The Painful Shoulder: Rotator Cuff Injuries

Shoulder strains and discomfort are common, especially if you engage in sports regularly. Once in a while, there may be a persistent shoulder pain that does not seem to go away. It’s normal to worry if there is something wrong with the shoulder. In this article, we will discuss the basic anatomy of the shoulder, why the shoulder may be painful, and what you can do to manage the symptoms.

Anatomy of the shoulder

The shoulder joint is formed by the connection between the arm bone (humerus), shoulder blade (scapular), and collar bone (clavicle). The ball of the arm bone sits in the socket of the shoulder blade, forming a ball and socket joint. The shallow socket of the shoulder blade allows the shoulder to have a wide range of movement and flexibility, at the cost of joint stability.

To compensate for the reduced joint stability, the shoulder has a group of muscles called the rotator cuff muscles to ensure that the ball of the arm bone (humeral head) remains aligned within the socket during movement. These muscles originate from the shoulder blade and attach to the arm bone, forming a cuff around the humeral head to help lift and rotate the arm bone, as well as stabilizing the shoulder during movement. Any injuries to the rotator cuff can result in pain and difficulty with moving and lifting the shoulder.

Factors that increase the chances of developing rotator cuff injuries include:

·Repetitive over use: Activities that involve repetitive overhead movement, such as throwing or swimming, places increased load and strain on the rotator cuff tendons. Excessive participation in these activities without adequate rest or preparation increases the chances of injury.

·Poor posture: Incorrect posture, such as a forward hunched posture, reduces the effectiveness of the rotator cuff muscles. The muscles have to work harder to provide stability during movement, increasing the strain on the tendons and muscles.

·Acute trauma: A fall or sudden force applied onto the shoulder can also cause injuries or tears to the rotator cuff muscles.

Signs and symptoms of rotator cuff injuries

·Pain with movement: Most rotator cuff injuries present with pain only during movement. There is usually nil pain when the arm is not moving. In cases when the muscle injury is more extensive, there may be instances when pain may be present even when the arm is not moving, or resting at night.

Difficulty and weakness with reaching overhead: As the rotator cuff muscles help with lifting and stabilizing the shoulder during overhead movements, injury to these muscles will usually result in pain and difficulty with performing such actions. Movements that involve rotation, such as reaching behind the back, will also become difficult and painful.

·Limited flexibility: Actions that provoke pain, such as lifting the arm above the shoulder or reaching behind, may become too painful to do, affecting the ability to do everyday activities and chores.

How physiotherapy can help with rotator cuff injuries

·Assessment and education: As there are many possible causes for having shoulder pain, a trained physiotherapist will be able to assess and determine the cause of your shoulder pain. This is important to ensure that the treatment is targeted and specific to your condition. Your therapist will also be able to advise you on better understanding your condition, and what you can do to manage the symptoms.

·Posture and movement correction: Proper body mechanics and movement patterns can help with reducing the pain and improving the recovery process. Your therapist will be able to show you how to modify painful movements, and how to improve your posture to recover faster. Ergonomic advice and workstation modifications can also be provided if it is determined that these may be affecting the shoulder pain.

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Customized, progressive exercise rehabilitation: Your therapist will also be able to provide a customized exercise program suited to your condition and needs. The exercise will consist of specific exercises that focus on the rotator cuff and scapular to help improve the strength and control of these muscles. These exercises usually start with gentle flexibility and strengthening exercises first, and gradually increase in difficulty and intensity as your condition improves. It is important to develop a good foundation of strength and flexibility to reduce the chances of recurrent injury.

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Manual therapy: Physiotherapists can employ a wide range of manual techniques to help reduce pain, and restore muscle and joint function. These techniques can help with reducing joint stiffness and muscle tightness, which help in turn with alleviating pain during movement, making it easier to participate in exercises and performing daily chores.

The shoulder is a complex joint that can frequently experience aches and discomfort. Physiotherapy provides an effective and non-surgical method of management that helps with reducing the pain and discomfort, as well as improving shoulder function and quality of life. Seeking early help and assessment from a healthcare professional is important in ensuring the best possible outcome. If you, or someone you know, is experiencing shoulder pain or stiffness, feel free to contact our team of dedicated therapists at info@prophysio.com.sg or 6581 9688.