Rotator Cuff Injuries

The rotator cuff is made up of 4 muscles which support the socket of the shoulder.  Injuries to the rotator cuff can happen with a traumatic injury such as a fall or can develop slowly over time.  People usually complain of pain on the top of the shoulder which sometimes radiates down the arm to the elbow and even to the wrist.  The pain is generally worse with reaching, lifting, overhead work and sleeping on the sore shoulder. Rotator cuff injuries are usually classified in 5 main categories; tendonitis, small tear, medium tear, large tear and massive tear.  Rotator cuff tendonitis and the small and medium tears generally resolve completely with physiotherapy.  The large and massive rotator cuff tears often require surgery but physiotherapy prior to surgery is often recommended to decrease pain and regain as much range of motion and strength as possible.

(Picture courtesy of mydr.com.au website, 2006)

Your physiotherapist will assess your neck, upper back and shoulder to determine the nature of your injury. If a rotator cuff tear is suspected your physiotherapist will report this to your doctor for further investigation. Your physiotherapist will look at factors that make your rotator cuff tear worse or prevent it from healing.  The physiotherapy treatment includes anti-inflammatory modalities to reduce pain and swelling.  Your physiotherapist will mobilize your shoulder and rotator cuff muscles to help you to regain full movement and flexibility. You will be given a safe strengthening program specific to your rotator cuff injury.  This strengthening will help to stimulate healing of the tendon and ensure that you have full strength of your shoulder.  In addition manual therapy to the neck and upper back will ensure that any of the factors that may be preventing your rotator cuff injury from healing are addressed. Physiotherapy will also reduce the risk that you will injure your rotator cuff again and help you return to your normal activities.

1.    Poor posture

2.    Muscle imbalance

3.    Previous shoulder injuries such as dislocation

4.    Neck pain, stiffness or dysfunction can mimic or contribute to rotator cuff injuries

5.    Upper back injuries or dysfunction can mimic or contribute to rotator cuff injuries

6.    History of overuse to shoulder through sports, hobbies or work