Rotator Cuff Injury

The rotator cuff is a group comprising of four muscles; the supraspinatus, infraspinatus, subscapularis and teres minor, that arise from the scapula and attach to the head of the humerus to provide support.

The rotator cuff not only permits a wide range of movement at the shoulder, the synergistic kinematics between the muscles is imperative to allow free and fluid movement. Due to the shallow socket that the head of the humerus articulates with, the rotator cuff is vitally important for shoulder stability.

Symptoms

Common injuries include rotator cuff tears or rotatory cuff tendinopathies, and symptoms can include:

•    Severe pain at time of injury
•    Night pain
•    Pain with overhead activities
•    Painful arc
•    Weakness
•    Shoulder stiffness
•    Difficulty in performing activities of daily living

Diagnosis

A detailed history is important to understand the mechanism of injury, followed by a thorough examination which usually incorporates inspection and palpation, range of motion examination and strength testing. There are tests which are reported to be able to accurately diagnose a particular muscle that is at fault, however there is not one single test that has been shown to accurately diagnose against other shoulder injuries. Therefore, a battery of tests usually has higher clinical value.

How Can Physiotherapy Help?

Conservative, non-surgical management is warranted in most rotator cuff injuries. Physiotheray can help bu providing a wide range of interventions, which include:

•    Advice and education
•    Pain reduction in the acute stages
•    Graded strength programme
•    Manual therapy
•    Electrotherapy
•    Range of movement exercises
•    Reduce tension via stretches
•    Improve proprioception and scapula control