Rotator Cuff INJURIES
Rotator Cuff injuries can be grouped into traumatic injuries, whereby you may have had a fall on the shoulder and degenerative injuries, which we will focus on below.
CAUSES AND SYMPTOMS
Degenerative rotator cuff injuries are commonly age related, mostly occurring after the age of 40 and become increasingly more prominent as people age. Degeneration is often due to overuse and repetitive actions of the shoulder over many years. This is common in people who have participated in overhead sports such as tennis or swimming. It is also common in people who have occupations requiring repetitive overhead actions such as builders.
Over time, small tears in the rotator cuff muscles can occur, leading to weakness and functional issues. If the condition is not treated these small tears can lead to bigger tears becoming more problematic as time goes on. It can also lead to shoulder impingement, a painful condition whereby the tendons of the rotator cuff become impinged as they pass through the shoulder joint, causing limited movement and pain when lifting your arm.
Shoulder pain from a rotator cuff injury typically presents as pain over the lateral aspect of the shoulder (deltoid). The pain can radiate down to the elbow and will be felt as more of an ache. You may also experience pain at night so it is important to avoid sleeping on the affected side. Shoulder weakness and loss of range of movement are a factor. Reaching behind you or washing your hair may now be very difficult and painful.
Treatment for Rotator Cuff Dysfunction and Injury
If you are experiencing shoulder pain the first thing to do is to have it assessed by your myotherapist. The assessment will typically include range of movement and specific functional tests. Further diagnostic tests may be required, including x-ray, MRI or ultrasound.
Initial treatment is to decrease the pain and increase your range of movement.
- Pain relief - Ice, rest and possibly NSAIDS (anti-inflammatory medication). Seek your doctors advice prior to taking any medication. Avoiding aggravating activities including overhead lifting and sleeping on the affected side are good starting points.
- Restoring pain free range of movement - Myotherapy treatment of the surrounding muscles (deep tissue massage, dry needling, joint mobilisations) can help restore range of movement along with specific range of movement exercises.
- Strength - Strength training is imperative for the recovery of many shoulder injuries, especially tendon injuries. A targeted and specific strength program will be part of your treatment plan.
The role of exercise in treating degenerative rotator cuff dysfunctions and tears has been shown to be very effective. (1) In many instances, muscles of the rotator cuff have become weak, leading to functional issues. Specific exercises to build the strength of these muscles along with patient education on posture and movement is paramount. Soft-tissue therapy, including massage, dry needling and trigger point therapy is also beneficial in reducing the tightness of surrounding muscles and increasing range of movement in the shoulder area. Your myotherapist can provide a thorough and specific treatment plan for your shoulder condition.
(1) Peter Edwards, MSc,1 Jay Ebert, PhD,1 Brendan Joss, PhD,1 Gev Bhabra, FRCS,3 Tim Ackland, PhD,1 and Allan Wang, PhD, FRACS1,2,3 EXERCISE REHABILITATION IN THE NON-OPERATIVE MANAGEMENT OF ROTATOR CUFF TEARS: A REVIEW OF THE LITERATURE Int J Sports Phys Ther. 2016 Apr; 11(2): 279–301.