Rotator cuff tear

Overview

Rotator cuff tear injuries are one of the most common shoulder problems we see at Physiotherapy@Woodbridge. The rotator cuff is located in the shoulder and consists of four muscles and tendons that surround the joint. The purpose of the rotator cuff is to stabilize the joint and keep the head of your upper arm firmly in the socket of the shoulder.  A rotator cuff tear injury can cause pain, weakness and/or stiffness in the shoulder.

Although rotator cuff tears are more common in the aging population, they are also quite prevalent in adults and teenagers. They are particularly common in sports that involve overhead activity and occupations that require repetitive use.

People who present to our clinic with rotator cuff injuries usually return to normality in a 3–6-week period. On occasion the damage can be more extensive leading to longer treatment times. If the injury is the result of a single accident medical diagnostics may be required. If this is the case your physiotherapist, Derek Mernagh will guide you on the best course of action.

Anatomy

Your shoulder consists of three bones: the humerus (upper arm), the clavicle (collar bone), and the scapula (shoulder blade). These three bones converge on one area known as the shoulder joint, which is a shallow ball and socket joint.

The humerus (your upper arm) is kept in the socket of the joint by the rotator cuff tendons and the shoulder labrum. Every time you move your arm the rotator cuff tendons are activated and help stabilize the shoulder throughout the movement.

The rotator cuff consists of four muscles:

  • Infraspinatus
  • Supraspinatus
  • Teres Minor
  • Subscapularis

Causes

Acute Tear: this is common in sports or if there is a fall on an outstretched arm, you can tear the rotator cuff tendons. If the impact is significant an ultrasound, x-ray or MRI may be indicated to assess the total damage done to the shoulder.

Degenerative Tear: this is the result of wear and tear. Over time the tendon gets worn down and begins to naturally degrade. This will cause pain and inflammation which will in turn result in decreased ability to use the arm in a normal capacity.

Factors that can lead to degeneration of the rotator cuff include:

  • Repetitive Stress: if you do sport or work in a job that includes a repetitive motion of the shoulder, this may apply to you. Sports that have a high impact on the shoulder include baseball, boxing, tennis, rowing, and weightlifting.
  • Lake of Blood Supply: as we age the natural supply of blood to our peripheral anatomical components lessons. This is significant because a lower blood supply means the bod’s natural ability to repair a damaged rotator cuff is impaired. This can have a negative cumulative effect over time.
  • Bone Spurs: as we age it is common for the body to develop bone overgrowth in or around our joints. Bone spurs can rub against the tendons which over time will cause weakness and make it more likely to tear.

Risk Factors

People aged 40 or higher are at a greater risk for rotator cuff tears. That is because of the body’s natural aging process.

People who do repetitive motion or perform overhead activities are also at a greater risk of rotator cuff tears. Because athletes do a lot of repetitive activity, they are particularly vulnerable. Occupations such as painters, electricians and others who have similar repetitive motions as part of their job description are also at a greater risk of developing rotator cuff tears.

Symptoms

  • Pain when resting or at night especially when sleeping on the painful side.
  • Pain with shoulder movement, especially overhead activity for hands behind your back.
  • Weakness in the shoulder
  • Shoulder stiffness
  • Crepitus (crackling or popping sensations in the shoulder)

What can physiotherapy do?

  1. Decrease Pain: this is usually the first port of call. We have many different options at our clinic to choose from depending on the type of shoulder condition you have. For example, dry needling +/or manual therapy works great for athletes. For a more sensitive or painful shoulder laser therapy is a fantastic choice to decrease the pain and inflammation inside the shoulder.
  2. Improve range of motion: it is important to get the shoulder moving as soon as possible. If pain allows, manual therapy will facilitate the normal movement of your shoulder. A home exercise program will also help to improve the movement of your shoulder.
  3. Improve Strength: when the pain has subsided, and the range of motion has improved it is important to strengthen the rotator cuff tendons. As the rotator cuff tendons act as a stabilizer mechanism it is critical to the stability of the shoulder that they are in perfect working order.

What kind of treatments?

  • Bioflex Laser Therapy: one of the most successful treatments you can get for a shoulder injury
  • Dry Needling : perfect treatment to reduce your pain levels
  • Shockwave Therapy: this treatment will help reduce calcium deposits in the shoulder
  • Manual Therapy: physiotherapists’ will use certain techniques to improve your range of motion
  • Electrotherapy: helps with pain reduction
  • Soft Tissue Work: will help to decrease overactive muscles

How long does treatment take?

The bulk of rotator cuff tears are greatly improved at Physiotherapy@Woodbridge in the 3-6 week period. On occasion the damage to the tendons is quite extensive, which will lead to longer treatment times of 6-12+ weeks.

Need More Info?

If you would like to learn more about a rotator cuff tear at Physiotherapy@Woodbridge then please get in touch for a free phone consultation. You can give us a call or book an appointment online with one of our experienced physiotherapists. We take pride in offering the best care in a super clean environment. All York Region public health guidelines are strictly followed in our friendly clinic.

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