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What’s a Rotator Cuff Injury? And How Can it Get Injured?

Posted on 28th March 2018 at 10:00

Shoulder injuries are one of the most common issues we deal with in clinic. It is so easy to pull your shoulder in the gym, or gardening, for example. This is especially a risk if your posture isn’t great in the first place and then you try and lift heavy objects.

What is the rotator cuff?

The rotator cuff, in its simplest form, is a group of four muscles that stabilise the head of the humerus in the glenoid fossa. These muscles are the supraspinatus, infraspinatus, teres minor, and subscapularis. Each muscle plays a key role and must work in synergy with the others to create stability and pain-free movement.

A great way to think about the shoulder joint is to think of the top of your upper arm is a golf ball and where it sits on your shoulder being a golf tee. While this setup provides a wealth of movement, this freedom comes at the cost of the shoulder being inherently unstable, say in comparison to a hip joint. So, in essence, these four small muscles have the tremendous job of “pulling” the head of the humerus (golf ball) into the glenoid fossa (golf tee) when the arm begins to move upwards.

With our modern way of living, often in front of a computer or not paying attention to our posture, it can lead to an imbalance in the rotator cuff and therefore injury

.If you have ever had a rotator cuff injury, physical therapy is important to help regain shoulder strength and range of motion. It is really important to keep your shoulder strong and mobile. It is very useful to see a professional (like us!) for advice and to be prescribed an exercise programme to do at home if the symptoms aren't settling quickly.

Risk factors to the rotator cuff

Damage to any or all of the four muscles and the ligaments can be caused by acute injury, chronic overuse, or ageing;

Overuse: Degenerative rotator cuff injuries are more common in people who engage in repetitive overhead shoulder motions, such as hammering, painting, swimming, playing tennis, or throwing a ball.

Shoulder arthritis: People with shoulder arthritis are more likely to develop shoulder instability, muscle weakness, and bony cysts, called osteophytes.

Older age: Degenerative rotator cuff injuries tend to occur in people over 40 and become increasingly more common as people age.

Smaller muscles tend to get fatigued more quickly than larger muscles. This is why your arms get tired more quickly than your legs when you’re carrying too much shopping in from the car at once. If you’re anything like me, I hate doing multiple trips! When muscles fatigue, they’re at greater risk of injury (whether through trauma or more long-term postural problems). As the rotators are small muscles the risk of injury can be high, so ensuring you are strong and stable is key to injury prevention.

Common rotator cuff disorders

Rotator cuff disorders are one of the most common causes of shoulder pain. Common conditions include;

Rotator cuff tear

Rotator cuff tendinitis

Rotator cuff impingement

Frozen shoulder

Subacromial bursitis

Symptoms of pain in the rotator cuff

Shoulder pain: People with rotator cuff injuries complain about pain, especially at night. Pain may also be felt during over-the-head motions or reaching behind the back.

Stiffness: The shoulder may feel most stiff when getting out of bed in the morning.

Muscle weakness: Lifting the arm overhead or holding the arm away from the body may be difficult. The muscles at the back of the shoulder may appear smaller on the injured side than on the unaffected side.

Loss of active range of motion: A person with an injured rotator cuff may not be able to move the arm through a normal range of motion. However, sometimes the arm can still be passively moved, meaning that someone else can lift the affected arm and rotate it through a complete range of motion.

Swelling and tenderness: The front of the shoulder is often swollen and tender.

Crepitus (shoulder popping): Cracking and popping sensations in the shoulder are also common, and may indicate the shoulder’s ball and socket joint is not tracking properly.

How to treat the rotator cuff

So, what can you do if you injure your rotator cuff? Well firstly, you need to stop whatever activity you’ve been doing that’s overloaded it. Secondly, you need to let it rest and heal in the first 24 to 48 hours of injury. The inflammatory process is also our friend, much like pain; a perfectly natural response our bodies have developed over the last 200,000 years.

Most importantly, you need to see a therapist. Not only will they be able to assess what’s happened, but they’ll be able to offer treatment and rehab techniques that won’t only get you on the road to recovery, through strengthening and re-education, but also hopefully help you to avoid re-injuring yourself in the future.

The human body is wonderfully resilient, however, we’re all guilty of ignoring pain and thinking we can “work through it”. Additionally, the stresses of modern life mean we often don’t listen to our bodies as we are too busy to take time for ourselves. So, remember to not leave it too long and book an appointment to see a therapist so they can help you recover faster and prevent re injury from occurring.

Here are some simple exercises you can do to aid your shoulder in mobility and strength.

5 simple stretches and exercises for rotator cuff

Pendulum Swing

Stand to the side of a table, steady chair, or railing and place the hand of your uninjured arm on the object for stability.

Gently lean forward without rounding the back and allow the affected arm to dangle freely. Then, lightly move this arm forward and back.

Starting in the same position, move your arm in and out (side-to-side).

Starting in the same position, move your arm in small circles. Start in a clockwise motion, then reverse and do it counter-clockwise.