Rotator cuff tears and rotator cuff pain are common complaints in a physiotherapy practice. There are a number of reasons why a patient may have pain in their shoulder in the region of the rotator cuff, but one of the more major reasons is due to sustaining a tear to one or several of the muscles that form the rotator cuff.
The rotator cuff consists of 4 muscles that act to rotate the shoulder and perform everyday movements and tasks. 3 lie on the back of the shoulder, around the shoulder blade (these are supraspinatus, infraspinatus and teres minor) and the other lies on the front of the shoulder blade (subscapularis). All muscles insert into a tendinous structure that then attaches to the top of the humorous on either the front or the back.
The rotator cuff can be injured or torn in several different ways. Most commonly, these tears occur with no trauma, and are because of ageing and normal tendon degeneration. These can be a wide range of sizes and thicknesses, but most often will result in some pain and loss of function in one or more directions. Less commonly, but more severely, these muscles can also be injured through trauma, such as a fall or sudden overload of the muscles. If the tear occurs traumatically, patients will sometimes experience a sudden snapping sensation, followed by more pronounced loss of function and significant pain.
As Physiotherapists we are asked how we can assist in recovery following a tear, especially as once a muscle is torn, the ends will often separate and not come back together. Patients will often wonder how this can be resolved using ‘conservative’ or exercise-based treatments as opposed to more invasive, surgical treatments.
The goal of Physiotherapy is not to ‘heal’ the tear specifically, but using hands on techniques, strength training and range of motion exercises to assist surrounding musculature and remaining muscles perform the functions we require out of our shoulder. A study release in 2019 found that for atraumatic full thickness rotator cuff tears (like the more degenerative kind described above) are unlikely to be improved with surgery, and physiotherapy or exercise therapy should be the first line treatment in managing these injuries. As with all strength programs, dedication and consistency is key, and by your Physiotherapist can assist you in building a program that works on your goals and needs.
As with all injuries, there are some that do require surgical intervention, and our highly trained Physiotherapists can refer you to several highly trained surgeons should they determine that more invasive treatments are required.
So if you, or someone you know has a rotator cuff tear and doesn’t know what to do or where to turn, give us a call and book in for a thorough assessment, and let us help you get back to doing what you love.