The shoulder joint consists of a very shallow ball and socket joint (think golf ball on a golf tee) and this enables the shoulder to be a very mobile. However this mobility comes at the cost of some stability. This is where the Rotator cuff comes in... The rotator cuff is a group of 4 muscles (supraspinatus, infraspinatus, subsacpularis & teres minor) that surround the head of the humerus (arm bone) in order to maintain that ball on top of the socket. The supraspinatus tendon which sits on top is the muscle more likely to experience tendinopathy.
Patients usually present with pain on the outside of the shoulder and upper arm may experience stiffness in their shoulder & difficulty lifting their arm above chest height.
What is its cause?
Rotator cuff tendinopathy is usually brought on by increased compression and tension at the site of the tendon insertion in the shoulder. This is usually a gradual onset condition by which the attachment site is slow to adapt to a sudden change in loading or direct compression causing damage to the tendon.
This can be caused by repetitive lifting, repetitive movement above chest height, weakness of the muscles of the rotator cuff and/or those that surround and support the shoulder blade, poor postural positions and a direct fall onto the shoulder.
What can I do for my pain?
If you suspect you have rotator cuff tendinopathy, then an accurate diagnosis is paramount by a health professional that has experience with this condition. In the meantime, limiting use of the shoulder may help, especially movement above chest height. Simple analgesics and ice may also help with managing pain until assessment is made.
What can a Physiotherapist do for me?Physiotherapists
are well equipped for dealing with this problem. There are a number of other structures in the area that could be that cause of your pain, and therefore a detailed history and examination will be able to gauge what is the actual cause of your symptoms. If it is diagnosed as rotator cuff tendinopathy, the Physiotherapist will identify the key areas of treatment and look at any other factors that may be contributing to the problem.
Depending on the stage of your pathology treatment may include any of the following:
- Activity modification
- Postural advice and re-education
- Manual therapy to decrease pain and restore normal movement
- Progressive program of tendon loading exercises
- General strength and co-ordination exercises
- Other modalities such as hot or cold packs, TENS machines or dry needling
- Sports technique correction (may need input from an experienced coach)
- Referral for imaging studies, injections or to other health practitioners if indicated