What is the rotator cuff?
The Rotator Cuff is a group of four muscles and tendons that help stabilize the shoulder: Supraspinatus, Infraspinatus, Teres minor & Subscapularis.
They also aid in movement: Every time you move your shoulder, you are using your rotator cuff to stabilize and help move the joint.
The rotator cuff is a commonly injured area and the most common injuries are strains, tendinitis, and bursitis.
What causes a Rotator Cuff injury?
There are 3 main categories when it comes to rotator cuff injuries:
- Chronic Overuse injuries
- Acute tendon/muscle tears
Chronic overuse injuries
Repeated aggravating movements over time can cause damage and inflammation to the muscles and tendons of the rotator cuff. Sports involving overhead movements such as tennis of weight training can be a culprit as well as day to day tasks or jobs such as reaching above one’s head, painting, etc. The result of repeated aggravating movements often results in a tendonosis in the shoulder. The pain can sometimes be local in and around the shoulder but pain can also be referred into the arms and hands. Poor posture also causes the shoulders to roll inwards which puts a lot of strain on the shoulder over time.
Bursitis is an inflammatory injury that can also occur in the shoulder. A bursa is a fluid-filled sack that sits beneath the bone and rotator cuff muscles and tendons acting as a cushion between the two structures reducing friction in the joint. The most commonly affected bursa in the shoulder is the Subacromial bursa:
Acute tendon/muscle tears
Acute injuries can occur from sports activities, falling or from prolonged overuse. The pain is usually quite severe and felt immediately after the injury occurs.
Symptoms of a rotator cuff injury
The type of pain experienced from a Rotator Cuff injury depends on the underlying cause. However, some symptoms can include:
- Pain in and around the shoulder
- Pain referring from the shoulder down into the arm and hand/wrist
- Avoiding certain movements or activities because they cause pain (reaching above your head, lifting objects, etc)
- Unable to sleep on the affected side as well as pain at night because of this
- Feeling that your shoulder is getting weaker
- Difficulty reach behind your back
Risk factors for Rotator cuff injuries
There are two risk factors to consider when it comes to shoulder injuries: Acute Traumatic injury or Chronic/degenerative injury
Acute Traumatic injury
These types of injuries commonly occur in one specific traumatic event such as lifting a heavy object falling. Acute i injuries usually occur in young people
Degenerative injuries are usually seen in older people, <40 years old. These are a result of long-term overuse and can also be associated with poor posture.
How are rotator cuff injuries treated?
Chiropractors treat shoulder injuries conservatively aiming to relieve their patient of painful symptoms as well as correcting any underlying dysfunction in the shoulder that may have caused the injury in the first place.
Treatments can include:
- Mobilisation and/or manipulation of the shoulder joints
- Dry needling and other soft tissue modalities
- Functional rehabilitation and treatment
Home treatments include:
- Stretches and exercises
- Anti-inflammatories and painkillers
If conservative treatment does not give a patient relief over several weeks to months, then surgery may be necessary.