The rotator cuff is the common name for the group of tendons and the four muscles that surround your shoulder. The rotator cuff ensures the proper functioning of the shoulder.
Many of the clients we treat at the Brixton Therapy Centre who present with shoulder pain and problems with shoulder flexibility have a rotator cuff problem.
This article will help you to avoid rotator cuff injuries, spot the signs of a rotator cuff issue, and understand the treatments that we provide for shoulder pain and rotator cuff problems at our treatment centre in South West London.
Types of Rotator Cuff Problems
Tendonitis
The inflammation of the rotator cuff tendon.
Bursitis
The inflammation of the bursa which are fluid-filled sacs which provide cushioning to the shoulder joints.
Rotator Cuff Strain
The overstretching of the rotator cuff muscles.
Rotator Cuff Tear or Sprain
The partial or complete tear of a tendon or muscle.
Causes and Prevention of Rotator Cuff Problems
Common causes of rotator cuff injury include the following:
Falls.
Road traffic accidents.
Other trauma to the shoulder.
Overloading the shoulder joint.
Excessive, prolonged or repeated overhead activity.
Degenerative wear and tear due to the ageing process.
There are some activities and professions which are prone to causing rotator cuff problems these include:
Painting and decorating.
Tennis.
Weightlifting.
Carrying a heavy shoulder bag often.
There are a few ways you can help to prevent rotator cuff injuries such as:
Opt for a rucksack carried on both shoulders rather than carrying a bag on one shoulder.
Be aware of your posture.
Warm-up and stretch your muscles before lifting anything heavy.
Signs and Symptoms of a Rotator Cuff Problem
Cracking, popping or crunching sounds when moving your arm and shoulder.
Pain on moving arm.
Pain at night that may cause problems with sleeping, as can’t lie on the affected shoulder/arm.
Loss of mobility in the arm, shoulder especially difficulties raising the arm.
Weakness in the affected shoulder and arm.
Diagnosing a Rotator Cuff Issue
A doctor, physiotherapist, or osteopath can diagnose a rotator cuff problem by asking you questions about your symptoms, habits, when the problem first occurred and any injuries or accidents you have sustained.
It is by understanding the nature of the problem in this way together with the following series of tests and observations that a diagnosis of a rotator cuff can be made and then a decision made on the best course of treatment.
Tests to Diagnose a Rotator Cuff Problem
1. Lateral Jobe Test
Your osteopath, physiotherapist or other practitioner will ask you to extend your arm out to the side at a 90-degree angle. Then rotate your arm until your palm is facing behind you with your thumb at the bottom. They will then push down on that arm and ask you to try to resist that force. If that resistance is painful and/or difficult it indicates a rotator cuff problem.
2.. Drop Arm Test
This test specifically checks the function of the supraspinatus muscle, one of the four rotator cuff muscles.
With you either sitting or standing your osteopath or other practitioner will ask you to extend your arm out to the side at a 90-degree angle and then slowly and in a controlled way lower it back down.
A tear, injury or problem with this muscle will make this difficult, painful or impossible.
3. Lift-Off Test
Your osteopath or practitioners will ask you to put your arm behind you with the back of your hand touching your lower back. They will then push against your hand and ask you to push back against them. If this is painful or difficult then you likely have a rotator cuff injury or problem.
Treating a Rotator Cuff Problem
Treating a Rotator Cuff Problem with Osteopathy
Initial assessment using the methods noted above by your osteopath will confirm a diagnosis of the type of rotator cuff issue. Following diagnosis, your osteopath will create a treatment plan with you. This will involve advice and exercises for you to do in between appointments and treatments which will commonly include: soft tissue massage and trigger point/myofascial release., muscle energy technique, manipulation of the shoulder joint, and acupuncture.
Soft Tissue Massage helps to relax the muscles, can release scarred tissue, reduce inflammation and increase blood flow to promote healing.
Trigger Point/Myofascial Release is the application of differing degrees of pressure at specific points often called knots to relieve pain and reduce tension.
Muscle Energy Technique helps to relax and lengthen muscles, reduce pain and inflammation and to increase strength.
Manipulation of the Shoulder Joint gentle manipulation of the shoulder may be a technique used by your osteopath to increase mobilisation, release scar tissue and increase blood flow to aid the healing process.
Treating a Rotator Cuff Problem with Acupuncture
Acupuncture needles in the shoulder area help to stimulate blood flow which carries oxygen and nutrients to the area and enables the body’s natural healing processes.
The insertion of needles into the muscles of the shoulder will also help to release tension, which will reduce pain in the area and potentially free the radial nerve which may be being squeezed by tight shoulder muscles, causing weakness in the arm.
Transferred pain is common with rotator cuff problems, meaning an issue in one of the rotator cuff muscles might be causing tension and pain in others as they work to compensate.
Acupuncture can help relieve the other muscles reducing pain and the likelihood of further damage to the rotator cuff.
What to Do If You Suspect a Rotator Cuff Problem
If you recognise the symptoms listed in the article then it is better to get treatment sooner rather than later. Rotator cuff tears, injuries or other problems do not go away on their own, they will require treatment.
It is a good idea to book an appointment with an osteopath, GP or another qualified practitioner. If you are in the South London area you can book here, for an initial consultation to diagnose and propose a treatment plan for your shoulder pain or problem using the tests and treatment options explained previously.