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The Hidden Culprit of Shoulder Pain: Rotator Cuff Injuries

Updated: Sep 6, 2023

Rotator Cuff is a term which is often raised when referring to many shoulder injuries. So, what is the rotator cuff and why is it important?


Rotator Cuff Muscles

The rotator cuff is a group of four muscles located in the shoulder: supraspinatus, infraspinatus, subscapularis and teres minor. They attach to areas of the shoulder blade (scapula) and humerus. The shoulder joint has many different planes of movement which allows us to do everyday tasks.



Whilst the rotator cuff muscles each have individual functions; they act together to give the shoulder dynamic stability. Dynamic stability refers to the ability of the shoulder joint to stay stable whilst moving through different ranges, for example, when reaching for a mug from a high shelf. The rotator cuff muscles also help to internally and externally rotate, and lift the arm away from the body.


Rotator Cuff Muscle Injury

One of the most common shoulder injuries which people present with is “Rotator Cuff-Related Pain” (RCRP). There are various causes of RCRP, such as, weakness, overloading the muscles or instability. There are various causes of RCRP, such as weakness, overloading the muscles or instability. Rotator Cuff muscle injury can occur due to trauma or overuse in repetitive motions. Chronic tears can also develop gradually in older people.


Symptoms of Rotator Cuff Related Pain

The presentation of Rotator Cuff Muscle Injury can be variable but may include:


· Pain in the shoulder or upper arm, which may be dull or sharp and worsen with movement

· Weakness in the shoulder, making it difficult to lift or move the arm

· Stiffness or limited range of motion in the shoulder joint

· Popping or clicking when moving the shoulder

· Shoulder tenderness

· Difficulty sleeping due to shoulder pain


Some of the above symptoms can overlap with other diagnoses, such as labral tears, bursitis, and frozen shoulder, so it is important to seek the assessment from a medical professional.


Management of Rotator Cuff-Related Pain

In the early stages of Rotator Cuff-Related Pain, patients should avoid activities which significantly aggravate the shoulder. This can include overhead movements or forceful rotation.

Depending on the cause of the Rotator Cuff-Related Pain, your physiotherapist may suggest strengthening, neuromuscular control, range of movement or stability exercises. Some deep tissue massage or taping can also be utilized to improve pain and movement. Ultimately, your rehabilitation will be dependent on your individual presentation, as well as your goals.


Should I be getting a corticosteroid injection?

This is a conversation we often have with patients. Evidence shows that these injections have associated risks and very variable results depending on the individual. Furthermore, these injections only provide temporary relief. A 2018 study showed that patients with corticosteroid injections were associated with a higher risk of rupture compared to those without the injections. It is often routine care to trial exercise before opting for injections.


Rotator Cuff injuries are very commonly seen at our South Melbourne clinic, and can be rehabilitated to reduce future risk of injury. If you have a shoulder injury, seek health professional guidance early.


References

Flury et al. (2018). High failure rate of corticosteroid injections for rotator cuff tears. American Journal of Sports Medicine, 46(2), 471-476. doi: 10.1177/0363546517745537


Hall, A., Coppieters, M. W., Dufour, S. P., McMeeken, J. M., & Rivett, D. A. (2021). Conservative interventions for rotator cuff-related shoulder pain: A systematic review and meta-analysis. Journal of Orthopaedic & Sports Physical Therapy, 51(5), 238-253. https://doi.org/10.2519/jospt.2021.10004


Oh et al. (2016). The efficacy and safety of corticosteroid injection for rotator cuff disease: A systematic review and meta-analysis. Journal of Bone and Joint Surgery, 98(15), 1253-1265. doi: 10.2106/JBJS.15.01042

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