal Neck-Scapulo-Thoracic-Shoulder Function
- Restore Rotator Cuff Strength
- Restore High Speed, Power, Proprioception & Agility
- Return to Sport or Work
For more specific advice about your rotator cuff injury, please contact your PhysioWorks physiotherapist.
More Information about Rotator Cuff Injury
What is Impingement Zone?
What Causes Rotator Cuff Impingement?
Your PhysioWorks physiotherapist is an expert in the assessment and correction of shoulder rotator cuff injuries. Any deficiencies that they detect during your assessment will be an essential component of your rehabilitation.
Your physiotherapist will be able to guide you in the appropriate treatment and exercises for your rotator cuff injury after their thorough assessment.
Common Shoulder Pain & Injury Conditions
- Rotator Cuff Syndrome
- Shoulder Tendinopathy
- Rotator Cuff Calcific Tendinopathy
- Rotator Cuff Tear
- Bicep Tendinopathy
- Shoulder Impingement
- Swimmer's Shoulder
- Shoulder Dislocation (Instability)
- Subacromial Decompression
- Shoulder Arthroscopy
- Rotator Cuff Repair
- SLAP Repair
- Biceps Tenodesis
- Biceps Tenotomy
- Total Shoulder Replacement
Researchers have discovered that managing your shoulder injury with physiotherapy is usually successful. Typically, you have two options: non-operative or a surgical approach. Your condition will dictate which option is best for you at this time. Non-operative care is conservative rehabilitation.
If shoulder surgery is required, then your physiotherapist may undertake:
- Pre-operative rehabilitation - to either try a non-operative treatment approach or to condition and prepare your body for a surgical procedure.
- Post-operative physiotherapy - to safely and methodically regain your normal range of movement, strength, speed and function.
PhysioWorks physiotherapists have a special interest and an excellent working relationship with leading shoulder surgeons. Our physiotherapy team provide you with both conservative and post-operative shoulder rehabilitation options. We aim for you attaining the best possible outcome for your shoulder injury.