Rotator Cuff Injury: Physical Therapy Treatment
The rotator cuff keeps the shoulder joint stable and allows the arm to have a significant amount of rotational and stretching mobility. Injury to the rotator cuff is fairly common, whether due to an acute tear from an accident or degeneration of the tendons from repeated overuse. Physical therapy can address pain, restore movement and range of motion to the shoulder and arm, and safely rehabilitate the rotator cuff following surgery.
What is the Rotator Cuff?
The shoulder is a ball and socket joint, in which the head of the upper arm bone (the humerus) fits into the shallow socket in the shoulder blade. The rotator cuff muscles come together as tendons to form a covering around the head of the humerus and attach the humerus to the shoulder blade, stabilizing the shoulder joint. This allow you to lift and rotate your arm. Bursa is the lubricating sac between the rotator cuff and the bone on top of the shoulder. The bursa allows the rotator cuff tendons to glide freely when moving the arm.
Rotator Cuff Injury
Injury to the rotator cuff is fairly common. The rotator cuff can become irritated or inflamed due to heavy lifting, repetitive arm movements, or trauma. Athletes like tennis and baseball players, older adults, and heavy laborers like construction workers are particularly susceptible to rotator cuff injury. Aging also weakens the muscles and tendons of the rotator cuff to the point where injury to the rotator cuff can occur.
Rotator cuff injuries include:
Tendinitis: overuse of the rotator cuff muscles and tendons, which become inflamed.
Bursitis: inflammation of the bursa.
Strains or Tears: occur due to overuse or acute injury. A strain occurs when the tendons are overstretched, whereas a tear is either a partial or complete tear through the tendon.
A rotator cuff tear can be:
Acute: a tear that occurs suddenly due to a trauma like a fall or lifting a heavy object.
Chronic: a slow-developing tear resulting from repeated movement of the arms working above shoulder level like a sport or certain work activities.
“Partial Thickness”: A partial tear occurs when a portion of a rotator cuff muscle or tendon is torn but it does not extend all the way through the muscle/tendon.
“Full Thickness”: A tear that extends from the top to the bottom of the rotator cuff muscles and tendons.
Symptoms of a rotator cuff tear include:
Pain over the top of the shoulder or down the outside of the arm
Shoulder weakness
Loss of shoulder motion
Feeling of weakness or heaviness in the arm
Inability to lift arm to reach up or reach behind the back
Inability to perform common daily activities due to pain or limited motion
Physical Therapy Treatment for Rotator Cuff
Physical therapy can address pain and stiffness of the rotator cuff muscles and tendons and restore mobility to the shoulder and arm. A physical therapist first evaluates a patient’s rotator cuff injury using a series of tests to measure arm and shoulder range of motion and strength. If surgery is needed, the physical therapist and orthopedic surgeon work together to ensure the patient has proper pre-surgery and post-surgery rehabilitation to ensure optimal recovery.
Working with a physical therapist is crucial to safely regain full use of the injured arm and rotator cuff. The physical therapist can reduce pain and inflammation using manual therapy and modalities of ice and electrical stimulation. Particularly in the first few weeks post-surgery, a physical therapist plays an important role in helping to strengthen and improve range of motion in the repaired rotator cuff, helping the muscles and tendons of the rotator cuff heal properly. A physical therapist strengthens smaller muscles that are important to the shoulder’s movement to compensate for the damaged tendons as they heal. The physical therapist then progresses the patient to more difficult mobility and strengthening exercises based on the patient’s needs and recovery timeline with the goal of returning the patient to full use, daily activities, and work or sport.
Rotator Cuff Strengthening Exercises
Mangiarelli Rehabilitation physical therapist Jen Kiernan-Story demonstrates rotator cuff strengthening exercises in the video below.
