Hey Team!

 

This week is an update on Rotator Cuff injuries.  We see a lot of these in the clinic, but how we approach our treatment plan is different based on the type of injury.  

 

Let’s talk first about what a rotator cuff injury is…

 

Rotator cuff injuries are common and increase with age. These may occur earlier in people who have jobs that require repeatedly performing overhead motions. Examples include painters and carpenters.  Pain typically presents to the side of the shoulder from a dull ache when at rest to a sharp pain with movement away from the body. This pain limits your life and ability to use the arm for activities such as throwing a ball to your dog, reaching for a plate on a tall shelf or with scratching your back.  Rotator cuff pain is limiting, and when present, makes life challenging.  

 

Many people with rotator cuff disease can manage their symptoms and return to activities with specific exercises that improve flexibility and strength of the muscles surrounding the shoulder joint.

 

So how do we know your rotator cuff is torn? 

• A rotator cuff tear presents with pain to the side of the shoulder and is usually not associated with pain above the shoulder (ie. Neck or upper trapezius).  Pain usually does not create numbness and tingling to the hand/elbow and does not travel down the arm.  Pain is dull at rest and can be sharp with increased use.

 

 

 Do we need imaging studies?  

• Imaging studies are usually determined based on severity of symptoms, limited function and mechanism of injury. 

• Imaging is not required to begin physical therapy treatment or to have symptoms alleviated.  

• A thorough clinical examination can isolate a full thickness tear versus and mild rotator cuff tear. 

 

Do I need surgery? 

• Rotator cuff pain can be related to a sprain, partial tear or a full thickness tear.  According to the Mayo Clinic, half of those with a rotator cuff injury recover using exercise and at-home care. These interventions reduce pain and encourage range of motion.

• Rotator cuff strain can be a small soreness or irritation to the muscle not resulting in a significant tear. These usually heal without intervention, but more severe strains may require treatment. 

• Rotator cuff partial tear is a tear in the muscle not completely through the cuff.  This may require surgical repair to allow the tissues to heal properly, however is dependent on the size of the partial tear.  

• Rotator cuff full thickness tear is a tear completely through the muscle and usually requires surgical intervention.  Surgery is required to approximate the muscle/tear together to allow proper healing to occur.  This is similar to stitches for a wound.  

 

So, If you don’t have to have imaging or surgery… what do I do?

• First, we want to maintain or keep your mobility.  This is commonly lost as pain prevents the shoulder from consistently meeting full range.  We inherently self-limit motion.  

• Second, we want to limit painful (exacerbating) movements or activities.  Our bodies want to heal themselves however if you keep pulling a wound apart every time a scab is starting… it is hard to heal.  

• Third we can begin some light exercises.  These exercises can be gradual in nature and used more for activation of the muscle than pure strengthening.  This is why a low stretch band is a great (and inexpensive) mode for exercise of the shoulder.  I have attached a video with 3 shoulder exercises we use with rotator cuff injuries. 

 

 

Click below to access our YouTube page (YES we have one)  if you want to learn more about ways to improve your rotator cuff.

 

  CLICK HERE: 3 Ways to Help the Rotator Cuff

 

Ok Team… that’s all for today.  Reach out to me directly if you have questions about the rotator cuff, youtube link or other physical therapy questions.  

 

-Keep Moving,

 

Rob 

•  The author, Rob Sumner, is a Doctor of Physical Therapy and owner of Sumner Specialized Physical Therapy. He's happy to answer any questions about this article, wellness, fitness, or physical therapy overall by phone at (509) 684-5621 or by email at Rob@SumnerPT.com

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