Rotator Cuff Injury

Wyclef Sports Medicine > Shoulder Injuries > Rotator Cuff Injury

If you’ve ever experienced shoulder pain in the rotator cuff, you’ll know that it can be one of the most frustrating areas on the body to injure.

That nagging dull pain that can limit just about everything you do in normal life. Simple things such as picking things up and moving them can become an ordeal and can’t be done without feeling a twinge in your shoulder.

And if you’re gym goer, you’ll know the frustration of waiting for a rotator cuff injury to heal so you can once again perform at your maximum.

It’s always tough to know how long to let it rest and how much to load up on strengthening exercises, so we thought we’d give you a quick overview of the injury and see if we can make things a bit clearer.

What is a Rotator Cuff Injury?

Injury to the rotatorc will usually begin as inflammation, often referred to as Rotator Cuff Tendonitis. The rotator cuff muscles (Subscapularis, Supraspinatus, Infraspinatus and Teres Minor) are small muscles situated around the shoulder joint. Although they have individual actions, their main role is to work together to stabilise the humeral head (ball) in the shoulder socket.

When it comes to rotator cuff injuries, people are often told that they have injured one particular muscle or tendon, with the most common diagnosis being supraspinatus tendonitis. However, it is unlikely that the problem is with just one of the muscles in isolation.

The world’s top shoulder surgeons refer to such conditions as a ‘rotator cuff injury’ and consider the picture as a whole.

Although the rotator cuff can be injured by a single traumatic incident, generally this isn’t usually the case. As we mentioned earlier it will usually begin as inflammation (tendonitis) caused by some form of micro trauma (a small but continuous source of irritation). If the cause of the inflammation is not addressed, and continues over a long period of time, partial tears may develop in the cuff that could eventually become complete tears (a tear all the way through one or more of the rotator cuff muscles).

There are three main causes of micro trauma to the rotator cuff:

  1. Primary Impingement

The ‘Coraco-Acromial arch’ forms a bridge over the Rotator Cuff. It is made up of bones and ligaments and is lined by a sac of fluid called the Subacromial bursa. The space under the bridge that is available for the Rotator Cuff is called the Subacromial space.

Many people will have a naturally small subacromial space, which is just bad luck, but the space can also be reduced by conditions such as Osteoarthritis. Whatever the cause of this small subacromial space, repetitive overhead activities (such as throwing a basketball or dusting high shelves) can cause the rotator Cuff to become continuously squashed against the coraco-acromial arch, causing inflammation of the cuff.

  1. Secondary Impingement

Many people will have what is called shoulder instability (a lax shoulder joint). This laxity may have been present since birth or may be due to an injury. Often it will have occurred over time due to repetitive overhead activity, poor posture or inactivity.

Due to this instability, the rotator cuff has to overwork to stabilise the shoulder, causing it to become inflamed. Eventually, the rotator cuff will become weak and tired, and will not be able to prevent the humeral head from squashing up against the coraco-acromial arch. Because this type of impingement is not due to a small subacromial space, it is called secondary impingement.

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