Symptoms of a rotator cuff injury can develop suddenly in response to an acute injury or may develop more slowly over time. Common symptoms of a rotator cuff injury are as follows:

• Pain over the top of the shoulder or into the upper arm.
• Weakness or a heavy feeling when you move the shoulder.
• Inability to move the shoulder through its full range overhead or behind your back.
• Loss of mobility and range of motion in the shoulder.
• Limited ability to participate in activities due to pain and/or weakness.

ANATOMY OF THE ROTATOR CUFF

The term rotator cuff refers to four muscles in the shoulder that work together to move the arm at the shoulder but also to stabilize the joint. The shoulder joint consists of the humerus bone of the upper arm where it meets the glenoid cavity created by the bones of the scapula or shoulder blade. The shoulder, or glenohumeral joint as it is anatomically known, is a ball-and-socket joint that allows for a high degree of movement of the arm.

If you think about all the directions you can reach with your arm, you can appreciate the dynamic capacity of the glenohumeral joint. With extra mobility comes the need for stability, however, and this is where the rotator cuff shines. The muscles of the rotator cuff originate either on top of the shoulder or at the shoulder blade and attach to the humerus. The rotator cuff helps keep the head of the humerus centered in the glenoid cavity throughout movement. This is necessary to generate the range of motion and force normally available at the shoulder. The muscles of the rotator cuff and their function are as follows:

Supraspinatus: Located over the top of the shoulder, this muscle aids in lifting the arm up at the side, a movement called “abduction”

Infraspinatus: Located posteriorly along the outside of the shoulder blade, this muscle aids in rotating the arm outward, a movement called “external rotation”

Teres Minor: Located posteriorly along the outside of the shoulder blade, this muscle aids in rotating the arm outward, a movement called “external rotation”

Subscapularis: Located posteriorly along the underside of the shoulder blade, this muscle aids in rotating the arm inward, a movement called “internal rotation”

If you decide to work with a physical therapist to help correct your rotator cuff issues, your entire treatment plan could consist of around 8-20+ different physical therapy sessions that will each last 60-90 minutes. Once you complete your customized rotator cuff physical therapy treatment plan, you will be able to continue to do the prescribed stretches and exercises utilized during your rotator cuff PT sessions yet in the comfort of your own home.

INJURIES TO THE ROTATOR CUFF

Injuries to the rotator cuff can occur to the muscles themselves or to the tendons that anchor the muscles to the bones. Rotator cuff tendinopathy is one example of a common injury to the rotator cuff. It may be caused by repeated overhead movements, poor posture, muscular imbalances or bony abnormalities. In the acute stages there may be inflammation in the tendon. Over time, inflammation tends to decrease but chronic pain, irritation and degeneration of the fibers that make up the tendon can occur. This can lead to some of the symptoms outlined above such as pain when reaching overhead or behind your back; pain while lifting heavy items; stiffness in the shoulder; pain while trying to sleep on that arm and sometimes feelings of weakness in the shoulder.

Rotator cuff tears are another category of rotator cuff injury that physical therapists commonly treat. They can involve the muscle and/or the tendon. Tears range from partial-thickness to full-thickness depending on how much of the muscle or tendon is disrupted. This type of injury can be acute and develop suddenly, often as a result of a trauma or from lifting something very heavy, or chronic. Chronic tears usually develop slowly overtime in response to repetitive trauma such as can occur in those who work in jobs that require frequently working overhead. Depending on the severity of the tear the symptoms may mimic that of rotator cuff tendinitis but with full thickness or otherwise large tears, significant muscle weakness develops along with the pain and discomfort felt in the shoulder.

WHAT TREATMENT IS BEST FOR A ROTATOR CUFF INJURY?

Both surgical and nonsurgical options exist to manage a rotator cuff injury depending on the type and severity. In most cases, physical therapy is an effective way to manage the symptoms of a rotator cuff injury, facilitate healing of the area and help prevent recurrence of symptoms in the future. In cases where surgery is necessary, for instance following a full-thickness tear, physical therapists play an important role in recovery after surgery. In the early phases of healing your PT will educate you on how to protect healing tissues including how to modify activities and manage your pain. As you improve, your PT will help guide you through a progressive rehab program that can strengthen the surrounding structures while gradually helping you return to your former level of activity. Rather than taking the wait-and-see approach, physical therapy can help you to heal faster and more completely while reducing your risk of future reinjury.

If you are dealing with a rotator cuff injury such as a rotator cuff tear, and are ready to find a long-lasting solution to your pain call us today to learn more about our services and schedule an evaluation