Rotator cuff tears are a very common type of 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 subscapularis, supraspinatus, infraspinatus and teres minor are your small rotator cuff muscles that wrap around the ball of the ball and socket and try to stabilise and control the movement of the ball in the small, shallow socket. As the name suggests, the rotator cuff muscles are responsible for shoulder rotation and form a cuff around the head of the humerus (shoulder ball).
Why do rotator cuff get injured?
All the extra mobility the shoulder gains from its design can lead to the rotator cuff being easily injured as it works constantly to stabilise the joint.
There are tears with lifting or falls and also rotator cuff tendonitis with overuse. Sometimes both conditions co-exist. Younger or older people may get these injuries – there are just normally different reasons why each age group would get injured.
In athletes with rotator cuff problems, the athlete often complains of pain with overhead activity such as throwing, swimming and overhead shots in racquet sports, and there is often tenderness on the outside of the shoulder. Activities performed at less than shoulder height are usually pain-free.
In older patients, the tendons can get weaker and more brittle over the years and there can be an accumulation of micro-damage from everyday activities that can result in sudden injury such as a rotator cuff tear with even minor trauma like a fall.
Supraspinatus is the most commonly injured cuff tendon. Bursitis and Shoulder Impingement is frequently associated with these injuries because of friction between cuff tendons and bone which can increase pain.
What can I do for my rotator cuff tear?
Leading Edge Physiotherapists are experts in the management of all shoulder injuries, but particularly rotator cuffs. Treatment often involves avoidance of the aggravating activities, local daily application of ice (15 minutes) and soft tissue muscle releases. The use of anti-inflammatories, either topical (i.e. Voltaren gel) or medication (i.e. as prescribed by your local doctor) will improve the healing rate of the tendons.
For effective and long lasting relief of symptoms, the rotator cuff muscles need to be strengthened and the underlying muscle imbalances needs to be corrected. These exercises need to be specifically designed for you by a Leading Edge physiotherapist and will involve the use of special elastic exercise bands (theraband) and weights. Strengthening these muscles can take several weeks to achieve and will need to be monitored and progressed over this time until a successful outcome is achieved.
My shoulder hurts, what should I do right now?
To help your injury resolve as fast as possible:
Avoid or modify activities and positions, which cause your pain. Recovery is easier if you stop irritating the shoulder.
Rest your arm on a pillow when sitting for prolonged periods
Use ice packs for 15 – 20 minutes regularly
Hug a pillow or rest your arm on a pillow during the night.