What is it? The rotator cuff refers to a group of four small muscles, which run from the shoulder blade to the top of the arm bone. They act to both support and move the shoulder joint. The most commonly injured muscle in the rotator cuff is the supraspinatus muscle.
How does it happen?
A rotator cuff muscle may be strained when it is forcibly contracted or overstretched. Rotator cuff tears often occur suddenly due to a high force going through the muscle and tendon beyond what it can withstand. This may be due to heavy or awkward lifting, a fall onto an outstretched hand, heavy pushing or pulling, or a forceful throw. Sometimes a rotator cuff tear may develop over time due to repetitive or prolonged activities placing strain on the rotator cuff. This may cause gradual degeneration and weakening of the rotator cuff predisposing it to further injury. These rotator cuff tears are more common in the older population.
How does it feel?
A tear of the rotator cuff muscle is usually felt as sudden pain or a twinge felt in the shoulder area. As the muscle cools down the pain may gradually worsen as bleeding and swelling around the injured muscle takes place. The shoulder may also feel weak. Patients with a rotator cuff tear usually experience pain that is localised to the shoulder. Occasionally, pain may radiate into the upper arm, shoulder blade, upper back or neck. Patients with a rotator cuff tear will usually experience pain or difficulty when elevating the affected arm. Pain may also increase when lifting heavy objects, during heavy pushing or pulling or when lying on the affected side. Night pain may also be present.
What should you do?
For the first 24 to 48 hours the injured shoulder should be rested and iced to limit the amount of swelling. Ice should be applied wrapped in a moist towel for 15-20 minutes every 2 hours. You should consult a physiotherapist within 2 days post injury.
How is it Managed?
The assistance of a physiotherapist is important in the treatment of a rotator cuff tear. Initially they can determine the exact tissues damaged and the extent of the damage. This may require the use of imaging techniques such as ultrasound. From this a determination of how long the injury is expected to take to heal can be provided. Management consists initially of activity modification, i.e. rest from aggravating activities. Activities which place large amounts of stress through the rotator cuff include overhead activities, throwing, heavy lifting, pushing, pulling or sleeping on the affected side. Resting from aggravating activities ensures that the body can begin the healing process in the absence of further tissue damage. Management also includes the use of soft tissue treatment such as massage and stretching, and the progression through a series of specific strengthening exercises. These exercises will facilitate your return to participation and help prevent re-injury.
How long will it take for my shoulder to get better?
Minor rotator cuff strains heal without complication within a matter of weeks. However tears of the rotator cuff require a more prolonged period of time to recover. Usually a period of conservative physiotherapy treatment is undergone for 6-8 weeks, if there has been no improvement in this time, review by an orthopaedic specialist may be required. When a rotator cuff muscle is torn completely, or your shoulder has failed to improve with conservative treatment, surgery may be performed to repair the muscle. After this surgery, a lengthy rehabilitation period is required. Your physiotherapist will guide you through this process.
What can I do now that I’m receiving treatment?
Avoid overhead activities and movements that make your shoulder sore. Perform the stretches and strengthening exercises your physiotherapist has given you. Physio Professionals are located in Caloundra and Kawana on the Sunshine Coast.
Caloundra Clinic Call (07) 5438 9111
Kawana Clinic Call (07) 5314 1150