Providing strength and stability to the shoulder joint, the rotator cuff is surprisingly susceptible to injury. In fact, rotator cuff injuries are common among both the young and active, and older, more sedentary patients we see at The Alignment Studio. So, what exactly is the rotator cuff, what does it do, and how can you keep yours happy and healthy?
The rotator cuff
The rotator cuff is a group of four muscles and their tendons that arise from the shoulder blade and attach to the head of the humerus (upper arm), forming a cuff. It centres the humeral head in the shallow socket, and provides strength and stability during motion of the shoulder joint. It helps you to abduct (raise your arm to the side), and internally and externally rotate the shoulder.
How rotator cuff injuries occur
Rotator cuff injuries are very common in people over the age of 40 due to normal age-related ‘wear and tear’ in the tendons. In younger patients, injuries are mainly due to a trauma to the shoulder, or overuse caused by repetitive overhead sports like tennis or volleyball. Rotator cuff injuries are also common in occupations that require working overhead or involve repetitive physical tasks, such as painting, carpentry etc.
Rotator cuff injuries usually start with a nagging ache in the shoulder when lifting/reaching overhead, dressing, or lying on the shoulder at night. This develops into pain and weakness with repetitive use, or when lifting the arm overhead.
Preventing Rotator cuff injuries
As the shoulder joint is so mobile, it depends on the strength of the rotator cuff muscles and tendons to stabilise the joint. To prevent injuries to the shoulder, it is important to strengthen the rotator cuff as well as the bigger muscles around the joint.
Rotator cuff exercises should therefore be incorporated into all gym programs that involve upper body strengthening. You also need to strengthen the muscles that stabilise the scapula, as this provides the base for all shoulder movements. If one of these muscles is weak, it places more stress on the rotator cuff tendons at the front of the shoulder.
Thoracic (upper back) mobility is also essential in preventing rotator cuff tears and shoulder injuries. Poor mobility in the thoracic spine will cause a person to have reduced thoracic extension and rounded shoulders. This places a lot more load on the rotator cuff tendons and can increase the risk of injury.
Treatment for rotator cuff tears
Treatment will depend on the severity of the injury, and the patient’s lifestyle. Partial thickness tears will usually heal themselves with rest and the appropriate rotator cuff strengthening program. Full thickness tears, however, may need to be surgically repaired if the person is returning to high level sport or activity.
Older individuals can typically return to normal function through conservative management that involves strengthening the remaining muscles of the rotator cuff. Rehabilitation involves strengthening the rotator cuff, the muscles that stabilise the scapula, and working on improving general mobility.
If you are experiencing any shoulder pain or weakness, please call The Alignment Studio on 9650 2220 to discuss an appropriate rehab or prevention program.
Pete Hunt is a highly skilled physiotherapist with nearly three decades of experience working in sports physiotherapy and private practice. The Director of The Alignment Studio, he has a special interest in musculoskeletal and sports injuries, orthopaedic rehabilitation and postural syndrome. With a caring, communicative approach, Pete uses a combination of joint and soft tissue mobilisation and exercise prescription to treat his clients. He’s also passionate about education for injury prevention and lasting results.