Furnace Brook Physical Therapy



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	>	Rotator Cuff Injuries



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How Physical Therapy Can Help You

Periodically, Furnace Brook Physical Therapy will offer a case study highlighting different conditions and treatments, and offering information on what patients can expect and how physical therapy can aid in their rehabilitation.

Rotator Cuff Injuries

What is the rotator cuff?

The shoulder joint is a ball and socket type of joint and is comprised of 3 bones, the shoulder blade, collarbone, and the humerus. These bones are connected by different ligaments, broad capsules, and the rotator cuff. The rotator cuff is made up of 4 muscles, the supraspinatus, infraspinatus, teres minor, and subscapularis. These work together to provide stability to the shoulder joint as well as rotate and raise the arm. Because the shoulder joint is built for so much motion, this leaves it vulnerable to injury.

What can go wrong with the rotator cuff?

Several factors may cause rotator cuff irritation and tears. It can be acute and occur with a fall or other strong force to the shoulder, or it may be chronic, meaning that the injury occurs and progresses over time. This can be due to repeated stress to the shoulder, such as repeated overhead activities and poor posture. The following are common types of rotator cuff injuries.


		Impingement: Impingement occurs when a tendon of the rotator cuff, most commonly the supraspinatus, gets pinched between the humerus and top of the shoulder blade. This can occur if bone spurs form and narrow the space where the tendon glides through. Bad posture and weak muscles can also lead to impingement as these factors put the shoulder in a position in which the space for the tendon is narrowed. This can also occur due to natural anatomical variations that might predispose you to an impingement. A rotator cuff impingement may be the cause of both tendonitis and bursitis.

		Tendonitis: Repeated impingement and/or stress to the rotator cuff tendons can lead to increased friction and inflammation to the tendon. This can occur with repetitive overhead motions.

		Bursitis: Between the rotator cuff tendons and the top of the shoulder blade lies a fluid filled sac called a bursa. The bursa helps to absorb shock and cushion tendons to reduce friction. A shoulder bursitis is an inflammation of this bursa. This can occur when the space in which the bursa lies becomes narrowed (impingement). The repeated rubbing or friction on the bursa can cause inflammation and pain.

		Tear: A tear can occur with continuous impingement and/or tendonitis of the tendon, which over time can cause fraying and weakening of the tendon, and eventually a tear. It can also occur with acute trauma, such as a fall onto the arm. Tears can be partial or complete.

Signs that you may have a rotator cuff injury:

Each of these types of rotator cuff injuries may cause similar symptoms. These include, but are not limited to:


		Pain with reaching overhead, out to the side, or behind your back
		Decreased shoulder motion
		Decreased strength in raising your arm
		Marked night pain that may awaken you and cause an inability to lie on the affected side.

If you note that you have any of these symptoms, contact your doctor for an examination of the shoulder. He or she may request that you have an X-Ray or MRI or refer you to physical therapy to help with determining the problem. If you do have a rotator cuff injury, there are several treatment options.

Treatment options for a rotator cuff injury


		Physical therapy: A physical therapist will fully examine your shoulder and the surrounding areas to determine your impairments and what may be causing the problem. He or she will then develop a full and comprehensive plan to address what is causing the inflammation. This may include pain control procedures, postural education and muscle strengthening, range of motion exercises, and a full exercise program including the tools you will need to keep your shoulder healthy.

		Cortisone Injections: Your doctor may suggest a cortisone injection. He or she will inject a dose of cortisone, which is an anti-inflammatory medication injected directly into the joint space to decrease the inflammation and pain.

		Anti-inflammatories: Your doctor may also prescribe an oral anti-inflammatory medication to help control the inflammation and pain.

		Surgery: If you have a rotator cuff tear and have exhausted your conservative treatment options, your doctor may suggest having surgery to repair the torn tendon.

Rehabilitation after Surgery:


	After having a rotator cuff repair, your doctor may recommend physical therapy. Physical therapy can help to restore shoulder motion and strength so that you can return to your every day life with ease.

Prevention of rotator cuff injuries:


		Watch your posture!
		Be sure that your workstation is set up in an optimal position
		Avoid repeated overhead motions. Use a stepstool if you must
		Contact your doctor if you begin to notice any of the above symptoms to correct the problem before it worsens