Rotator Cuff Injury -
Pain arising around your shoulder can originate from your rotator cuff tendons. Your rotator cuff is made of four muscles and their tendons that surround the shoulder joint. They provide stability to your shoulder helping keep the head of your humerus (upper arm bone) in the shallow shoulder joint socket. The muscles originate on the scapula (shoulder blade) and connect to the head of the humerus creating a cuff around the joint.
There are four muscles: infraspinatus, supraspinatus, teres minor and subscapularis. Much like a stable core allows you to create movement and improve your function; a well functioning rotator cuff creates stability allowing full shoulder motion and improves the ability to produce and distribute force.
The rotator cuff muscles originate on the scapula creating a very important relationship between the two. The scapula and muscles supporting the scapula form the foundation upon which the rotator cuff works. It is important that both elements are addressed when managing shoulder pain and dysfunction.
There are many pain sensitive structures in the shoulder region, as well as many reasons why one structure such as the rotator cuff may be causing pain. Rotator cuff injuries often occur due to overuse and repeated overhead activities. However, some rotator cuff tears occur due to one acute incident.
There are three distinct rotator cuff injuries that may occur. The causes of each injury have similarities, however will differ in their pain presentation and management strategies.
1. Rotator cuff impingement - the space in the shoulder where the tendons run is very small. Anything that impacts on this space can increase the pressure and friction on the tendon causing impingement.
2. Rotator cuff tears - these can be caused by overuse and repeated friction causing a degenerative tear or can occur in one acute incident where the load is too great for the tendon and it fails.
3. Rotator cuff tendinitis (tendinopathy) - another overuse injury of the rotator cuff where it is worked beyond its capacity.
If you have injured your shoulder it is important to get professional advice. Early activity has been shown to decrease pain, swelling and stiffness and can help preserve joint mobility. It is important that maintaining activity is done within the limits of pain. Avoiding provocative and repetitive activities in the early stages whilst preserving as much range of motion and strength as possible.
Rotator cuff injury rehabilitation has stages. At each stage there are goals, however the exercises, advice and management vary for each individual.
Early stage rehab - the goal is to reduce pain and inflammation whilst restoring normal range of motion.
Intermediate stage rehab - progression strengthening program with focus on the scapula as well as the rotator cuff.
Late stage rehab - the focus is on advanced strengthening and endurance, dynamic movements and stabilisation.
Rotator cuff injuries are common and with targeted management they recover well.