Rotator Cuff Injury
The rotator cuff are a group of four muscles which support the shoulder joint, especially during rotation movements. These four muscles are Supraspinatus, Infraspinatus, Subscapularis and Teres Minor.
Injury to these muscles is common in sports requiring overhead movements such as throwing (cricket, baseball etc) as well as racket sports and swimming.
Injury to one of the rotator cuff muscles is usually in the form of either a tear to the muscle belly or tendon following a trauma, or inflammation (usually of the tendon) following overuse.
Tears
Tears to one of the rotator cuff can occur following a traumatic injury to the shoulder. Sudden forceful movements such as pitching, falling awkwardly onto the arm or a tackle forcing the arm into excessive rotation (such as football/rugby) may be responsible for a torn rotator cuff muscle. Tears can be either partial or full, and as with all muscle tears are graded 1-3 based on severity. Symptoms include:
Sudden pain in the shoulder on impact.
Inability to move the arm fully due to weakness and pain.
Pain eases after a few days.
Obvious tender spot on palpation
Inflammation
Inflammation of one of the tendons of the rotator cuff is common in the over 35 age group. The cause of this can be due to overuse of the tendon (posture related) or possibly caused by impingement of the tendon within the shoulder joint.
Less pin-pointed area of pain.
Aching deep within the joint.
Pain comes on gradually.
Overhead movements tend to aggravate it.
Makes the tendon more susceptible to tearing.
Treatment
Immediate treatment for both conditions should include:
Rest and support the shoulder.
Apply R.I.C.E protocol (Rest, Ice, Compression, Elevation)
Visit your Doctor if pain persists for 2-3 days.
You may be prescribed anti-inflammatory medication such as Ibuprofen.
A sports injury specialist may:
Use sports massage to relax any muscle spasms and increase blood flow to the area to aid healing.
Use electrotherapy such as Ultrasound.
Develop a rehabilitation programme.
Rehabilitation should include mobilisation and stretching exercises to improve range of motion at the joint to equal the unaffected side. Strengthening the rotator cuff muscles should start isometrically (without movement) and progress onto isotonic (with movement). Resistance bands are excellent for shoulder rehabilitation as they can be used in every direction and resistance can be altered by shortening the band as you progress.
The the case of a full rupture, or a tear which does not respond to conservative treatment, surgery may be performed to repair the muscle. This is a relatively straightforward operation with good outcomes.
