ROTATOR CUFF SHOULDER INJURY
The rotator cuff muscles and rotator cuff tendons are an integral part of a normally functioning shoulder. Therefore it is no surprise that rotator cuff injuries including rotator cuff tears, rotator cuff tendonitis and subacromial bursitis can cause significant shoulder pain and dysfunction. Fortunately, your team at Aevum Physio in the Sutherland Shire and Helensburgh know a thing or two about fixing a rotator cuff injury.
Rotator Cuff Muscles and Tendons
The rotator cuff muscles are a group of four muscles that originate on the scapula or shoulder blade and insert onto the head of the humerus or arm bone. The supraspinatus muscle originates from the top of the scapula, infraspinatus and teres minor from the back and lastly the subscapularis from the front. As the shoulder is a ball (top of the humerus) and socket (edge of the scapula) joint, the rotator cuff muscles function together to wrap around the ball and ensure it remains centered in the socket. As the muscles near their attachment on the humerus they change structure to tendon and loose significant blood supply, compared to “red muscle tissue”. This is where rotator cuff tears and rotator cuff tendonitis more often than not occur. These injuries can cause significant shoulder pain so it is essential to receive rotator cuff treatment immediately.
Rotator Cuff Tendonitis or Rotator Cuff Tendinopathy
Although the term rotator cuff tendonitis is still commonly used, the more accurate diagnosis is rotator cuff tendinopathy. I’ll use the more accurate term of rotator cuff tendinopathy for the remainder of this article.
We must be careful about interpreting the words rotator cuff tendinopathy on an ultrasound or MRI report as many people have this condition without any symptoms at all. This is also often the case with bursitis of the shoulder. However rotator cuff tendinopathy, especially in the acute phase can be a very painful and debilitating condition of the shoulder. Rotator cuff tendinopathy commonly co-exists with subacromial bursitis or shoulder bursitis.
Supraspinatus Tendinopathy – The most common form of shoulder tendinopathy is supraspinatus tendinopathy. This affects the supraspinatus tendon, which comes from the top of the scapula and attaches to the outside of the humerus. It is essential for elevating the arm and commonly causes pain on the outside of the shoulder during overhead activities, lifting and lying on the shoulder.
Subscapularis Tendinopathy – The least common tendinopathy of the shoulder is subscapularis tendinopathy. The subscapularis tendon comes from the front of the scapula and is most commonly irritated when stretched by moving the arm away from the body.
Infraspinatus Tendinopathy – The second most common form of shoulder tendinopathy is infraspinatus tendinopathy. The infraspinatus tendon comes from the back of the scapula and also attaches to the outside of the humerus. It rotates the arm and also has an important role in elevating the arm but doesn’t work as hard as the supraspinatus so doesn’t tend to cause as much pain.
Partial Rotator Cuff Tears – Partial rotator cuff tears are extremely common in those above the age of 40. They are usually a progression of rotator cuff tendinopathy and as such, the symptoms and treatment are very similar.
Full Thickness Rotator Cuff Tear – Full thickness rotator cuff tears cause more significant weakness and loss of function. Full thickness rotator cuff tears do not heal on their own. Physiotherapy treatment and rotator cuff exercises can assist the other rotator cuff muscles to work more effectively but often rotator cuff surgery is required to repair full thickness rotator cuff tears.
Signs and Symptoms of Rotator Cuff Tendinopathy and Rotator Cuff Tears
Deep aching pain at the front, side or back of the shoulder. Often worse when lying the shoulder at night time.
Occasional sharp shoulder pain when lifting or raising the arm.
Weakness of the shoulder, which is usually associated with shoulder pain.
Inability to raise arm above head in severe cases due to pain and weakness.
Note that rotator cuff tendinopathy and rotator cuff tears do not cause pain to radiate below the level of the elbow.
Rotator Cuff Treatment Perth
The treatment of rotator cuff tendinopathy and partial rotator cuff tears can be very difficult and frustrating for the patient and inexperienced physiotherapist or doctor. The team at Aevum are all experienced in treatment for rotator cuff tears and rotator cuff tendinopathy treatment. Early diagnosis and treatment of rotator cuff tendinopathy and partial rotator cuff tears is ideal as subtle changes in activity can often lead to significant pain relief and improvement in function. If you have already had supraspinatus tendinopathy, infraspinatus tendinopathy or subscapularis tendinopathy for some months, it is likely that you will require a formal rotator cuff exercise program. A specific rotator cuff exercise program needs to be prescribed for the individual and gradually progressed over the course of three to six months. Generic rotator cuff exercise programs can lead to increased pain. Book an appointment with the Aevum team to get your shoulder looked at as soon as possible.
Additionally our recovery room which utilises cold therapy and compression can be an excellent way to help settle the inflammation associated with this condition which can often ache a lot at night.