Rotator Cuff Related Shoulder Pain
What is a Rotator Cuff Related Shoulder Pain?
Rotator cuff muscles are a group of muscles which are essential for shoulder health and function. Despite being the smaller muscles surrounding a shoulder joint, injury to these structures could be debilitating due to its role in stabilising the shoulder during everyday function. Injuries or tears to the rotator cuff are either traumatic or degenerative in nature with the latter normally occurring in the older population.
How do I know if I have a rotator cuff tear/injury?
Signs and symptoms of a rotator cuff tear/injury may include:
- Reduced shoulder movement strength
- Painful arc of movement present – also known as shoulder impingement
- Pain with overhead movements
- Inability to sleep or lie on the painful side
- Radiating pain from shoulder down to the middle of arm
How is Rotator Cuff Related Shoulder Pain diagnosed and managed?
It is usually diagnosed through a physical examination carried out by a Doctor or Physiotherapist. The use of ultrasound or MRI scan can help to determine the extent of the rotator cuff injury and to help exclude any other pathology present.
Degenerative tears of the rotator cuff are normally treated with a trial of conservative management before any surgical intervention is warranted. Traumatic tears can be managed conservatively but are also highly dependent on the severity of the symptoms present and the extent of the structural damage.
How can Physiotherapy help?
The Physiotherapist will carry out an assessment of your shoulder region to determine what movements are being affected the most and if the rotator cuff is the root cause of your pain. This would include an assessment of the range of movements in your shoulder, the mobility of the shoulder joint and the flexibility of the surrounding muscles. The role of Physiotherapy is to assist with regaining pain-free movement of the shoulder and restoring the strength of the rotator cuff muscles.
Treatment may include but is not limited to:
- Advise and education pertaining to your condition
- Soft tissue therapy
- Joint mobilisation of the shoulder joint
- Personalised home exercise program
- Heat therapy
- Mobilisation with movement techniques
- Dry needling
- Shockwave therapy
What are the risk factors for rotator cuff injury?
For rotator cuffs which have been injured due to a degenerative tear, it occurs in individuals usually above the age of 50 and also affects a large majority of manual labourers. Elite athletes such as tennis players and rowers are also another population where rotator cuff injury is prevalent due to the physical load being placed on these structures. Although not conclusive, having a genetic history of rotator cuff injury or arthritis increases the likelihood as well.
How long will it take to recover from rotator cuff injury?
Depending on the nature and extent of injury, rotator cuff injury recovery can vary from a few weeks to 6 months. The long healing time is due to the relatively lower recovery potential of the rotator cuff and individuals have to balance rest and rehabilitation in order to make a good recovery. It is also important to note that recurrence is quite common but this can be minimised with a supervised rehabilitation and injury prevention program.
When should I have surgery for rotator cuff injury?
Most cases can be managed conservatively with rest and rehabilitation but there are circumstances where the pain does not improve and hence surgical intervention can be considered. This consideration can be made after a period of 3-6 months of attempting a conservative treatment route and is also highly dependent on the pain levels present.