There are four muscles that make up the rotator cuff in the shoulder. They all work together to provide dynamic stability in the shoulder. This means that when the shoulder is being used these muscles are activated to keep the shoulder stable and in place.
Although pain may originate from the rotator cuff tendons, the cause is often related to how the shoulder joint moves and the interaction of the muscles of the shoulder working together to create movement. Suboptimal biomechanics in the shoulder can apply stress to the rotator cuff tendon and lead to pain.
What are the characteristics of activities that cause a rotator cuff tear?
- Repetitive shoulder movement especially at or above 90 degrees e.g. swimming, tennis, throwing
- Fall on outstretched hand
Signs and symptoms of a rotator cuff tear
- Pain in the shoulder as you lift your arm up in front and to the side, in particular past 90 degrees
- Pain with throwing action
- Pain with bearing weight through your hands
- Pain lying on the injured shoulder
- Although painful, you are still able to reach full range
What does the science currently say?
- 50% of people over the age of 50 will have a rotator cuff tear and not know it as not all rotator cuff tears become painful
- Not all rotator cuff tears require surgery
- Physiotherapy exercises to help improve the functioning of the muscles in the shoulder can adequately help reduce the pain caused by a rotator cuff tear
- It may take 3- 6 months for these exercises to help and pain to resolve
- Ultrasound results for the shoulder are not very accurate
How can Physiotherapy help?
Your Physiotherapist will be able to:
- Identify suboptimal shoulder mechanics and provide exercises to target and improve the mechanics in the shoulder
- Provide manual therapy to reduce pain and tightness
- Provide scapular stabilisation and shoulder strengthening exercises
- Provide exercises to focus on improving shoulder biomechanics and strengthening to reduce forces applied onto the rotator cuff tendons
- Tailor strengthening exercises to your chosen sport or physical activity
- Provide exercises and guide through rehabilitation post- rotator cuff repair surgery