You got shoulder pain? Been told it’s your rotary cup? Or maybe your rotation cuff? Well, those things don’t exist. But it might be your rotator cuff.
Shoulder pain is one of the most frequent complaints I see in my clinic. Up to 70% of people who complain of shoulder pain have some sort of rotator cuff involvement/disorder. Now that we know how to pronounce it, what is it?
Your rotator cuff is a group of four muscles located on the back of your shoulder. These muscles include your supraspinatus, infraspinatus, teres minor, and subscapularis. Each muscle is different and performs different tasks, but as a group, your rotator cuff is responsible for rotating your arm, keeping the head of your humerus (the ball of your arm bone) in the socket, and helps raise your arm overhead. So, a lot of things. It is kind of a big deal.
Because these muscles have a lot of responsibility, there is also a great risk of injury. (did I just sort of quote spiderman?) Your rotator cuff is prone to becoming overused and inflamed, can get pinched or put in poor positions, as well as undergoes tears. A tear in your rotator cuff is most commonly due to “wear and tear” or overuse of this muscle group. You can also get a tear after a traumatic event such as a fall or lifting heavy objects.
Rotator cuff tears are more common the older we get (most commonly seen in people over 40 years of age) This is thought to be due to hormonal changes that happen with time that affect the structure and integrity of our tendons. After many years of “wear and tear” (without addressing weakness and imbalances), we begin to see the toll on our shoulders.
People who start new, overhead activities but don’t prepare their shoulders for these new tasks are at a great risk for rotator cuff pain and tears. I see this a lot in older individuals who start a new work out plan or activity, doing “too much, too soon, too fast”.
Painters or overhead athletes who do the same motion over and over again are highly prone to overuse tears as well.
Rotator cuff disorders can present differently, but there are some commonalities I will look for when assessing a shoulder. A thorough examination is required to help diagnose. Things practitioners look for can include:
pain at night
inability to raise arm overhead or behind the back
loss of strength in the arm
loss of range of motion in the shoulder
pain on the top or outside of the shoulder
difficulty performing daily tasks due to pain or loss of function
Sometimes an MRI or CT scan is warranted to help diagnose shoulder as well.
In part 2 of this series – we will look into management options for rotator cuff tears and disorders; surgical intervention and conservative treatment. (spoiler alert – one of these is cheaper, less painful, and just as effective if not more effective than the other).
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