The “rotator cuff” is a group of 4 muscles and their tendons (which attach them to the bone). These muscles connect the upper-arm bone, or humerus, to the scapula or shoulder blade. The rotator cuff functions to move the arm in many directions and also stabilizes the shoulder joint.
Unfortunately, injuries to the rotator cuff are very common, either from injury or with repeated overuse of the shoulder. Injuries to the rotator cuff can vary as a person ages. Rotator cuff tears are more common later in life, but they also can occur in younger people. Athletes and heavy laborers are commonly affected. Older adults also can injure the rotator cuff when they fall or strain the shoulder. When left untreated, this injury can cause severe pain and a decrease in the ability to use the arm.
Sometimes, the rotator cuff becomes inflamed or irritated due to heavy lifting, repetitive arm movements, or a fall. This condition is called Rotator Cuff Tendonitis and often responds well to rest, ice, anti-inflammatory medication, and physical therapy.
A rotator cuff tear is a more serious problem when injuries to the muscles or tendons cause tissue damage or disruption.
Rotator cuff tears are called either “full-thickness” or partial-thickness,” depending on how severe they are. To diagnosis if you have rotator cuff problems, your health care provider will review your health history, perform a thorough examination, and conduct a series of tests designed specifically to help pinpoint the cause of your shoulder pain.
In some cases, the results of these tests might indicate the need for a referral to a specialist or for imaging tests, such as an MRI.
Once a rotator cuff injury has been diagnosed, you will work with your orthopedist and physical therapist to decide if you should have surgery or if you can try to manage your symptoms with conservative treatment. If you don’t have surgery, your physical therapist will work with you to restore your range of motion, muscle strength, and coordination, so that you can return to your regular activities. In some cases, your therapist may help you learn to modify your physical activity so that you put less stress on your shoulder.
If a significant rotator cuff tear develops, you will most likely need surgery to restore use of the shoulder or decrease painful symptoms. After the surgical repair, you will need to wear a sling to keep your shoulder and arm protected as the repair heals. The repaired rotator cuff is vulnerable to re-injury following shoulder surgery, so it’s important to work with a physical therapist to safely regain full use of the injured arm. Once you are able to remove the sling for exercise, the physical therapist will begin your exercise program.
Your treatment program will include gentle range-of-motion and strengthening exercises designed to restore movement, strength and function to your shoulder and arm. The rehab of a rotator cuff tear can at times be quite painful. It takes the combination of a skilled therapist, and a determined patient to get the very best results after surgery.
The timeline for recovery will vary depending on the surgical procedure and your general state of health, but full return to sports, heavy lifting, and other strenuous activities might not begin until 4 months after surgery.
Darren Marchant, PT,MSPT,OCS
FIT Physical Therapy