Shoulder Pain And Rotator Cuff Injuries

Shoulder Pain

Like most parts of the body, we usually take the shoulder for granted until we start to experience pain. Pain in the shoulder can be very debilitating and prevent us not only from playing sports but also day to day activities like brushing our teeth, reaching up to an overhead cupboard and even from getting a good night sleep. There can be many causes to shoulder pain but today we are going to be specifically looking at pain caused by the Rotator Cuff.

The Rotator Cuff

The Rotator Cuff is made up of 4 muscles:

  • Supraspinatus
  • Infraspinatus
  • Subscapularis
  • Teres Minor

They are situated deep within the shoulder close to the joint. The rotator cuff muscles have a number of roles within the shoulder. Firstly, the rotator cuff muscles help move the shoulder in all directions. Secondly and most importantly the 4 muscles act together to provide stability to the shoulder joint, it does this by keeping the head of the humerus (the top of your arm bone) firmly located within the socket.

 

Rotator Cuff Muscles

The 4 muscles in the rotator cuff work together help the shoulder move and provide stability

 

Mechanism of Rotator Cuff Injuries

The two most common ways to injure or hurt the rotator cuff are from either mechanical trauma or from overuse/repetitive movements.

  • Mechanical Trauma – This can occur during sporting events such as a rugby tackle, diving to catch a ball in cricket or during tennis. It can also happen falling onto an outstretched arm.
  • Overuse/Repetition – Again this can occur in sports that require repetitive movements involving the shoulder such as tennis, swimming or golf. It can commonly affect people who take up a new sport or join a gym and lift too heavy too soon and don’t give their body adequate time to recover. It can also affect people whose job requires repetitive movements such as paint and decorators.

Rotator Cuff Injuries

Rotator cuff injuries can be caused by mechanical trauma during sports such as rugby

Types of Rotator Cuff Injuries

  • Rotator Cuff Tear – micro or macro tearing of the muscle bulk (usually a large force is required for this to happen.
  • Rotator Cuff Tendinopathy – usually associated with over use of the tendon part of the muscle causing irritation and sometimes inflammation to the tendon.

It is important to see a physiotherapist or specialist to accurately diagnose the problem so that the best treatment can be given.

Rotator Cuff Age Prevalence 

Rotator cuff injuries can affect all age groups. Within the younger age population, it is more common to see issues caused by mechanical trauma and injury. Whereas within the older population it is more common to see pain through overuse and repetition. This is also exacerbated by a reduction of muscle strength and degenerative changes seen in the older population.

Common Symptoms  

  • Pain – Pain can be localised over the shoulder but can also refer down the upper arm
  • Painful Movements – Pain comes on with movement especially overhead movements
  • Weakness – Reduced ability to carry out normal movements
  • Functional Impairments – Being unable to do complete normal day to day activities involving the shoulder due to pain
  • Disrupted Sleep – Sleeping on the affected shoulder can cause pain and irritation

Golf shoulder pain

If you experience shoulder pain during activities like golf, you should listen to your body and let it rest.

What You Can Do Help Manage Your Shoulder Pain

If you are unfortunate to experience shoulder pain then you should try the following steps to help reduce the pain and prevent it from getting worse.

  • Avoid activity that causes the shoulder to be painful in the short term – if you notice the shoulder is painful when serving a tennis ball then stop this activity, likewise if the shoulder is painful reaching up to a high cupboard, then it is advisable to avoid this in the short term.
  • Avoid sleeping on the shoulder that is painful – many people wake up in the morning in pain which then continues through into the day. Try to sleep on your back or on the opposite side.
  • Rest – giving the shoulder a chance to settle is very important, but that does not mean doing nothing with it. You should still use it for activities that are not painful

 

If your pain is due to trauma or an accident then it is important to get it checked out immediately. If the pain has gradually started then you should follow the above steps for a couple of weeks. If the pain has not settled by then then you should see a physiotherapist who will do a full assessment of the shoulder. It is important not to ignore your pain, in many cases people who ignore their pain find that it gradually worsens resulting in a longer period of rehabilitation before they are able to become pain free again.

 

Written by: Matt Cornwall, Registered Physiotherapist (HK, UK, SG), BSc (Hons) Physiotherapy

Graduated from Salford University in 2013, Matt immediately moved to Singapore. He spent 7 years working in a variety of hospital and private clinic settings. Whilst in Singapore, Matt was working with multiple sports teams including Singapore Rugby. After a year working in a private clinic in London, Matt made the decision to relocate back to Asia and join the Prohealth Sports and Spinal team in Hong Kong. During his time as a physiotherapist, he has continually looked to keep his knowledge up to date by attending many musculoskeletal courses.

Get more personalized advice by booking a session and assessment with Matt.

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