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Rotator Cuff Injuries

What Is The Rotator Cuff?

The rotator cuff is a group of muscles surrounding the shoulder that act to support and stabilise the joint. The muscles help to lift and rotate the arm. There is also a lubricating sac called a bursa which sits between the rotator cuff tendons and the bone on top of your shoulder. The bursa provides cushioning and allows the tendons to glide freely as you move your arm. Injury to the rotator cuff tendons can also cause inflammation and pain in the bursa. 



How Do Rotator Cuff Injuries Happen?


Rotator cuff injuries can be acute or as a result of degenerative wear and tear. Acute injuries can be caused by falling on an outstretched arm, lifting something too heavy at an awkward angle, trying to catch a falling object, or repetitive overhead work. It can also happen with sports such as tennis or baseball. 


As people age and are less active, tendons start to degenerate and lose strength, and hence can be torn more easily. Tendons have a poor blood supply which also makes it harder for them to heal quickly. Repetitive stress on the shoulder can increase the risk of developing a degenerative tear. Some occupations which involve repetitive overhead work such as carpentry or painting can predispose the shoulder to a tendon tear. 


What Are The Symptoms Of A Rotator Cuff Injury?

  • Dull, deep ache in the shoulder

  • Reduced range of motion of the arm

  • Pain and weakness when lifting the arm

  • Pain at night and difficulty lying on the affected side

  • Difficulty doing daily tasks such as combing your hair or reaching behind your back



Treatment Of Rotator Cuff Injuries


It is important to address your pain early. If you don’t modify any of your activities and continue to use the shoulder while you have a tear, you run the risk of making the tear worse. Early treatment can help prevent your symptoms from getting worse.


In the initial stages of your injury, you will need to rest the arm and avoid overhead activities. Depending on your level of pain, a sling may be recommended to provide the arm with some additional support. Anti-inflammatories should be taken to help with the pain and swelling. A heat pack should also be applied on the shoulder for approximately 20 minutes before bed to help relax the muscles and increase the blood flow to help with healing. 


Physiotherapy will involve soft tissue massage and joint mobilisations to help relax the muscles and work on improving your range of motion. We also use ultrasound, heat packs and TENS for pain relief. You will be prescribed a comprehensive exercise program consisting of stretches and strength work. Stretches will help to improve your flexibility and range of motion. The muscles will then require strengthening exercises to help restore your function and prevent further injury. We will also give you important advice on posture, desk setup and sleeping positions to reduce the stresses placed on the shoulder. We will advise you on how to modify daily activities. 



In more severe cases, surgery may be indicated to repair the torn tendon. Surgery usually involves re-attaching the tendon to the bone. Your specialist may suggest surgery if you are young, active, and need to use your arms for overhead work or sport. Surgery may also be indicated if your pain does not improve with conservative methods. Rehabilitation following a rotator cuff repair is quite a lengthy process and you will require regular physiotherapy to help restore your range of motion, strength and function back in the shoulder. 


Preventing rotator cuff injuries

  • Perform regular strengthening exercises for the rotator cuff to ensure the muscles are strong enough to cope with the demands of your work or sport

  • Desk workers must ensure they have good posture. Slouching your head and shoulders forward can cause problems around the shoulder blade and may lead to impingement of the rotator cuff tendons

  • If you have pain, avoid lying on that shoulder while you sleep

  • Avoid repetitive overhead activities. Find ways to modify the task and ensure you take frequent breaks.

  • Avoid lifting heavy objects above shoulder height

  • Avoid lifting heavy objects with an outstretched arm. Ensure that the load is close to your body to reduce the strain on the shoulder. A good example of this is to ensure you never reach across to place your handbag on the backseat of the car. Instead, open the back door and place your bag down before you get in the car.



If you are suffering from shoulder pain and would like more information or help please call us on 9875 3760 or email us on info@wphphysio.com.au. We would be more than happy to assist you in your recovery.  



You do not need a Doctors' referral in order to make an appointment with a Physiotherapist

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