The rotator cuff refers to a group of four muscles which run from the shoulder blade to the top of the arm bone. These muscles attach to the arm via tendons; strong connective tissue that connects muscle to bone. Rotator cuff tendonopathies, or impingement, occur when there is inflammation, degeneration or swelling in one or more of these tendons in the shoulder. This is normally due to overuse, especially in people that play a lot of racquet sports or perform a lot of repetitive overhead movements.
The most commonly affected rotator cuff tendon is the supraspinatus muscle, which helps to lift your arm up to the side. Its tendon passes through a small space below the acromion, the bony point on the top of the shoulder. It is particularly susceptible to wear and tear when passing through this space. Therefore, repetitive use of the supraspinatus muscle (and the tendon) can result in it rubbing against the other tendons and edges of the bony space causing many microscopic tears and degeneration within the tendon.
This degeneration and irritation to the tendon results in further inflammation and pain, often felt deep in the shoulder and the upper part of the arm. Initially, pain may only be felt following exercise or after heavy use of the shoulder. However, as the condition worsens it may be felt during exercise and specifically upon waking the following day. You may also feel a form of stiffness or tightness within the shoulder.
This is a common condition that we see in the clinic. Your physiotherapist will perform a full examination of the shoulder, utilising a variety of tests to determine whether you are suffering from an impingement. Our treatment for this condition involves advice regarding the RICE principle (rest, ice, compression, elevation) and activity modification acupuncture, electrotherapy and deep tissue massage, along with a strengthening exercise plan for you to complete at home between sessions. We generally recommend weekly sessions for a rotator cuff impingement, however these are spaced out as the condition improves.