Shoulder pain is a very common presentation we see in the clinic, with around 70% of individuals experiencing shoulder pain at least once in their life. Rotator cuff tendinopathy is the most common cause of shoulder pain, with it being seen in 30% of the overall population. A rotator cuff tendinopathy is chronic inflammation of the rotator cuff tendons and can be attributed to pain and weakness in the individual’s shoulder.
Anatomy:
The rotator cuff is comprised of 4 muscles (supraspinatus, infraspinatus, subscapularis and teres minor). These muscles originate from your scapula and attach onto the humerus. The rotator cuff holds the upper arm onto the body and provides strength and stability throughout shoulder movements. These muscles are prime movers in external and internal rotation as well as abduction. The rotator cuff requires balance, strength and flexibility to ensure the head of the humerus stays centered on the scapula.
Causes:
Rotator cuff tendinopathies have a variety of causes. The most common causes being:
- Repetitive arm movements
Overhead activities- Heavy work
- Muscular imbalances
- Degeneration/wear and tear
Signs and Symptoms:
There are some classic tell-tale signs of having a rotator cuff tendinopathy. Such as:
- Pain when reaching forward, reaching behind your back and lifting
- Pain when sleeping on the affected side
- Pain around the rotator cuff region and shoulder which is normally a dull ache
- Difficulty lifting the arm higher than the shoulder
- A gradual increase in pain over a period of time
- A feeling of weakness in the shoulder
Keep in mind injuries have a lot of variance between individuals. If you have a suspected shoulder injury, for accurate diagnosis, it is best to book an appointment with your physiotherapist to understand your specific injury completely.
Treatment:
The aim of treatment is to reduce pain, restore full range of motion and strengthen the muscles surrounding the shoulder. One of the first steps in treatment would be trying to limit or avoid the aggravating factors where possible.
To improve your range of motion your therapist might use a variety of techniques. One of these techniques can be soft tissue massage. This is useful in reducing stiffness and tightness in the muscles surrounding the shoulder. Soft tissue massage can be helpful for reducing pain in the short term as it can provide an analgesic effect to the area. Rotator cuff tendinopathies require more treatment than solely soft tissue massage. As it is a functional injury and load tolerance issue, exercise prescription is the MOST IMPORTANT aspect of treatment.
Your physiotherapist will provide you with a tailored exercise program that targets the specific muscle/tendon that is affected but also any underlying weaknesses. Your therapist will work with you to provide appropriate range of motion exercises, allowing you to move your arm more freely. As you increase the available range of your shoulder you will find you will start to feel less pain and have more use of your arm. Increasing the strength in the rotator cuff is extremely important to restore the integrity of the shoulder joint. This strengthening will target specifically the rotator cuff muscles but will also include shoulder stabilisation exercises. Stabilisation exercises will work to ensure the scapula and humerus are able to function as one cohesive unit again, which will reduce your risk of re-injury. In the later stages of rehabilitation, you may also undergo a sport specific or occupation specific program. This will develop increased shoulder strength and control in activities normal in your daily life. Combining all these treatments together can provide great relief and restore full function in the upper extremity.
If you are experiencing shoulder pain, you could have a potential rotator cuff tendinopathy and will benefit from seeing one of our physiotherapists to ensure correct treatment. Please get in touch with us on 9672 6752 (Kellyville) or 9871 2022 (Carlingford) and one of our friendly receptionists will be able to arrange an appointment for you.
