Rotator Cuff treatment at Naas Physio Clinic



KFM Radio Interview
Ross discussing Rotator Cuff. Press Play Below:


What is the Rotator Cuff?

The rotator cuff is a group of four muscles that provide stabilisation & support to the shoulder joint. A rotator cuff injury refers to an injury of the cuff muscles or their tendon insertions onto bone. Rotator cuff injuries will commonly result in pain with activities involving lifting or pushing. In more severe cases, pain will be present at night & may cause the person to wake.

The shoulder is a ball and socket joint that is capable of extreme mobility. As a consequence of this mobility the shoulder is inherently less stable than other joints. The rotator cuff muscles have an important role in shoulder stability through their action in compressing the humeral head (top of the arm) into the glenoid fossa (shoulder socket). Injury to any of these important support structures can give rise to instability of the shoulder joint and this may cause pain with movement.

Conditions affecting the rotator cuff may include acute or chronic tears & tendonopathy. An acute tear of the rotator cuff usually occurs as a result of a trauma in a younger person. Tears can be either partial thickness or full (complete muscle tear). Clinically, there may be severe pain, weakness and a significant decrease in motion. Cuff tears can be diagnosed using ultrasound.

Causes of Rotator Cuff Injury

Injury to the rotator cuff may occur due to poor lifting technique, muscle imbalance or repetitive activities. Rotator cuff injury is particularly common in overhead athletes such as swimmers or badminton players or occupations requiring overhead positions such as painters or plasterers.

Rotator Cuff Tendinopathy

Most people with rotator cuff tendinopathy will report a gradual onset of pain. Most cases occur in those over 40 years of age & patients will often report pain lying on the affected side.

Surgery for the Rotator Cuff

Recent research suggest that there is no difference between non-surgical and surgical management of  rotator cuff tears. The theory of shoulder impingement by bony structures has not proven to hold up to scientific scrutiny and this may undermine the the supposed mechanism by which surgery is supposed to exert its effects. This has led to suggestions that surgery may act as a placebo or benefits may arise due to greater adherence to rehabilitation protocols used after surgical interventions

Rehabilitation for Rotator Cuff

Rehabilitation of the shoulder commences with low level exercises & progresses sequentially through stages of increasing difficulty. Exercises focus on the cuff muscles & also incorporate the scapula & thoracic spine. Posture at the thoracic spine & neck can play an important role in determining the angle of the shoulder socket (glenoid fossa) & therefore can significantly alter the movement characteristics & muscle recruitment patterns present at the shoulder. Over time this can place pressure on the rotator cuff & give rise to impingement.

Other treatment modalities include soft tissue release techniques, joint mobilisations, dry needling & postural re-education. Pain during shoulder movements can occur due to superior migration of the head of the humerus (arm) in the shoulder socket. The aim of the rehabilitation programme is to strengthen the cuff muscles in order to prevent abnormal translation of the humerus and to gradually increase stability. This process requires persistent effort from the patient & it can take a number of months to recover from this injury. In cases where improvement does not take place with consistent rehabilitation, then orthopaedic referral may be warranted.

To find out more regarding Rotator Cuff Injury, contact the Physio Clinic Naas & Newbridge now on:
(045) 874 682

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