What is a rotator cuff injury?
The rotator cuff comprises 4 muscles that run from the shoulder blade to the ball of the shoulder and they play a crucial role in fine control of the shoulder.
Rotator cuff injuries are quite common and can occur at any age. The younger population is more likely to injure the rotator cuff through trauma or overhead activities such as throwing, tennis or volleyball. The aging population is more likely to injure from overuse, often related to weakness and degradation of the tendon tissue in the shoulder as we age.
Diagnosis
Correct diagnosis of rotator cuff pathology is important. Injury will range from short term overload to the tendon through to chronic tendinopathy and weakness of the tendon or a frank tendon Management will differ considerably based on which sort of injury has occurred. There is a battery of tests your physio can perform and features from your history which are important to consider ensuring your management is guided in the correct direction.
Symptoms
Those with rotator cuff tendon injuries often present with:
- Shoulder pain and/or weakness
- Limited range of movement
- Pain that is often worse at night
- Aggravated by:
- Lifting, pushing or pulling
- Overhead activity/movements
- Lying on the side
- Reaching behind the back
Rotator cuff tendon tears often present with:
- Marked lack of shoulder range
- Sudden, moment in time onset of pain.
- May ache at rest
Management
With all cuff injuries, an initial degree of offload to the tissue is required, however the length and degree of offload varies considerably depending on the degree of change to the tendon tissue involved.
Following an appropriate period of offload for the injury that you have sustained, rotator cuff injuries generally respond well to a graduated loading program of strength exercises. As research around the shoulder progresses, it is becoming more common that these injuries are managed conservatively rather than surgically, other than in the case of quite large tendon tears.
It is also necessary to address postural or biomechanical issues to ensure adequate mobility and loading of the muscles around the shoulder joint.
