“I Think I Tore My Rotary Cup.”

by Dr. Brett L. Lukert, DC

Common mispronunciations of the rotator cuff seem to indicate that this area of the shoulder is not very well understood. The shoulder is particularly vulnerable to injury because what it gains in mobility (the shoulder is the most mobile joint in the body), it loses in stability. This makes the shoulder very susceptible to injury. There are many muscles involved with the shoulder, but one of the most commonly injured areas is called the rotator cuff.

The rotator cuff is composed of four main muscles called the “SITS” muscles, which are the supraspinatus, infraspinatus, teres minor, and subscapularis. Their main job is to stabilize the posterior aspect of the shoulder. They also help lift the arm overhead and rotate the arm internally and externally. This is why an injury to the rotator cuff is most commonly seen in workers who have a lot of repetitive overhead lifting or in athletes who either fall on an outstretched arm, or have overused the shoulder while throwing. Symptoms include shoulder pain (often worse during the night), pain when lifting the arm, and point tenderness over the site of injury.

Once an injury to the rotator cuff has occurred, the next step is to determine if it is a strain/sprain injury or a tear. A sprain/strain injury will respond well to conservative treatment. This consists of ice, rest, myofascial release to break up scar tissue, rehabilitation, home exercises, and avoidance of further irritation until the area heals. If the case history and orthopedic exam indicate a likely tear, an MRI is usually performed, since this type of imaging specializes in soft tissue injuries. If a tear is confirmed, the patient will be referred to an orthopedic surgeon for further treatment options.

As with most injuries, early detection is the key to successful rotator cuff treatment. This can keep a potentially mild inflammatory condition from progressing into a chronic impingement or tear. If appropriate treatment and exercise is not followed through, the shoulder can permanently lose full function, and cause scarring around the joint. This eventually results in limited shoulder range of motion, and is referred to as a “frozen shoulder.”

Even better than early detection of a rotator cuff injury is prevention. The combination of a good warm-up, consistent stretching/strengthening exercises, using both arms rather than just the dominant arm at work, and icing after work or workouts has been consistently shown to minimize the risks of rotator cuff injuries. Additionally, if we are coordinated enough to avoid falling on an outstretched arm, we will really be in business! It’s always better to be proactive than reactive, so take measures to be healthy, live healthy, and stay healthy!