The shoulder is a very important joint in our body. If it isn’t hurting, we often don’t think about it. However, when it is injured, we find that there is very little that we can do without using our shoulders.
The shoulder is a joint that moves easily in a lot of different directions. One of the ways that our bodies protect us from moving too far is to stabilize it with the muscles of the rotator cuff. The rotator cuff muscles also help to lift our arms overhead, as well as rotate the arm in and out.
What Is the Rotator Cuff?
There are four muscles that form the rotator cuff: the supraspinatus, the infraspinatus, the teres minor, and the subscapularis. These muscles attach to the shoulder blade, then come together to form a ‘cuff’ of tendons that attaches to the upper part of the humerus, or arm bone.
Common Rotator Cuff Injuries
Of course, we’ve all heard of a rotator cuff tear. The muscle that is usually injured is the supraspinatus, but other muscles may be involved. Rotator cuff tears may be partial (some of the muscle fibers are torn) or full thickness tears (the muscle is torn completely through). The size of the tear can range from small (<1cm) to massive (>5 cm).
There are a couple of different ways to tear the rotator cuff. One is some kind of a trauma, such as a fall. This is usually the type of tear that occurs for someone that is younger than 35. Another way that the rotator cuff can be torn is through wear and tear, especially with using the arm overhead frequently. This usually occurs more with middle aged to elderly adults.
Another injury is rotator cuff tendinitis/tendinosis. This is usually due to repeated overuse. This may be due to something a person does frequently, or it may occur after a person is doing a new task doing more activity than they have done in a long time. For example, this can happen after someone had to rake the yard in the spring, after a winter of limited use of the shoulders. Another common way for this to occur is when someone begins a new exercise program, especially if they have not been doing many exercises previously.
Treatment of the Rotator Cuff
Treatment of a rotator cuff injury depends on the severity of the injury. Initially, treatment includes promoting tissue healing and avoiding further injury. Your physical therapist can teach you positions to use for sitting, standing, and sleeping to reach these goals. Other parts of the initial treatment include gentle exercises for range of motion, and teaching of appropriate ways to use heat and ice.
As the shoulder begins to heal, further strengthening can be done. This is gradually progressed as the muscles get stronger. If the muscle is not injured too severely, it may heal over time. However, a muscle that is completely torn will require surgery in order to regain full use of the shoulder.