The rotator cuff is a group of 4 muscles which attaches from the shoulder blade to the humerus in the upper arm. The rotator cuff is designed to support the shoulder joint as well as aid with elevation and rotation movements. Rotator cuff strain occurs when too much tendon in placed on the muscles and connecting tendons resulting in damage or tearing of the muscles.
The most common cause of rotator cuff strain is overuse injury and it usually seen in patients who perform excessive amounts of heavy lifting, pushing and pulling movements in which poor technique may be adopted. Rotator cuff strain may also occur as a result of impact or strain to the area causing damage to happen suddenly for example after falling on an outstretched arm.
This injury is commonly seen in throwing and racquet sports such as cricket, baseball and tennis due to the nature of throwing hard and excessive swinging against force.
When a rotator cuff strain occurs, patients are likely to feel a pain in the shoulder which becomes more apparent over time as activity is resumed and the area is placed under further strain. In the case of sudden impact, the pain may come on suddenly at the point of injury and may prvent the individual from continuing activity.
Patients are also likely to feel pain and stiffness in the shoulder even after activity is halted which will become more apparent first thing in the morning. In more severe cases, individuals may also feel pain in upper arm, shoulder blade and upper back and muscle weakness and even wasting can occur.
In order to diagnose rotator cuff strain, a doctor or physiotherapist will give an examination of the area and often a ultrasound or MRI scan will be undergone in order to confirm the amount of tearing and also to rule out any further complications.
In order to treat rotator cuff strain, rest is crucial in order to allow the injury time to heal and to prevent any further activity which could cause damage or discomfort to the injury. Applying ice to the injury is an important aspect of healing as it will reduce any swelling and inflammation as well as providing cooling pain relief to the injury. Using the RICE method (rest, ice, compression and elevation) is beneficial for the first 72 hours of the injury occurring as it will reduce swelling to the area and by keeping the injury elevated blood flow is restricted which can prevent further inflammation.
Anti-inflammatory medications can also be taken in order to reduce swelling as well as relieving pain or aching from the injury. When the injury has begun healing and you are advised by a physiotherapist or doctor, it is important for the patient to undergo a rehabilitation program such as strengthening and stretching exercises which will keep the area strong and make it easier to return to sports once the injury has fully recovered. These exercises should not be carried out if the patient feels pain in the area and the advice of a physiotherapist should always be sought in order to obtain an exercise regime suitable for the individual.
If the injury is reoccurring, the patient may find it beneficial to re-evaluate their technique depending on how the injury was sustained for example if the injury frequently occurs after heavy lifting the patient may decide to look at the way they perform this movement to improve their posture and technique. This may put a stop to any bad habits which have caused the injury in the first place and prevent it from happening in the future. In very severe cases such as in the case of a major or complete tear or if other methods have proven unsuccessful, surgery may be required to correct the injury which will need to be followed by an intensive course of rehabilitation to ensure the patient makes a full recovery.