The Rotator Cuff
What is it?
The Rotator Cuff is the collective name for of a group of four muscles (called the subscapularis, supraspinatus, infraspinatus and teres minor) and their tendons which wrap around the shoulder joint, providing support and stability. The shoulder is a ball and socket joint – formed by the ball shaped end of the humerus (upper arm) and the the small and shallow socket known as the glenoid fossa, on the edge of the scapular (shoulder blade). The Rotator Cuff holds the humerus and glenoid fossa tightly together, as if holding a golf ball on a tee.
Causes of injury
Rotator Cuff damage can occur due to trauma, such as a heavy heavy fall. Dislocation of the shoulder will often cause rotator cuff damage.
Repative arm movements can increase the risk of rotator cuff injury. Overhead movements are particulary suceptable. Examples include raquet sports, swimming, weightlifing, throwing and occupations such as paniters and decorators.
Age plays a role too. If over the age of 40, you are considered to be more at risk from damage to the rotator cuff through wear and tear. Calcium deposits can also build up and in turn rub against the tendons, this is know as calcific tendonitis.
Attempting to lift too much weight, or using poor techinique can result in a rotator cuff muscle or tendon strain or tear. This is partiuclary common in the gym with such exercises as the benchpress, shoulder press and dips.
Likewise, if some of the muscles in your rotator cuff are stronger than others, your shoulder may be more prone to injury. This often happens when an indivdual focuses on too many “pressing” exercises and not enough “pulling” ones. It is very important to delvelop all muscle groups as to not create a muscle imbalance.
Finally, musculoskeletal diseases can deterioate the health of the rotator cuff muscles, such as rheumatoid arthritis.
Pain and tenderness in the shoulder. This may also extends down the arm. The pain may be dull and persistant or it may occur as sharp and painful, particular when you attempt to using the shoulder
Pain at night, particularly when you sleep on the affected side
A lack of strength in the sholder
A decreased range of movement in the shoulder
Depending on the type of injury you have, the pain may come on gradually (common in tendonitis) or you may have a sudden twinge of pain (common if it’s a tear).
Types of Injury:
Tendinitis. Tendons in the rotator cuff can become inflamed due to overuse or overload. The tendon can also be pinched when the arm is raised in a certain position. In some invididuals, the space where the rotator cuff resides can be narrowed due to the shape of different shoulder bones, including the outside end of the collarbone or shoulder blade.
Bursitis. The fluid-filled sac (bursa) between your shoulder joint and rotator cuff tendons can become irritated and inflamed.
Strain or tear. When ignored, tendinitis can weaken a tendon and this can lead to chronic tendon degeneration or to a tendon tear. Trauma from overuse also can cause a shoulder tendon or muscle to tear.
Depending on the severaty of the injury, the rotor cuff may take weeks or even months to recover. Most of the time treatment for rotator cuff injuries involves exercise therapy. The aim is to improve the flexibility of your rotator cuff and shoulder muscles and provide balanced shoulder muscle strength.
Excerises to try…
Pull your arm across the front of your body, so the elbow is roughly level with the chest. You should feel the back of the back of the shoulder stretch. Hold for 10 seconds and repeat as neccersary.
Bend the arms at the elbow and attempt to pull them back, behind you. This will cause the shoulder blades to squeeze closer together. Hold for 10 seconds and repeat as neccersary.
Eleveate the elbow until it is level with the shoulder. With the arm bent so the hand is facing out in from, rotate the arm 90 degrees so that the hand is now pointing up. Now rotate the arm 180 degrees so that the arm is now pointing downwards. Repeat as neccersary. This exercise can also be performed with a dumbell to futher increase the rotator cuff muscles.
Rest is also very important. Initially when the injury is sustained, you should avoid any movements or exercises that agrivate the injury. However, you should gentally easy your way into execise and movement as soon as possible though to prevent stiffness in the shoulder.
Ice can be useful to help reduce imflamation and swelling, as can anti-inflammatory medication such as ibuprofine.
There are many speciafally formulated joint support supplements on the market helpful in your recovery. These contain ingriedents to promote healing, reduce swelling and ease pain.
A last resort for the non surgical treatments is often a doctor reccomended corticosteroid steroid injection. This is usually only done when other treatments have tried but failed.
Largeer tears in the rotator cuff may potentialy need surgical intervention. Removal of a bone spur or calcium deposits can also be delt with during surgery. The surgery may be performed as an open repair through a 6- to 10-centimeter incision, or you may have an athroscopy in which a narrow, flexible, tube-like telescopic camera called an arthroscope is inserted through a small incision in your shoulder (commonly known as keyhole surgery).
Always warm up and stretch prior to undertaking any exercise.
Concentrate on useing correct technique and form when undertaking any activity
Ensure good shoulder stabilty by performing exercises that strengthen all of the rotator cuff muscles
Do not attempt to lift more weight than you can comfortably do so
Consider using a joint support formula.