Rotator Cuff Injuries

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Rotator Cuff Injuries Simon Evans Physiotherapy

What is the Rotator Cuff?

The Rotary Cuff is known as a group of muscles and tendons which surround the shoulder joint, firmly holding the head of the bone of the upper arm in the shallow socket of the shoulder. A dull ache in the shoulder can be caused by a Rotator Cuff injury which is often worsened when you try to sleep on the affected area.

Rotor injuries most often occur in people who repeatedly perform overhead motions in their work or in their sport. Examples of those who are affected with rotator cuff injuries include painters, carpenters, and people playing baseball or tennis. Age is one of the risk factors as a rotator cuff injury increases with age.

Physical therapeutic exercises have been found to help some people to recover from Rotator Cuff.  This physical therapeutic exercise helps to improve the flexibility and power of the muscles around the shoulders.

Most of the time a single injury can result in rotator cuff tears. In such circumstances, medical assistance should be provided as soon as possible. Severe cases of rotator cuff tears may require surgical repair, transfer of alternative tendons or joint replacement.

What are the causes of a Rotator Cuff Injury?

Rotator cuff injuries differ as it can range from mild to severe. They usually belong in one of three categories.

Tendinitis is an injury which is caused by an excessive use of a rotator cuff. This causes inflammation. Tennis players, who use overhead services and painters who have to climb up before doing their job are the groups of people that are affected by this type of injury.

Bursitis is another common rotator cuff injury. It occurs as a result of the inflammation of the bursa. These are fluid-filled sacs which sit between the rotator cuff tendons and the underlying bone.

Another thing that causes rotator cuff tears is excessive use or acute injury. The tension which connects the muscle to bones can overstretch (strain) or tear, partially or completely. Shortly after a fall, the rotary cuff can also strain or tear, a car accident or other sudden injuries. These injuries usually cause intense and immediate pain.

Symptoms of Rotator Cuff Injury

It is not all rotator cuff injuries that cause pain. Some occur as a result of degenerative conditions, which mean that the rotator cuff can be damaged for months or years before the onset of the symptoms.

Common symptoms of rotator cuff injury include:

  • Avoid certain activities because they cause pain
  • finding it difficult in reaching the entire range of shoulder movements
  • it will be difficult to sleep on the affected shoulder
  • pain or tenderness when reaching overhead
  • shoulder pains, especially at night
  • progressive shoulder weakness
  • it will be difficult to get behind

If you experience any of these symptoms for more than a week or if you lose the function of your arm, contact your doctor.

Risk Factors

The following factors can increase the risk of Rotator Cuff Injury:

  • Age: As you grow older, there is an increase in your risk of developing a rotator cuff injury. Individuals who are above the age of 40 years are prone to rotator cuff tears.

  • Some sports: Athletes who make use of arm motions regularly, such as baseball pitchers, archers, and tennis players, have a higher risk of having a rotator cuff injury.

  • Construction jobs: Jobs that require repetitive arm motion such as carpentry or home painting which are often overhead can cause to the rotator cuff as time goes on.

  • Family history: There may be a genetic component that is associated with rotator cuff injuries since they appear more often in some families.

Prevention of Rotator Cuff Injuries

If you are in danger of developing a rotator cuff injury, or in the event that you have had a rotor cuff injury in the past, engaging in daily shoulder stretches and strengthening exercises can prevent future injuries.

A lot of individuals exercise the front muscles of the chest, shoulders and upper arms, but it is of equal benefit to strengthen the muscles in the back of the shoulder and around the shoulder blade in order to optimize the muscle balance of the shoulder. Your doctor or physiotherapist can help you plan your exercise program.

Diagnosis of Rotator Cuff Injury

During a physical examination, the doctor will press on various parts of your shoulder and move your arms into different positions. He or she will also test the strength of the muscle around your shoulders and your arms.

In some cases, an imaging test such as X-rays may be recommended.

  • X-ray: Although this test may not show the rotator cuff tear the test can be able to visualize bone spurs or other potential causes of pain, such as arthritis.

  • Ultrasound: This type of test makes use of sound waves to create images of structures in your body, especially soft tissues such as the muscles and tendons. It provides dynamic tests, assessing the structures of the shoulder as they move. Ultrasound also provides a quick comparison between the affected shoulders and the healthy shoulders.

  • Magnetic Resonance Imaging (MRI): MRI makes use of radio waves and a powerful magnet. The resulting images show all the structures of the shoulders in a great detail. Image quality depends on the quality of the equipment used.

Treatment of Rotator Cuff Injury

Conservative treatments, such as rest, ice and physical therapy, are sometimes all you need to recover from rotator cuff injuries. If the injury is serious and involves complete tears of the muscles or tendons, surgery may be the best option for you.


In case your pains have not been reduced by conservative treatments, your doctor may recommend a steroid injection which will be given in your shoulder joint, especially if the pain affects your sleep, daily activity or exercise. Although these injections are often of temporary use, care must be taken in order to ensure that they are used properly because they can contribute to the weakening of the tendon.


Physical therapy is usually one of the first treatments that your doctor may suggest. Exercises adapted to the specific location of your rotator's injury can help you restore the flexibility and strength of your shoulder. Physical therapy is also an important part of the recovery process after rotator cuff surgery.


Different types of operation are available for the rotator cuff injuries, including:

  • Arthroscopic tendon repair: During this procedure, the surgeons insert a small camera known as arthroscope and tools through small cuts in order to reattach the torn tendon to the bones.

  • Open tendon repair: This can be a better option in some situations. In these types of surgery, the surgeon works through a larger cut to reconnect the damaged tendon to the bone. Unlike arthroscopic procedures, open tether repair is usually cured in the same time frame, but recovery may be more uncomfortable.

  • Tendon transfer: If the torn tendon is too damaged to be reattached to the arm bone, the surgeons may decide to use a nearby tendon as a replacement.

  • Shoulder Replacement: Massive rotator cuff injury can require the replacement of the shoulder. In order to improve the stability of the artificial joint, an innovative procedure (reverse shoulder arthroplasty) installs the ball part of the artificial joint on the scapula and the socket part onto the arm bone.

Rotator Cuff Injuries Simon Evans Physiotherapy

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