How is the rotator cuff damaged?
The rotator cuff can be damaged in one of two ways:
- Traumatic injury: Any sudden unprotected movement can tear the rotator cuff. Examples include a fall onto the arm, or a fall where you stop yourself with your arm, a pull whist lifting or throwing
- Repetitive strain injury: repetitive movement undertaken for sport or work can build up to cause rotator cuff problems. The risk factor is higher is when the movements are above the head or require a higher force. Sports that are commonly affected include canoeists, cricketers, swimmers and racket sports. Occupations that are particularly at risk are those in the construction trades such as joiners and builders.
The risk of sustaining a rotator cuff injury increases if your posture is poor. Rounded shoulders are an indication of weak scapula muscles and may lead to pinching of the rotator cuff, the rotator cuff is also working at a mechanical disadvantage which increase the risk of damage. Damage to the roator cuff is more commonly sustained after the age of 40.
What are the symptoms of a rotator cuff tear?
- Pain : usually felt over the outside and upper part of the arm. Pain is often worse when moving the arm especially overhead movements, or across the body.
- Decreased strength in the shoulder
How is a rotator cuff injury diagnosed?
The first step in diagnosing a rotator cuff injury is the history that you give of your injury. Specific clinical tests will further isolate the site of the injury.
Rotator cuff injuries, including complete or partial rotator cuff tears do not show on normal X rays, they may be diagnosed by MRI or ultrasound scanning.
What is the treatment for a rotator cuff injury?
- Ice. See the Physiobench advice sheet
- Physiotherapy/ physical therapy rotator cuff muscle exercises rehab programme consisting of muscle imbalance exercises scapula stability exercises and shoulder strengthening exercises. If the muscles are not strong enough, or one part of the cuff is working harder than the rest then the shoulder will be pulled out of alignment and pain will result. Specific exercises address this muscle imbalance.
- Surgical intervention. If conservative measures fail surgery is considered, this is usually performed by a keyhole approach.
