Relevant Anatomy:
The Rotator Cuff is a collection of four muscles that control the movement of the shoulder; supraspinatus, infraspinatus (not shown in image), subscapularis, and teres minor (not shown in image). See picture below (Designed by Freepik).
The shoulder joint is the most mobile joint in the body, and requires the strength of the rotator cuff muscles for stability. A rotator cuff tear is the most common cause of shoulder pain and disability among adults, and increases with age.
What Causes Rotator Cuff Tears?
Rotator cuff tears can be caused by various factors, including:
Acute Injury: A sudden, traumatic event like falling on an outstretched arm or lifting something too heavy can result in an acute tear. This is more common in younger individuals or athletes.
Degenerative Wear and Tear: More often, rotator cuff tears develop gradually over time due to wear and tear on the tendons. This is most common in people over 40 and can be exacerbated by repetitive motions (e.g., in sports like tennis, baseball, or occupations like painting or carpentry).
Tendinitis or Impingement: Chronic inflammation or pressure on the tendons, such as poor posture, can weaken the tissue, making it more prone to tearing.
Clinical Presentation of Rotator Cuff Tears:
- Pain: Often localized to the front or side of the shoulder, it can radiate down the arm. The pain may worsen with activities like lifting, reaching, or lying on the affected shoulder.
- Weakness: A loss of strength and difficulty lifting the arm above the head.
- Decrease Range of Motion: A rotator cuff tear can make it hard to perform everyday activities that involve moving the arm, like brushing your hair or reaching for objects.
- Clicking or Popping Sensations: At times, rotator cuff tears can lead to clicking/popping with certain movements.
How Can Physiotherapy Help?
Physiotherapist will perform a physical examination, assessing the range of motion, strength and stability of your shoulder. Based on the objective findings, Physiotherapists can determine if there is a Rotator Cuff Tear. Physiotherapists will be able to identify the muscle(s) affected and target these muscles during the rehab process. During the early stages, Physiotherapy will help to regain the range of motion, strength and stability of your shoulder. Later stages of rehabilitation will include progressive resistive strengthening, proprioception training and sport-specific exercises.
If necessary, a Physician (Family Doctor, Sports Medicine Physician or Physiatrist) requisition for diagnostic imaging (x-ray, ultrasound, and/or MRI) may be indicated.
Massage Therapy is a common adjunct to Physiotherapy during the recovery process. It can help relieve pain symptoms from shortened and tight muscles, stimulate blood flow to promote healing, and decrease stiffness to improve joint range of motion.
How Long Does It Take To Recover From Rotator Cuff Tears?
Depending on the severity of the injury, full recovery may take several months. But early intervention and appropriate treatment can lead to a successful recovery. Delay in seeking proper treatment may lengthen your recovery time, and may create further degradation.
What Are Some Safe Home Exercises I Can Do For Rotator Cuff Injuries?
Mobility training and strengthening exercises are important for the recovery of rotator cuff injuries. Check out our video section for exercise demonstrations.
Please note, these exercise demonstrations are for educational purposes only. We always recommend that you see a qualified healthcare professional before attempting, who will be able to provide you with individualized advice and exercises that cater to your specific needs.