Rotator Cuff Therapy Exercises

Rotator Cuff Tear

A rotator cuff tear is a term given to a rupture in one of the rotator cuff tendons.

Generally the term refers to a tear in the tendon where it attaches to the Humeral Head of the upper arm bone. Of the four rotator cuff tendons a cuff tear most often occurs in the Supraspinitus tendon.

Rotator cuff tears are classified as either partial or full thickness. In the case of a partial cuff tear the tendon is damaged but that damage does no extend completely through the tendon.

A full thickness tear however extends through the whole tendon that is torn away from the bone.

Rotator Cuff TearWhat causes a rotator cuff tear?

There are two distinct types of tears.

  1. Acute tear – Caused by an identifiable trauma or accident
  2. Chronic Tear – An injury with a gradual onset over time.

Acute rotator cuff tears

Acute tears are difficult to quantify as they can have so many different causes. Accidents such as car crashes, slips, trips or falls and tears caused when lifting heavy weights. These are by no means all the possible causes but they do represent the major contributors.

Acute tears are the most common type in those under 40 years old. With advancing age tears are more commonly associated with chronic tears.

Chronic tears

Chronic cuff tears are associated with a number of factors.

  1. Overuse
  2. Gradual weakening of the tendons
  3. Poor blood supply
  4. Impingement
  5. Advancing age

A typical scenario is this.

  1. As we get older we use our shoulders less and less.
  2. Our rotator cuff muscles become weaker.
  3. The shoulder becomes unstable
  4. The humeral head rides up
  5. The rotator cuff tendons become impinged (squashed)
  6. The tendons are gradually weakened
  7. A tear occurs

This is just one example but it is a classic scenario. There are other common scenarios and sometimes things are not so black and white. For example, it is also common for someone with a gradually weakening rotator cuff to suffer a mild trauma that my result in an acute injury.

Rotator cuff tear symptoms and diagnosis

Symptoms

There are a number of symptoms that are regularly reported. Everyone is different so you may experience some but not necessarily every typical rotator cuff symptom. 

  1. Pain ranging from a dull ache to an intense sharp pain
  2. Muscle weakness especially in lifting
  3. Limited motion
  4. Grating, cracking or catching noises / sensations
  5. Pain at night disturbing sleep

Diagnosis

An accurate diagnosis can usually be made by a doctor. The diagnosis will be based upon obtaining a thorough medical history of the shoulder and a physical examination. It should be possible for a tear to be diagnosed and even the affected tendon identified.

The initial diagnosis will often be followed up with a more detailed investigation. If it is decided a more detailed diagnosis is required then range of options are available, such as

  1. Xray
  2. Ultrasound
  3. Mri
  4. Arthroscopy

Rotator cuff treatment

Treatment of a cuff tear is best done naturally. Unless you are young and have suffered an acute tear then rotator cuff treatment will be by exercise. Surgery is only the first option for large cuff tears.

I have had surgery and believe me exercises for rotator cuff injury treatment is the way to go. Surgery has to be followed by virtually the same rehab program anyway. Since that is the case it’s best to save yourself the trauma and go for the natural option first. If you don’t respond to rehab then surgery can still be considered at a later date.

In the mean time however, get yourself a shoulder wrap or shoulder support to ease tension on your rotator cuff and not aggravate it further.  You need to take care of it immediately until you decide on a game plan, or it will get much worse.

 

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