The rotator cuff is a group of muscles and tendons that surround the shoulder joint, providing stability and enabling a wide range of motion. It consists of four main muscles: the supraspinatus, infraspinatus, teres minor, and subscapularis. The rotator cuff helps to lift and rotate the arm.
Rotator cuff tears can occur due to various reasons, including:
• Trauma or injury: Falling on an outstretched arm, lifting heavy objects, or a sudden forceful motion can lead to a rotator cuff tear.
• Age-related degeneration: As we age, the tendons of the rotator cuff can degenerate, becoming weaker and more prone to tears.
• Overuse or repetitive stress: Engaging in repetitive overhead motions, such as in sports like swimming or tennis, or certain occupations that involve repetitive shoulder movements can contribute to rotator cuff tears.
• Poor posture and muscle imbalances: Weakness in the muscles surrounding the shoulder joint or poor posture can affect the mechanics of the shoulder, increasing the risk of a tear.
The symptoms of a rotator cuff tear may include:
• Pain and tenderness in the shoulder, especially when reaching or lifting the arm.
• Weakness in the affected arm, making it challenging to perform certain movements or activities.
• Difficulty in lifting objects or reaching behind the back.
• A popping or clicking sensation in the shoulder.
To diagnose a rotator cuff tear, healthcare professionals may employ the following methods:
• Physical examination: A thorough evaluation of the shoulder, assessing range of motion, strength, and any signs of tenderness or deformity.
• Imaging tests: X-rays can help rule out other potential causes, while MRI or ultrasound scans can provide detailed images of the shoulder structures, including the rotator cuff, to confirm the presence and extent of a tear.
There are two main types of rotator cuff tears:
• Partial Thickness Tear: This is a tear in the tendon that does not completely sever it from the bone. These types of tears can be less severe and may not require surgery.
• Full Thickness Tear: This is a complete tear of the tendon from the bone. These types of tears may require surgical intervention.
• Other ways to classify tears are on their location on top of the tendon (bursal surface), or under the tendon (humeral/articular surface)
Treatment options for rotator cuff tears may vary depending on the severity of the tear. Common approaches include:
• Conservative management: Rest, ice, and physical therapy exercises prescribed by a physiotherapist can help reduce pain, restore shoulder mobility, and strengthen the muscles surrounding the rotator cuff.
• Medications: Non-steroidal anti-inflammatory drugs (NSAIDs) or corticosteroid injections may be recommended to manage pain and inflammation.
• Surgical intervention: In severe cases or when conservative treatments fail, surgery may be necessary to repair the torn tendon or reattach it to the bone.
Exercises play a crucial role in the rehabilitation of rotator cuff tears. However, it is important to consult a healthcare professional or a qualified physiotherapist before attempting any exercises. Some useful exercises may include:
• Range of motion exercises: Gentle movements that help restore flexibility and mobility of the shoulder joint, such as pendulum exercises or shoulder circles.
• Strengthening exercises: Targeted exercises that focus on the rotator cuff muscles, such as external and internal rotations with resistance bands or dumbbells.
• Scapular stabilisation exercises: Exercises that promote proper shoulder blade positioning and stability, such as scapular squeezes or wall slides.