We get a lot of clients coming to us with shoulder pain or decreased movement in one or both shoulders. This is good for us and for you. The shoulder is a complicated joint and has many, many parts to it. In this blog post we will give you some background on the rotator cuff, the injuries to it, and the rehab process for the rotator cuff.
Anatomy
The rotator cuff consists of four muscles that are designed to help stabilize the shoulder for things like reaching overhead, throwing, pushing away, or lifting things off the ground. These four muslces are:
Supraspinatus
Infraspinatus
Teres Minor
Subscapularis
You can remember these four muscles with the acronym SITS.
Although the shoulder joint is called a ball and socket joint, it is more like a golf ball on a tee turned sideways. This is not a very stable structure, and the rotator cuff muscles help wrap around the ball portion of the joint.
The shoulder gets even more complicated when we note that, after the 4 rotator cuff muscles, there are 13 other muscles that attach to the shoulder complex.
Common Injuries to the Rotator Cuff
There are three common injuries to the rotator cuff; impingement, strain, and tear. Neither of these injuries by themselves mean anything by themselves.
Impingement
This is an injury that is usually due to an overuse or repeated stress of the shoulder (lifting too often overhead, throwing too much, not warming up, etc.). There are two common muscles or groups that get impinged; the rotator cuff and the bicep long head. Recent studies have come out saying that a diagnosis of impingement doesn't really mean or say much. It may be any of the following things that present with similar symptoms at varying stages of injury/recovery:
Bursitis
Adhesive Capsulitis (Frozen Shoulder)
Muscle Strain
Muscle Pull
The thing to note if you are given the diagnosis of impingement, it may be one of these other things that may only be teased out in a full evaluation. The good news is that all of these can recover with non-surgical interventions like physical therapy!
Rotator Cuff Strain
A rotator cuff strain will hurt, there is no doubt about that. It may also present as impingement or a tear, as far as symptoms (pain patterns, use, weakness, etc) are concerned. With proper care and diagnosis, most people with a strain of the rotator cuff return to full activity in a few months without any surgery or injections!
Rotator Cuff Tear
There are many things to consider about rotator cuff tears. The rotator cuff tear has been shown to be found as partially torn in a majority of adults even if they don't have any symptoms. So with that knowledge a rotator cuff doesn't mean the end of the world, or that you won't be able to use your arm/shoulder again.
When someone has a rotator cuff tear there are many things that need to be considered and checked out before we decide, together, what the next steps are going to be. Ask yourself the following questions:
Do you have pain, numbness, or tingling when using your arm?
Do you notice a difference in range of motion (raising your arm up or reaching for something, etc.)
Have you noticed any changes in strength when using your arm, shoulder, or hand?
Do certain positions cause you to have shoulder, arm, or hand pain?
If you answered yes to any of these questions, then speaking with us on the phone or scheduling an eval is the best next step.
When your shoulder symptoms interfere with you doing the things that you enjoy doing, then we need to work together to calm those symptoms down, look at how you are moving, and try to make some changes in pain, movement, and strength to see if we can return you to full help.
Rotator Cuff tears often don't need surgery! They can be treated with physical therapy and most people are able to avoid surgery!
Rotator Cuff Rehab
Rehabilitating the rotator cuff consists of relieving pain/symptoms, modifying activity, and strengthening the musculature.
To help decrease pain we will do manual therapy to the muscles and fascia, pain free range of motion activities, and joint mobilizations.
We will look at the way you move things and address changing your movement to what fits your body and natural tendencies to optimize movement for you. We will help you stay active while you are recovering and give you recommendations for how to continue your activity level.
We will not only target the rotator cuff with strength, but work on the whole body. We believe that the shoulder is part of the entire body and will benefit not only from targeted movements, but from movements that use the entire body.
If you have shoulder pain, call us to talk about it and figure out if we are a good fit for you.
Phone: 425-202-5687
email: info@bodyfixpt.com
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