What is rotator cuff dysfunction?
The rotator cuff are a group of muscles that form a cuff around the shoulder joint. They control the movement at the shoulder ensuring a smooth, natural movement. If one or more of these muscles becomes compromised, control at the shoulder is hindered resulting in pain.
What causes rotator cuff dysfunction?
There are many different causes:
- Inflammatory conditions e.g. tendonitis, bursitis, arthritis
- Trauma e.g. falling or contact sports
- Repetitive strain
- Whiplash injury
What are the symptoms of rotator cuff dysfunction?
Rotator cuff dysfunction is characterised by a loss of control of the movement at the shoulder joint resulting in pain and/or clicking. The pain is most often felt at the side and front of the upper arm and is worse with usage of the arm especially with overhead activities, lifting and reaching behind your back. The pain is often bad at night and you may not be able to sleep on the affected side. You may also experience weakness which can then become worse through not using your arm due to the pain.
Diagnosis of rotator cuff dysfunction
A thorough subjective and objective assessment will need to be carried out by your physiotherapist to ensure correct diagnosis and therefore appropriate and effective treatment. Due to the complexity of the shoulder complex and the fact that the neck can also have a part to play in referring pain to the shoulder, a thorough assessment is essential. Your physiotherapist will tailor your assessment to your needs but it is likely to include some or more of the following; observation and palpation, range of motion, strength, flexibility, stability and specific special testes for the rotator cuff.
Physiotherapy treatment for rotator cuff dysfunction
The main goals of treatment will be to reduce pain and stiffness, improve strength and function and prevent re-injury by addressing the causal factors. Your treatment will be tailored to your needs and based on the assessment findings. It may include; advice and education, joint mobilisations, soft tissue mobilisations, strengthening and stability exercises, electrotherapy (ultrasound), acupuncture, taping, postural re-education and self management strategies.
When to seek help from a physiotherapist
If your pain has come on gradually but does not seem to be settling within two to three weeks then you should seek help from a physiotherapist. Due to the complexity of the shoulder complex, pain from the rotator cuff can result in you adopting abnormal muscle patterning which can become habit so it is essential to seek help from a physiotherapist. If your pain has come on suddenly from trauma you should first seek advice from your GP in case an X-ray is required then seek help from a physiotherapist after 48 hours of RICE (rest, ice, elevation, compression).