What is Rotator Cuff injury?
There are a group of four muscles that largely attach to the scapular then stretch over the head of the humerus bone, creating a cuff of muscle. The positioning and attachment of the muscles stabilises and facilitates movement of the arm in relation to the shoulder, and collectively the muscles are referred to as the rotator cuff. The rotator cuff muscles are called;
Above: One of our patients targeting his rotator cuff using a thera band.- Teres Minor.
The Joint is further secured by the presence of the Joint capsule that surrounds the whole joint and the Labrum, which is a thick band of cartilage tissue that wraps around the joint socket, deepening the cup where the head of humerus sits.
Due to the complex articulation of the shoulder joint and its primary involvement in daily tasks and sports, there are a large number of ways the rotator cuff can get injured. In particular, the sharp, sudden movements associated with throwing or racket sports puts great strain on the shoulder and rotator cuff. Although any direct trauma, repetitive strain or general wear and tear can cause damage leading to pain, stiffness and inhibited movement.
What causes a Rotator Cuff injury?
Rotator cuff injuries usually refer to strains of the muscle or tendons that attach around the head of the humerus. This type of injury can be the result of sudden excessive force applied to the tissues in the form of an accident, such as a fall or impact. Alternatively, the tissue strain can occur gradually over time from repetitive overuse, either during sports or in the workplace. In some cases a traumatic injury causes damage that weakens the tissue integrity or heals poorly, making the tissues susceptible to repetitive strain injury. The rotator cuff muscles and tendons are most at risk when the arm is exerting itself in a raised position, above shoulder level. This type of injury is also far more common in people over 40 years, with the reduction in joint flexibility and tissue extensibility that occurs as we age.
How is a Rotator Cuff injury diagnosed?
If you have pain, stiffness and reduced mobility in your shoulder you may have a rotator cuff injury. A doctor or physiotherapist will be able to conduct a full assessment and confirm the presence of a rotator cuff injury.
The strain to the connective tissues is graded based on the level of damage that has occurred. A rotator cuff injury will typically fall into one of these grades, which include;
- Grade 1 strain: Overstretch of tissue, causing damage but remains intact.
- Grade 2 strain: Partial tearing of the muscle or tendon tissues, but still functional.
- Grade 3 Strain: Complete tear of muscle or tendon, loss of function.
Above: Scapular setting using taping techniques and pilates based strengthening exercises.For more information about physiotherapy for shoulder problems, or to book an appointment please email office@liverpoolphysio.co.uk or ring us on 0151 558 0077 .
What are the symptoms of Rotator Cuff injury?
The method of rotator cuff injury will affect which symptoms you develop and how severe they are. Common symptoms could include;
- Sensation of tearing or popping at the moment of injury.
- Pain, either sudden onset following injury or gradual build from overuse.
- Reduced joint mobility due to pain from inflammation around the joint tissues.
- Weakness in lifting the arm or objects, due to torn ligaments.
- Stiffness and pain that is worse after long periods of inactivity.
What would Physiotherapy assessment for a Rotator Cuff injury involve?
If you book in for an appointment, the first session would be spent doing a comprehensive assessment before deciding on an appropriate treatment plan. Our physiotherapists at Liverpool Physio will divide this into two parts:
Subjective
A discussion between you and our physiotherapist to find out where in your shoulder the pain is, how long it has been there, what activities aggravate and ease your symptoms and how your injury is affecting you and your lifestyle.
Objective
An assessment of your pain, range of movement, muscle strength and a series of special tests to rule out other possible conditions.
What would Physiotherapy treatment for a Rotator Cuff injury involve?
Our experienced physiotherapists at Liverpool Physio can perform detailed assessment of your rotator cuff injury and develop treatments to target your specific symptoms. Physiotherapy treatment can significantly reduce your recovery time, especially if you receive intervention early. Our aim throughout will be the quickest possible return to pain free, independent, normal functional activity. Treatment for rotator cuff injury may include;
- Ice therapy, to alleviate pain and reduce swelling.
- Heat treatments to relieve pain and increase circulation for tissue repair.
- Advice on the use of slings to relieve weight from the shoulder joint.
- Joint mobility exercises to maintain and improve the shoulder range of movement.
- Stretch exercises to maintain muscle length and connective tissue flexibility.
- Progressive strengthening exercises to improve joint stability and functional strength.
- Soft tissue massage, including Trigger Point, to reduce stiffness and disperse swelling.
- Ultrasound to encourage soft tissue healing.
- Personal rehabilitation programme for gradual safe return to normal daily activities and sports participation.
In the early stages of the injury the focus will be on maintenance of the shoulder to prevent further loss of function. Once the tissue have sufficiently heal treatment can move onto rehabilitation. Use of a sling is important to help the joint rest but should not be used excessively or it may exacerbate joint stiffness.
How can I arrange a physiotherapy assessment for frozen shoulder?
If you are experiencing pain, aching, swelling or stiffness around your shoulder, and feel unable to continue with your normal daily activities, you would benefit from an assessment with one of our experienced physiotherapists at Liverpool Physio.
You can contact us directly to arrange an assessment and we can advise you if further treatment is recommended, or give you details on self-management for minor cases. To arrange an appointment please email office@liverpoolphysio.co.uk or call 0151 558 0077 .
Summary
Rotator cuff injuries can happen to anyone but are most commonly seen in people playing sports that involve a lot of throwing or use of a racket. The condition can be very painful and end up inhibiting all significant movement at the affected shoulder. Our physiotherapists at Liverpool Physio will apply a range of treatments to alleviate your painful symptoms so you can maintain normal function. They will then tailor a rehabilitation programme to regain full strength and mobility to facilitate your return to normal activities and sports participation.
For more information about physiotherapy for shoulder problems, or to book an appointment please email office@liverpoolphysio.co.uk or ring us on 0151 558 0077 .
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