Rotator Cuff Injuries Types, Diagnosis & Treatment

Rotator Cuff Injuries: Types, Diagnosis & Treatment

Rotator cuff injuries are common and often lead to long-term pain. They can be caused by overuse, repetitive movements or impact injuries. 

If you have a rotator cuff injury it is important that you receive medical attention as soon as possible in order to avoid further damage and pain. The best way to treat this type of injury is with physiotherapy for the shoulder, but there are some things you can do at home before your appointment with the therapist.

In this blog, we’re going to share some tips that can help reduce your risk of rotator cuff injury, the best exercises for you to perform, genetic conditions and the various treatments available. Please continue reading below to learn more!

What Is The Rotator Cuff?

The Rotator Cuff is a group of 4 muscles in the shoulder. These muscles are:

  • Supraspinatus
  • Infraspinatus
  • Subscapularis
  • Teres minor

These 4 muscles provide strength and stability for the shoulder. They arise from the scapular (shoulder blade) and come together to form a covering around the head of the humerus. 

The rotator cuff muscles act to move the shoulder joint and additionally act to stabilise the ball (humeral head) in the socket (glenoid fossa). These muscles are involved in almost every type of shoulder movement, in fact, they are “fine-tuning” the movement of the arm within the joint capsule. 

Rotator Cuff Injuries Types, Diagnosis & Treatment

What Causes Rotator Cuff Injuries?

Injuries of the rotator cuff are very common and can occur in any age group for a variety of reasons. For example, overhead sports such as volleyball, tennis, or swimming, or occupational activities that require repetitive frequent movements, such as painters can all put excessive load on the rotator cuff. 

Additionally, degenerative changes can occur in the tissue as a result of advancement in age. Another important factor that can be involved in rotator cuff injury is posture. Having a slouched posture can have a significant deteriorating effect on the rotator cuff tendons. 

A slouched posture reduces a space above the shoulder joint called the subacromial space. This important space has about 10 mm in width, and within this narrow space, there are some parts of rotator cuff tendons and bursae. Having slouched posture decreases the space width, which can result in compressing and irritation of the rotator cuff tendons in the space.

Different types of injuries could occur to the rotator cuff tendon, including tendinopathic changes to the tissue, partial tendon tears or full-thickness tendon tears.

Rotator Cuff Tears

  • Partial Tear: This causes damage to the tendon without completely severing it. 
  • Full-thickness Tear: Complete tear of the tendon, resulting in the tendon separating from the bone. 

Rotator cuff tears can occur in an acute manner, for example, a fall onto an outstretched arm, lifting a heavy item or in conjunction with a shoulder dislocation. Otherwise, tears can occur due to either chronic overload on the tissue or due to degeneration (wear and tear as a result of age).

Typically, you feel pain in the front of your shoulder that radiates down the side of your arm. It may be present with overhead activities such as lifting or reaching. It may prevent you from sleeping on the affected side. There might be a weakness in your arm and difficulties in doing your routine activities such as reaching up and behind your back.

Many rotator cuff injuries can be treated nonsurgically. The goals of the treatment are to relieve pain and restore movement and strength to the involved shoulder. 

A physiotherapist can help you to diagnose the level of the injury, provide you with education and a tailored exercise therapy program to gain normal shoulder function and strength. If indicated, they will recommend referral to an Orthopaedic Specialist for an opinion on management.

Rotator Cuff Injuries Types, Diagnosis & Treatment

What Is The Best Exercise For Rotator Cuff?

Depending on the stage, location and symptoms of the rotator cuff injury there are many different rotator cuff exercises that can be prescribed. Your physiotherapist will assess your individual needs and prescribe a personalised program for you. 

Exercises can range from scapular stability and postural exercises, to assisted or unassisted movement exercises, to resistive exercises utilising therabands and weights.

Will A Rotator Cuff Injury Heal Without Surgery?

This will depend on the extent of the tear. While there is some uncertainty regarding the treatment of choice in rotator cuff tears, if the tear is small and partial, it is well recognised that physiotherapy can help to restore shoulder function. 

Additionally, if the tear has developed gradually over time, conservative treatment is often appropriate and can achieve desired functional results. However, full-thickness tears in young athletes often require surgical repair. In addition, surgery is often recommended if you have persistent pain or weakness in the shoulder that does not respond to physiotherapy and other non-surgical treatment.

Genetic Factors Affecting Risks For Rotator Cuff Disease 

Against the traditional belief that rotator cuff injuries are a result of normal wear and tear, new research is suggesting that genetic factors play an important role in the development of complete tears of the rotator cuff. 

The siblings of the patient with tears of the rotator cuff have more than twice the chance of developing an injury in the rotator cuff and experiencing symptoms of pain and discomfort. These results imply that there are genetic factors that have a significant role in the development of rotator cuff tears.

Rotator Cuff Injuries Types, Diagnosis & Treatment

Physical Therapy Guide To Rotator Cuff Tear 

Generally, a physiotherapy treatment plan has two parts. The initial focus is on reducing acute symptoms such as pain and discomfort in the shoulder. At this stage, you will be guided on how to avoid aggravating activities, on the use of ice if this is indicated for you, and prescribed gentle movement exercises. 

The second phase of your rotator cuff treatment plan is the rehabilitation exercise of the rotator cuff itself to build load tolerance and strength. The selection of exercise will depend upon your symptoms, posture and the specific tendon which is irritated in conjunction with your goals for treatment. 

Summary

The most common symptom for a rotator cuff injury is pain, but there may be other signs that something more serious has occurred such as difficulty moving your arm at all. Resting an injured shoulder will usually help with inflammation and avoid further damage if done properly. 

A doctor should always diagnose any potential problems before making decisions about which treatments would work best for you individually based on where the pain comes from and what kind of movement limitations exist because this also varies greatly depending on severity. If you require treatment from a professional and experienced physiotherapist, Melbourne Hand Therapy is here to help.

Please call us at Melbourne Hand Therapy today (03) 9899 8490 or leave an enquiry and we will get back to you as soon as possible.

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