What is the rotator cuff?... How does it get injured?... Is it causing your shoulder pain?... What to do if it is?... Read on to learn more!
What is the Rotator Cuff?
Firstly, the 'rotator cuff' is a common term we use to categorise a group of 4 important muscles (and their tendons) which provide stability, strength and mobility to our shoulder.
If you're interested - the technical jargon names of the 4 muscles that make up the rotator cuff are the supraspinatus, infraspinatus, subscapularis and teres minor.
Let me put things in the simplest terms for the best understanding of what the rotator cuff is and what it does. Our shoulder joint is a ball and socket joint and these 4 muscles hold the ball of our upper arm into the socket of our shoulder. They are vital in keeping our arm attached to our shoulder and are responsible for all our shoulder movements, especially raising our arm and reaching above shoulder height.
How commonly are rotator cuff injuries?
Studies and basic physiotherapy experience shows that almost every case of shoulder pain has some form of rotator cuff involvement. This is because the rotator cuff muscles form such a vital role for stabilising and moving the shoulder during all movements. Shoulder pain related to rotator cuff tendinopathies and shoulder bursitis are among the most common in everyday people as well as athletes.
What are the different types of Rotator Cuff injuries and how do these occur?
There are many different degrees to which the rotator cuff can be damaged with 4 main categories. These themselves can range from mild to severe. I will outline these below starting with the least severe and moving towards the more severe rotator cuff injuries.
1. Shoulder Bursitis: This is the swelling and inflammation of the tiny sacs of fluid that the rotator cuff tendons constantly glide over to move our shoulder and arm. Despite it ranking low in regards to 'damage' it can still cause high levels of pain.
2. Tendinopathy/Tendinitis/Tendinosis: This is the damage and inflammation of one or more of the rotator cuff tendons and can range from mild to severe. It is usually caused by overuse or a sudden change in repetitive shoulder activity. This injury is not permanent but can usually take a long time to heal. And obviously, the more of the 4 tendons that are affected, the greater the pain and recovery time.
3. Tendon Partial Tear: This is where one or more of the rotator cuff tendons has an actual tear. But the tear is only partial meaning it does not go through the entire tendon. Prolonged periods of tendinopathy/tendinitis/tendinosis can lead to a tear or it can occur suddenly due to trauma. The bigger the tear and the more of the 4 rotator cuff tendons that are torn, the greater the pain and recovery time. Tears are usually confirmed by scans.
4. Tendon Complete Tear: This is the highest possible damage that can occur to the rotator cuff and can happen to one or more of the tendons. A complete tear is when the tendon has been completely torn, meaning the tendon has completely separated from itself and can no longer be used by your shoulder. If the person is elderly or if there are 3 other intact rotator cuff tendons, it may be conservatively managed. However, most complete tears need to be surgically repaired.
What to do if you think you have 'rotator cuff' related shoulder pain?
While rotator cuff injuries are common, they can also be very stubborn to heal and in most cases an early diagnosis can significantly impact your recovery and recovery time.
If you are experiencing shoulder pain, it is highly likely that the rotator cuff is involved and you should get it assessed by your doctor and/or your local physiotherapist. Especially if the pain levels are severe or if mild to moderate pain persists for more than a few days.
By: Adam Fracassi
(Physiotherapy Recovery Clinic Concord)