What is your Rotator Cuff?
Rotator cuff syndrome is very common 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 stabilise and control your shoulder movement on your shoulder blade (scapula).
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).
What Rotator Cuff Injuries are Common?
Your rotator cuff muscles and tendons are vulnerable to rotator cuff tears, rotator cuff tendonitis and rotator cuff impingement and related rotator cuff injuries.
Rotator cuff injuries vary from mild tendon inflammation ( rotator cuff tendonitis), shoulder bursitis (inflammed bursa), calcific tendonitis (bone forming within the rotator cuff tendon) through to partial and full thickness rotator cuff tears, which may require rotator cuff surgery.
Some shoulder rotator cuff injuries are more common than others.
- Rotator Cuff Impingement
- Rotator Cuff Tendonitis / Tendinopathies
- Shoulder Bursitis (fluid-filled sac that provides a cushion between a bone and tissues)
- Calcific Tendonitis
- Rotator Cuff Tears
- Bicipital Tendonitis
Where are your Rotator Cuff Muscles?
Your rotator cuff muscles hold your arm (humerus) onto your shoulder blade (scapula). Most the the rotator cuff tendons are hidden under the bony point of your shoulder (acromion), which as well as protecting your rotator cuff can also impinge into your rotator cuff structures.
What Causes a Rotator Cuff Injury?
Your rotator cuff tendons are protected from simple knocks and bumps by bones (mainly the acromion) and ligaments that form a protective arch over the top of your shoulder.
In between the rotator cuff tendons and the bony arch is the subacromial bursa (a lubricating sack), which helps to protect the tendons from touching the bone and provide a smooth surface for the tendons to glide over.
However, nothing is fool-proof. Any of these structures can be injured - whether they be your bones, muscles, tendons, ligaments or bursas.
Rotator cuff impingement syndrome is a condition where your rotator cuff tendons are intermittently trapped and compressed during shoulder movements This causes injury to the shoulder tendons and bursa resulting in painful shoulder movements.
What are the Symptoms of Rotator Cuff Injury?
While each specific rotator cuff injury has its own specific symptoms and signs, you can suspect a rotator cuff injury if you have:
- an arc of shoulder pain or clicking when your arm is at shoulder height or when your arm is overhead.
- shoulder pain that can extend from the top of your shoulder to your elbow.
- shoulder pain when lying on your sore shoulder.
- shoulder pain at rest (in more severe rotator cuff injuries).
- shoulder muscle weakness or pain when attempting to reach or lift.
- shoulder pain when putting your hand behind your back or head.
- shoulder pain reaching for a seat-belt.
How is a Rotator Cuff Injury Diagnosed?
Your physiotherapist or sports doctor will suspect a rotator cuff injury based on your clinical history and the findings from a series of clinical tests.
A diagnostic ultrasound scan is the most accurate method to diagnose the specific rotator cuff injury pathology. MRI’s may show a rotator cuff injury but have also been known to miss them. X-rays are of little diagnostic value when a rotator cuff injury is suspected.
How to Treat a Rotator Cuff Injury?
Once you suspect a rotator cuff injury, it is important to confirm the exact type of your rotator cuff injury since treatment does vary depending on the specific or combination of rotator cuff injuries.
Your rotator cuff is an important group of control and stability muscles that maintain “centralisation” of your shoulder joint. In other words, it keeps the shoulder ball centred over the small socket. This prevents injuries such as impingement, subluxations and dislocations.
We also know that your rotator cuff provides subtle glides and slides of the ball joint on the socket to allow full shoulder movement. Plus, your shoulder blade (scapula) has a vital role as the main dynamically stable base plate that attaches your arm to your chest wall.
Researchers have concluded that there are essentially 7 stages that need to be covered to effectively rehabilitate these injuries and prevent recurrence.
- Early Injury Protection: Pain Relief & Anti-inflammatory Tips
- Regain Full Range of Motion
- Restore Scapular Control
- Restore Normal Neck-Scapulo-Thoracic-Shoulder Function
- Restore Rotator Cuff Strength
- Restore High Speed, Power, Proprioception & Agility
- Return to Sport or Work
This article originally appeared on physioworks.com.au and was written by Sam Moyle