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Oct 2021

What are Rotator Cuff Injuries?

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Rotator cuff injury symptoms and causes

The rotator cuff is a group of muscles and tendons that surround the shoulder joint that help keep the head of the humerus (upper arm bone) firmly within the socket of the shoulder. The rotator cuff muscles help to stabilize the shoulder joint. Rotator cuff injuries are common injuries of the shoulder and usually increase as one gets older however may occur earlier especially in jobs that require repetitive overhead motions. The rotator cuff consists of four muscles:

The Supraspinatus which is the most commonly injured rotator cuff muscle


Teres Minor

Subscapularis muscles

These muscles function to allow the shoulder to move laterally (outer) rotation or medially (inner) rotation of the shoulder. Rotator cuff injuries are common injuries to the shoulder as the muscles are often used to do many tasks such as cleaning, playing sports or jobs that involve the hands and arms such as skilled trade workers (painters, carpenters, drywallers, plumbers and floor installers). Rotator cuff pain is most commonly caused by an inflamed tendon or tendinitis or a torn tendon.

What does a rotator cuff injury or tendinitis feel like?

The pain associated with an injury or tendinitis of the rotator cuff may be described as a dull deep ache in the shoulder which can disturb sleep. Usually the arm will feel weak and movements which require rotation of the shoulder such as combing your hair or reaching behind your back will be painful and limited. Many people with rotator cuff injuries or tendinitis can manage their symptoms with physiotherapy and exercise that help improve flexibility and strength of the muscles that surround the shoulder joint. However without treatment some rotator cuff may lead to a significant loss of motion or range of motion as well as weakness.

Do rotator cuff injuries heal on their own?

Rotator cuff tear

When a shoulder is inflamed treatment such as physiotherapy can be very effective and long lasting. However when the shoulder or rotator cuff is injured such as a tear these injuries usually do not heal on their own without surgery especially when it is a major tear. But in a large amount of cases surgery may not be necessary when the tear is minor. Many patients rotator cuff tears can be improved first by reducing pain and inflammation (without surgery) then by strengthening the muscles that surround the shoulder joint.

What factors may increase the risk of having rotator cuff tendinitis or injuries?

Age is one risk factor as the older you get the risk increases. Rotator cuff tears are most common in people older than 60. Construction jobs or skilled trade occupations that require repetitive arm motions especially overhead can injure the rotator cuff over time. Usually the inflammation becomes worse with repetitive use often requiring extensive rest or a combination of rest and therapy. Since many skilled trades don’t want to take time off work, then a physiotherapy program which helps to reduce pain and swelling will be required. There may be a genetic component involved with rotator cuff injuries as they appear to occur more commonly in some families.

What complications may occur without treatment of rotator cuff injuries?

Rotator cuff muscles

In many cases without treatment rotator cuff injuries especially serious tears may lead to a significant loss of motion and/or weakness which may result in a progressive degeneration of the shoulder joint. And while resting your shoulder is necessary to help in your recovery keeping the shoulder immobilized for prolonged periods of time can cause the connective tissues that surround and enclose the joint to become thickened and possibly to a frozen shoulder which is also known as adhesive capsulitis (shoulder becomes stiff).

If conservative treatment haven’t helped to reduce pain your doctor may recommend steroid injections into your shoulder especially if pain interferes with daily or physical activities or with your sleep. Please note that while these shots May offer temporary relief they should be used with good judgement as they can contribute to a weakening of the tendon and may lower success of surgery if it is needed.

How are Rotator Cuff Injuries and Tendinitis Treated?

Physiotherapy is usually one of the primary treatments your family doctor may suggest. Physiotherapy is an important part of the recovery process after rotator cuff surgery. Treatment of the rotator cuff tendinitis may include physiotherapy modalities such as IFC (Interferential Current) as well as exercise that are specific to the location of your shoulder injury. These exercises can help to restore range of motion and strengthen the shoulder.

How to Prevent Rotator Cuff Injuries?

Pendulum exercise

The best way to avoid an injury is to try to prevent them happening in the first place. First avoid activities that require repetitive overhead arm movements. For many professions this may be difficult to do but anything that can help to even reduce the risk will help. Try avoiding sleeping on your side with your arms stretched out overhead. Keeping good posture can help as well. Exercises that strengthen and support the muscles of the shoulder can be helpful. The shoulder joint is not well vascularized (low blood flow) which means that some forms of exercise can help with injuries. Pendulum exercises can be helpful in helping to improve range of motion and to improve blood flow to the shoulder which helps tissue to heal. This exercise is low risk and should be done with both arms instead of just for the affected arm.

If you have any questions about the shoulder and Rotator cuff injuries or tendinitis please contact Dynamic Physiotherapy & Sports Injury Clinic Inc. at 905-273-5433 or on our website www.dynamicphysiotherapy.ca

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