Rotator Cuff Injuries

The rotator cuff is a group of four small muscles and their tendons that play an important role in keeping your shoulder stable and moving smoothly. Because we use our shoulders for so many daily activities—lifting, reaching, throwing—rotator cuff injuries are very common. These injuries can vary in type and severity, but most fall into a few main categories:

1. Tendinitis (irritation of the tendons)/ Tendinosis/ Tendinopathy:
This happens when the tendons in the rotator cuff become inflamed from overuse, repetitive movements, or poor posture. You may notice pain when lifting your arm, reaching overhead, or doing activities like hanging out the washing or throwing a ball. The ability of the Rotator Cuff tendons to withstand your daily activity demands is impaired.

2. Bursitis (inflammation of the cushioning sacs):
Near the rotator cuff tendons are small fluid-filled sacs called bursa, which help reduce friction & enhance movement. When a bursa becomes irritated, it can cause pain, impingement and limit your shoulder motion, often in conjunction with tendinitis or tendinopathy.

3. Partial tears:
Sometimes the tendon develops small tears or fraying, but it isn’t completely torn. This may cause weakness, pain with movement, or a feeling that the shoulder isn’t as strong as it used to be. With partial tears we remove the symptoms with hands-on manual therapy and then strengthen and heal with specific exercises proven to help rotator cuff function. 

4. Full-thickness (complete) tears:
In more severe cases, the tendon can completely tear away from the bone. This might happen suddenly with an acute traumatic injury, such as falling onto the arm or lifting something heavy. Acute traumatic tears are more common in young, active people and cause immediate pain and loss of strength.

Full-thickness tears may also develop gradually over time following multiple partial tears that have weakened the rotator cuff tendons. A full tear often causes significant weakness and difficulty lifting or rotating the arm and an accurate clinical assessment and MRI is often needed for diagnosis.

5. Degenerative changes:
As we age, the blood supply to the tendons reduces, making them more prone to wear and tear. Over time, this can lead to chronic irritation or tears without a single obvious injury. Addressing any imbalances and strengthening surrounding muscles is important to restore shoulder function.