Rotator Cuff Syndrome

Rotator Cuff Syndrome

Article by John Miller

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 subscapularissupraspinatusinfraspinatus 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 humerus’s head (shoulder ball).

Rotator Cuff Injury

Your rotator cuff muscles and tendons are vulnerable to rotator cuff tears, rotator cuff tendonitis, 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.

These include:

Where are your Rotator Cuff Muscles?

rotator cuff syndrome

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 protects the tendons from touching the bone and provides a smooth surface that your tendon glides 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 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 your rotator cuff injury’s exact type 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 the “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 entire 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 a recurrence effectively.

These are:

  • 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 Rotator Cuff Impingement Syndrome?

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 examination 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

Adhesive Capsulitis

Shoulder Bursitis

Shoulder Instability

Acromioclavicular Joint

Bone Injuries

Post-Operative Physiotherapy

Muscle Conditions

Systemic Conditions

Referred Pain

Shoulder Treatment

Researchers have discovered that managing your shoulder injury with physiotherapy is usually successful. Typically, you have two options: a 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 trial a non-operative/conservative treatment approach or condition and prepare your shoulder and body for a surgical procedure.

Post-operative physiotherapy will safely regain your normal range of movement, strength and function.

PhysioWorks physiotherapists have a particular 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 to attain the best possible outcome for your shoulder injury.

For specific information regarding your shoulder, please consult your trusted shoulder physiotherapist.

Arm Pain Causes

Arm pain and injuries are widespread. Arm pain can occur as a result of either sudden, traumatic or repetitive overuse. The causes can be related to sports injuries, work injuries or simply everyday arm use.

Arm pain can be a local injury, musculoskeletal injury or could even be referred from nerves in your neck (cervical radiculopathy). This can result in neck-arm pain.

Causes of Arm Pain by Region

Causes of Arm Pain by Structure

Neck-Related Arm Pain

Shoulder-Related Arm Pain

Elbow-Related Arm Pain

Wrist-Related Arm Pain

Hand-Related Arm Pain

Muscle-Related Arm Pain

Other Sources of Arm Pain

Common Causes of Arm Pain

The most common sources of arm pain include shoulder painwrist pain and elbow pain.

Referred Arm Pain

As mentioned earlier, arm pain can be referred to from another source. Cervical radiculopathy is a common source of referred arm pain. Cervical radiculopathy will not respond to treatment where you feel the arm pain. However, it will respond positively to treatment at the source of the injury (e.g. your neck joints).

Professional assessment from a health practitioner skilled in diagnosing both spinal-origin and local-origin (muscle and joint) injuries (e.g. your physiotherapist) is recommended to ensure an accurate diagnosis and prompt treatment directed at the arm pain source.

Arm Pain has Diverse Causes.

The causes of your arm pain can be extensive and varied. Due to this diversity, your arm pain should be assessed by a suitably qualified health practitioner to attain an accurate diagnosis, treatment plan and implementation specific to your arm pain.

What Arm Pain is Associated with a Heart Attack?

Left-arm pain can be an early sign of a life-threatening cardiac issue. Based on this, a professional medical assessment that involves an accurate history, symptom analysis, physical examination and diagnostic tests to exclude a potential heart attack is important to exclude this potentially life-threatening source of arm pain.

For more information, please consult with your health practitioner, call an ambulance on 000, or visit a hospital emergency department to put your mind at ease.

Good News. Most Arm Pain is NOT Life-Threatening.

Luckily, life-threatening arm pain is far less likely than a local musculoskeletal injury. Arm pain caused by a localised arm muscle, tendon or joint injury should be assessed and confirmed by your health practitioner before commencing treatment.

Arm Pain Prognosis

The good news is that arm pain, and injury will normally respond very favourably to medical or physiotherapy intervention when early professional assessment and treatment is sought. Please do not delay in consulting your healthcare practitioner if you experience arm pain.

Common Arm Pain Treatments

With accurate assessment and early treatment, most arm injuries respond extremely quickly to physiotherapy or medical care, allowing you to resume pain-free and normal activities of daily living quickly.

Please ask your physiotherapist for their professional treatment advice.