The rotator cuff is a group of four muscles that surround the shoulder joint. These muscles are responsible for stabilising and maximising movement efficiency within the shoulder joint. Sometimes one or several of these muscles can become injured either through an injury or through general 'wear and tear'. In some instances the tendon, bursa or muscle is not damaged but is irritated due to being impinged or squashed between two bony structures. Interestingly many of us will develop signs of rotator cuff degeneration as we grow older, but be completely asymptomatic. It is those who develop symptoms who may need further intervention either from a physiotherapist or a shoulder specialist.
Signs and symptoms
People who have rotator cuff injuries will often have pain around the shoulder joint, extending down the upper arm. They may also have a decreased range of movement especially in lifting the arm out to the side and forwards. Depending on the severity of the injury to the muscle complex the patient may also have a reduction in strength. on having an ultrasound scan this may show signs of tendon injury or tear and/or bursa inflammation. In some cases an X-ray will show a bone spur with may have developed due to mechanical wear or compression.
How physiotherapy can help
If you have sustained a rotator cuff injury it is essential you do the correct strengthening exercises to improve the strength of the affected muscles and just as importantly the muscles around the whole shoulder girdle. This can dramatically improve pain and function. Usually small tears respond very well with physiotherapy, however larger or more degenerative tears take longer to respond and may require surgical repair.
As part of your treatment process your physiotherapist may also use a combination of other modalities including joint mobilisations, massage, acupuncture, ultrasound and taping, as well as exercise rehabilitation. Your physiotherapist can also advise you on activities to avoid and appropriate pain relief options, should this be necessary.