Everything you Need to Know about Rotator Cuff Injuries

Shoulder injuries are COMMON! 

Many people have heard about the Rotator Cuff as important part of our shoulder’s function but aren’t quite sure why it’s so important and furthermore why it gets injured so often!

What is the Rotator Cuff?

The rotator cuff is comprised of 4 muscles that work together to assist the shoulder with different movements of the shoulder. The 4 muscles are the: supraspinatus, infraspinatus, teres minor, and subscapularis.

So just why is the Rotator Cuff so important for shoulder function?

The shoulder joint is often referred to as a “ball and socket” joint. More accurately it should be referred to as a “ball and saucer” joint. The shallowness of this joint gives the shoulder the greatest mobility of ANY joint in the human body. The downside is that it requires more control from the supporting muscles to prevent injury. While the rotator cuff does assist in moving the shoulder, one of its most important functions is to act almost like a suction cup to hold the joint in a good position while the larger muscles around the shoulder provide the greatest amount of force for movement. Imagine now if you had some sort of problem with your rotator cuff causing an imbalanced or insufficient “suction”. This is where the injuries start! Difficulty in providing good balance to your shoulder’s range of motion can result in faulty movement patterns causing shoulder impingement, bursitis, and tendonitis.

 What are some risk factors for Rotator Cuff injury:

• Age: As you get older, your risk of a rotator cuff injury increases. Rotator cuff tears are most common in people older than 40.
• Certain sports: Athletes, who regularly use repetitive arm motions, such as baseball pitchers, archers and tennis players, have a greater risk of having a rotator cuff injury.
• Construction jobs: Occupations such as carpentry or house painting require repetitive arm motions, often overhead, that can damage the rotator cuff over time.
• Posture and ergonomics: Sitting in a prolonged poor posture or having a bad work set-up can cause a muscle imbalance in the rotator cuff; which leads to some of the muscles to becoming weak, and others tight. 
• Family history: There may be a genetic component involved with rotator cuff injuries as they appear to occur more commonly in certain families.

Types of injuries that can affect your Rotator Cuff

Tendonitis: inflammation of the tendonitis which is usually the result of an acute trauma or overuse

Calcific Tendonitis: Small calcium deposits can form within the tendon (can be “silent” or painful)

Tears:

1-Partial thickness, which can be on the undersurface or the top surface of the tendon.

2-Full thickness, which is a tear that extends fully through the tendon

What can be done to help if I have a rotator cuff injury?

Depending on when and how the onset of you injury occurred, your treatment may vary. In the acute phase of an injury you generally want to implement a period of modified rest. That is, maintain activities that do not aggravate your symptoms, but avoid total avoidance of any use of your shoulder. Range of motion exercises, to reduce the chance for shoulder impingement and to allow for normal shoulder ROM, are important to do during this period.  Finally, strengthening exercises to restore strength and muscle balance to your shoulder.

Your physiotherapist can help you determine when and how to safely implement these different interventions.

What if I was told I have a tear in my Rotator Cuff? Do I need surgery?

Not all tears require surgery. Many people can have tears that are painless; however the fact that they have a tear could lead them to be susceptible to injury. If someone with an asymptomatic tear takes on a heavier or more repetitive task than they are accustomed to, that could cause that area of the tendon to become inflamed (tendonitis).

Your first line of defense, if you know you have a tear, should be conservative management. This means sticking to a well-rounded rehabilitative strengthening and mobility routine which is specific to your needs. These would include a variety of strengthening and ROM exercises that you can incorporate on a regular basis to keep the supporting muscles strong and your shoulder moving as well as possible to avoid impingement and proper shoulder mechanics.

Chris Burke – Registered Physiotherapist