The Big Bad Rotator Cuff

Finally, the conclusion to our series and the main event- the rotator cuff! If you haven’t read our other two blogs, be sure to check out the blogs on Upper Crossed Syndrome and Shoulder Anterior Impingement Syndrome. Why do we want you to have checked these out first? Well, patients with scapular dyskinesis or upper crossed syndrome are at a much higher risk for rotator cuff related injuries/strain/tendinopathy. (3) So- we want you to be familiar with these.

Let’s start by go over what tendinopathy actually means. A lot of times, this word gets used interchangeably with tendinitis. While the two have nearly identical symptoms, tendinopathy is a degeneration of the collagen protein that forms the tendon, which differs from tendinitis because tendinitis is just inflammation of the tendon itself. (2) Got it? Great! Let’s dive in.

The shoulder is comprised of a ball-and-socket joint that offers us great mobility. The more mobile the joint is, the greater the risk of structural instability.

*note, the subscapularis muscle sits on the other side of the shoulder blade (scapula) in between your shoulder blade and ribs

**This would show you the subscapularis looking at a shoulder from the front, with the rib-cage removed.

The rotator cuff is made up of the tendons of four muscles: the supraspinatus, infraspinatus, teres minor, and subscapularis. Its primary function is to stabilize the shoulder while the larger muscles move it. (3)

Rotator cuff injury is by far the most common shoulder injury, accounting for 4.5 million physician office visits per year (yeah- WHOA). (1) Injuries can range anywhere from a mild strain of just one tendon, to a complete rupture of multiple tendons. Rotator cuff strains can be caused by a single insult: like falling, pushing, throwing, lifting, etc. Although a rotator cuff strain could be caused by a single injury event, it is much more likely that a strain would develop due to repetitive injury or age-related attrition. (3)

Sports that include a repeated overhand motion are more likely to predispose a patient to impingement related injury (tennis, volleyball, CrossFit, softball, baseball, quarterback position in football, swimming). This same type of impingement related injury is also very common in people with jobs that include carpentry, painting, etc.

If you are diagnosed with a rotator cuff injury, a treatment plan will follow (I mean, hopefully anyways!). Most likely, this will first involve modifications to activity, stretching, and strengthening of scapular stabilizers and rotator cuff. Patients should also avoid sleeping on the affected side, especially with their arm stretched overhead- no matter how comfortable it may be! In office, IASTM (Graston) and kinesiology tape may be implemented, as well as adjusting your neck and midback. (3)

*Being unable to sleep on your side due to a painful shoulder is a sign you need to address your rotator cuff! Nagging rotator cuff pain? Give us a call- conservative care is VERY effective at treating rotator cuff pain! You don’t need to live like that! Until next time, Dr. Amy

References:

1. Oh LS, Wolf, BR, Hall MP, Levy BA, Marx RG. Indications for rotator cuff repair: a systematic

review. Clin Orthrop Relat Res 2007;455:52-63.

2. Heck, M. (2018, November 8). Tendinopathy: Definition, Comparison to Tendinitis, and

Treatment. Healthline Media. https://www.healthline.com/health/tendinopathy.

3. ChiroUp. (2020a). Rotator Cuff Strain/Tendinopathy. ChiroUp, 1-4.

4. Netter, F. (2014). 6. In Atlas of human anatomy: Including student consult interactive ancillaries and guides. Elsevier Saunders.