Why Your Rotator Cuff Matters More Than You Think – Part 1: How Your Rotator Cuff Works & What Happens When It Fails

Rotator Cuff painIt’s no surprise that the rotator cuff muscles are often ignored and rarely properly trained. A set of four relatively small muscles and tendons in the shoulder, their job is to keep the ball of the shoulder joint in place. That task may sound relatively simple, but consider the enormous forces that sometimes pass through our shoulders, putting serious strain on the little rotator cuff muscles. If they fail, a combination of pain, weakness and inefficient mechanics may prevent you from performing certain activities, limit your athletic pursuits or hurt your job performance.

The good news is that rotator cuff problems can often be prevented, and, if caught early, these injuries can often be treated with physical therapy alone. More serious rotator cuff injuries may require surgery. Our surgeons at Emory Sports Medicine are experts at performing rotator cuff surgery and getting you back to regular activity as soon as possible.

When The Rotator Cuff Fails…

Let’s back up and talk about what happens when your rotator cuff develops a problem. There are three stages of rotator cuff injury. The first stage is tendonitis, a simple inflammation of the rotator cuff, which can be painful but is relatively simple to treat. The second stage is tendinosis, in which the tendons of the rotator cuff start to degenerate. The third stage is a tear of the rotator cuff.

Tendonitis and tendinosis can usually be treated with physical therapy alone, with a high success rate. Very small tears may also be treatable with physical therapy, but generally a larger tear will require surgery to repair, followed by physical therapy to rebuild the rotator cuff and help prevent a future injury.

Signs of a Rotator Cuff Injury

The very best thing you can do to successfully treat a rotator cuff injury is to recognize it early and seek treatment promptly, hopefully before a tendonitis or tendinosis becomes a tear. Early treatment can mean the difference between physical therapy and surgery, and the difference between returning soon to the game or your work and an extended absence while recovering from surgery.

Early warning signs of a rotator cuff injury include:

  • Pain in your shoulder when you’re getting dressed, particularly when you are putting your shirt on or taking it off.
  • Pain in your shoulder when you’re reaching behind your body, such as to grab something out of the back seat of your car.
  • Pain when sleeping on your shoulder.

If any of these signs persist for more than a couple weeks, you should get your shoulder looked at promptly.

Signs of a more advanced rotator cuff injury include:

  • Weakness or a sense of instability in the shoulder.
  • “Night pain” in the shoulder: pain experienced when you are lying on your back and resting, pain that continues through the night.

If you have these symptoms, you should get your shoulder examined at Emory Sports Medicine right away. People over 50 who experience any of these symptoms are considered even more likely to have a rotator cuff injury.

So what are your treatment options if you injure your rotator cuff? And, more importantly, how can you prevent rotator cuff injuries from occurring in the first place? I’ll address those questions in part two of this post, so check back on the blog in about a week.

Michael Biller is the director of physical therapy for Emory Physical Therapy’s Perimeter and Sugarloaf locations and currently treats patients at the Perimeter location. He graduated from the University of North Carolina at Chapel Hill with his physical therapy degree in 1992. He is a board certified clinical specialist in orthopedics and is a McKenzie credentialed practitioner. Biller is a guest lecturer on many topics, including the spine and extremities, and serves as a book reviewer for the Journal of Orthopedic & Sports Physical Therapy. He is also Emory Physical Therapy’s clinical coordinator for student education. He is married to his lovely bride, Rachel, who is also a physical therapist, and has two children. Biller enjoys getting outdoors on the weekends, especially to go mountain biking and hiking.

 

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