What is the Rotator Cuff?
The shoulder is a ball and socket joint that offers a remarkable amount of motion unparalleled anywhere else in the body. Because of this high degree of mobility, this joint requires a lot of stability in order to keep it in its proper place. The rotator cuff is a series of muscles and tendons that surrounds the shoulder joint with the purpose of providing stability as well as helping lift and rotate the arm.
Rotator cuff tears are the leading cause of shoulder pain and shoulder-related disability (1). The two main causes of rotator cuff tears are injury and degeneration. The prevalence of degenerative tears increases with age and is more common among people who perform repetitive shoulder movements. As we age, normal micro-tears in our rotator cuff tendons will occur, think of them as grey hairs and wrinkles on the inside. One study found as many as 62% of patients over the age of 80 to have abnormalities in their rotator cuff (1). Most small degenerative tears usually show no symptoms. In fact, they are shown to be about twice as common as symptomatic ones (2). When tears become larger over time, there may be dull shoulder pain with some associated range of motion and strength deficits. Complete tears will result in increased pain, more severe range of motion limitations, and significant difficulty in performing daily living activities such as lifting the arm, picking up and grabbing objects.
Signs to look out for:
- Symptoms in the dominant arm
- Pain (dull/deep) top of the shoulder or down outside of the arm
- Increased pain at night and when laying on the affected shoulder
- Shoulder/arm weakness and pain with lifting items to the side or overhead
Treating the Rotator Cuff
Research has shown that conservative treatment such as Physical Therapy has been successful in treating degenerative rotator cuff tears with 75% of patients reporting symptom alleviation at 2 the year follow up (1). Don’t wait until the pain starts to affect your day-to-day to go see a Physical Therapist for treatment.
During your first appointment at Excel Physical Therapy, our experienced Physical Therapist will review with you your medical history and perform a comprehensive physical examination. Depending on the findings, we will create an individualized program to help you regain your shoulder function. Our program will consist of hands-on manual treatments to help resolve your pain and improve your range of motion. Once the pain is managed, corrective exercises will be prescribed to help build strength and optimize the mechanics of your shoulder as well as nearby joints and muscles.
Surgical treatment options may also be recommended for some tears depending on factors such as severity, age, activity level, etc. If surgery is indicated, we also provide post-surgical rehabilitation and will work with your surgeon closely to create and follow a treatment plan that is appropriate for you.
Aging is natural, pain is not! If you are currently experiencing mild symptoms or if you are at risk for rotator cuff tears, Excel Physical Therapy can help you get in front of the aging process to keep your shoulder functional and healthy. Give us a call today to get started.
By: Philip Zhu, PT, DPT, Assistant Clinic Director at University City
Nolte, P. C., Seiter, M., Elrick, B. P., & Millett, P. J. (2021). Rotator cuff tears in elderly patients: repair worthwhile? Annals of Joint, 6, 20. https://doi.org/10.21037/aoj-20-41
Minagawa, H., Yamamoto, N., Abe, H., Fukuda, M., Seki, N., Kikuchi, K., Kijima, H., & Itoi, E. (2013). Prevalence of symptomatic and asymptomatic rotator cuff tears in the general population: From mass-screening in one village. Journal of Orthopaedics, 10(1), 8–12. https://doi.org/10.1016/j.jor.2013.01.008
Rotator Cuff. (n.d.). [Illustration]. https://cck-law.com/wp-content/uploads/2020/12/AdobeStock_372323169-scaled.jpeg