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  - 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.

Acute Injury Signs

Acute Injury Management.

Here are some warning signs that you have an injury. While some injuries are immediately evident, others can creep up slowly and progressively get worse. If you don't pay attention to both types of injuries, chronic problems can develop.

For detailed information on specific injuries, check out the injury by body part section.

Don't Ignore these Injury Warning Signs

Joint Pain

Joint pain, particularly in the knee, ankle, elbow, and wrist joints, should never be ignored. Because these joints are not covered by muscle, pain here is rarely of muscular origin. Joint pain that lasts more than 48 hours requires a professional diagnosis.

Tenderness

If you can elicit pain at a specific point in a bone, muscle, or joint, you may have a significant injury by pressing your finger into it. If the same spot on the other side of the body does not produce the same pain, you should probably see your health professional.  

Swelling

Nearly all sports or musculoskeletal injuries cause swelling. Swelling is usually quite obvious and can be seen, but occasionally you may feel as though something is swollen or "full" even though it looks normal. Swelling usually goes along with pain, redness and heat.

Reduced Range of Motion

If the swelling isn't obvious, you can usually find it by checking for a reduced range of motion in a joint. If there is significant swelling within a joint, you will lose range of motion. Compare one side of the body with the other to identify major differences. If there are any, you probably have an injury that needs attention.

Weakness

Compare sides for weakness by performing the same task. One way to tell is to lift the same weight with the right and left sides and look at the result. Or try to place body weight on one leg and then the other. A difference in your ability to support your weight is another suggestion of an injury that requires attention.

Immediate Injury Treatment: Step-by-Step Guidelines

  • Stop the activity immediately.
  • Wrap the injured part in a compression bandage.
  • Apply ice to the injured part (use a bag of crushed ice or a bag of frozen vegetables).
  • Elevate the injured part to reduce swelling.
  • Consult your health practitioner for a proper diagnosis of any serious injury.
  • Rehabilitate your injury under professional guidance.
  • Seek a second opinion if you are not improving.