Understanding rotator cuff injuries is important since variations of this problem exist and confuse many. Did you ever hear someone say, “Yeah, I have a problem with the rotator cuff in my shoulder” and wonder what that meant? In addition, what is worse is to hear all the explanations given to define a rotator cuff injury or condition.
While often diagnosed, few understand what rotator cuff syndromes of the shoulder actually mean. The rotator cuff stands for a group of four muscles including the supraspinators, infraspinators, subscapularis and teres miner. All these muscles surround the shoulder. Each muscle helps to move the long bone of your upper arm, the humerus, in different movements. These movements help stabilize the shoulder joint. Larger muscles, such as the deltoid, move the arm to perform activities of daily living.
The most important function of these muscles is to pull the upper end of the humerus down so that it will clear bone above it and allow deltoid muscle to raise your arm overhead. To explain further, your shoulder blade, or scapula, includes a long piece of bone (acromion) that sits above the shoulder joint. This long piece of bone forms a bridge (at the acromioclavicular joint or AC joint) with the collarbone (clavicle). This bony bridge above the shoulder joint helps to protect the shoulder joint from forces above it while allowing soft tissue in the shoulder to move freely.
Each of your four rotator cuff muscles ends as a tendon which attaches to the upper-most part of the humerus directly underneath that bony bridge. When the rotator cuff muscles become weak for various reasons, they don’t fully depress the humerus as you raise your arm overhead. This results in the humerus bone banging into the bony bridge above and pinching the tendons of the rotator cuff muscles in between. Due to this banging and pinching, tendonitis or inflammation of the tendon often result.
Even worse is the fact that several other soft tissue structures also exist in this limited space. These include ligaments, capsular tissue and bursa sacs. Consequently, any one of these structures can become inflamed if they are pinched repeatedly.
Understanding Rotator Cuff Injuries – Treating This Condition
There are two main goals to improving rotator cuff syndromes. First, you must determine which soft tissue is inflamed and attempt to treat that inflammation. Your physician, physical therapist or athletic trainer can test range of motion, strength and touch in the area of the rotator cuff to determine the involved tissue. Appropriate measures can then be directed to treating the inflammation in that particular tissue. An ice cup massage for 10 to 15 minutes over a tender area often resolves less severe inflammations.
The second goal, part of any good treatment program, is regaining the strength in these muscles. Strength is essential for these muscles to perform their function. Many sports-related shoulder injuries that involve the rotator cuff can be prevented with a regular exercise program that involves strengthening. Often these injuries occur in baseball, swimming and weightlifting
Thomas Suspenski, PT, ATC
797 E Lancaster Ave. Suite 2
Please refer to patient education for other brief articles in our educational series. It is through these articles, in part, that we keep our patients (and others) informed of common injuries and conditions, their treatment and healthcare in general.