Written by: Marcia D’Argenio PT, DPT
Almost every week we have a patient come into the office explaining how they injured their rotator cuff. Some do it lifting weights overhead, for others it’s an old baseball or tennis injury. Whatever the difference in the origin of the injury, one thing is common, it’s something that usually lingers for a long time if not initially treated properly and it is NOT normal.
The rotator cuff is made up of several muscles that help support and guide range of motion for the shoulder joint. Pain arises when someone injures or overuses the surrounding muscles, tendons, ligaments and joint surfaces.
The rotator cuff is a large tendon comprised of four muscles which combine to form a “cuff” which attaches to the head of the humerus. The muscles that comprise the rotator cuff are:
• Supraspinatus
• Infraspinatus
• Subscapularis
• Teres Minor
These muscles originate from the “wing bone” aka the scapula and together form a single tendon unit that attaches to the humerus. Rotator cuff injuries occur when tendons are impinged by the acromion (part of the anterior scapula).This mechanism is believed to be a major cause of cuff tears in individuals older than 40 years. Rotator cuff injuries also happen after a fall or may be caused by chronic wear and tear leading to degeneration of the tendon.
The shoulder is considered a ball-socket joint. It allows the arm to move in many directions. It is made up of the humeral head (a ball at the end of the bone of the upper arm) fitting into the glenoid fossa of the scapula (the socket). The humeral head is kept in place by the thick bands of cartilage and the joint capsule. The joint itself contains a synovial membrane. It is the inner membrane of tissue that lines a joint. The synovial membrane secretes synovial fluid that lubricates the joint. The rotator cuff muscles are the dynamic stabilizers and movers of the shoulder joint and adjust the position of the humeral head and scapula during shoulder movement.
Symptoms of rotator cuff injuries are pain in the front of your shoulder that may radiate down the side of your arm. Overhead activities such as lifting or reaching usually hurt and sleeping on the affected side may hurt. The arm may be weak and can cause difficulty with even routine activities such as combing your hair or reaching behind your back. When the rotator cuff is damaged it can produce pain, spasm, inflammation and swelling. All of those ailments restrict movement and mobility. Non-surgical options include anti-inflammatory medication, steroid injections, acupuncture, laser therapy and/or physical therapy.
The aim of physical therapy is to keep the shoulder joint stable by strengthening the muscles of the rotator cuff and to restore full range of motion. Typically rotator cuff rehabilitation takes 4-6 weeks but varies depending on the type of injury and the patient. Some examples of exercises that comprise a rotator cuff program are active assisted range of motion exercises with a wand or stick and strengthening exercises with a theraband to support the shoulder joint. After recovery, these exercises should be continued as a maintenance program 2-3 days per week for lifelong protection of your shoulders.
When a patient comes to our office with a rotator cuff injury, our approach is to first and foremost decrease the pain, swelling and inflammation.Our goal is to assist healing without painful or invasive procedures. If after our evaluation and examination we have the opinion that a condition requires medical intervention beyond the procedures available our office, the patient will be referred to other professionals who offer more invasive procedures such as injections and surgery (But only if absolutely needed!).
In most instances rotator cuff injuries can be remedied rather quickly by the painless, non-invasive procedures available at Monmouth Pain & Rehabilitation. Because of our excellent track record in taking care of these injuries, we receive a great deal of referrals from various physicians in our community.
So while it is true that many rotator cuff injuries evolve into chronic issues, it is usually because from the start they are not treated or allowed to heal properly. At our office we have great success in recognizing and treating the injury properly. With the attention, patience and techniques available in our office it is an infrequent occurrence for this type of injury to cause discomfort beyond the normal time of healing.
When considering a remedy for your rotator cuff injury, Monmouth Pain & Rehabilitation should be your first stop. Give us a call at 732-345-1377. Mention that you read this blog and you will receive a complimentary in-office evaluation (a $245 value).
