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Rotator Cuff: Secrets of the Shoulder Stabilizer

2/12/15 11:20 AM

What is Shoulder Impingement?

Your “shoulder” is a very complex joint that is actually comprised of several joints. The primary joint of the “shoulder” is the Glenohumeral joint (where the shaft of the arm meets the socket). Other joints that make up the shoulder complex include the Scapulothoracic Joint (shoulder blade and mid-back) and the Acromioclavicular Joint (this is where the collar bone meets the shoulder blade). These three joints work together to make your arm move. Pain can occur if these three joints do not work together.

One of the most common injuries to the shoulder involves the Rotator Cuff...

The Rotator Cuff is made up of four muscles: Supraspinatus, Infraspinatus, Teres Minor and Subscapularis. These four muscles work together to control the stability of the shoulder during movement, especially overhead, and rotation motions.

The Rotator Cuff injuries can include strains / sprains, tears (mild to severe / complete) and impingement. There are also several other injuries that can occur in the shoulder.



Injury to the Rotator Cuff (or RTC) can result from repetitive movements: throwing, rowing, swimming, factory / industrial work, anything that involves arms over head repeatedly or for a long period of time (mechanics, painters, etc). Another mode of injury is falling onto the arm with an outstretched hand, landing on your hand.

The Rotator cuff is commonly injured because of the poor blood supply to these muscles. This puts them at a higher risk for injury. This can also add to the reason why the Cuff heals slowly. 

Impingement Syndrome is a common injury to the shoulder that involves repetitive movements, especially overhead. “Impingement” essentially means “pinching”. The Rotator cuff muscles are surrounded by the bones of the shoulder. When they become injured, swelling of the tendons and muscles can occur. This will create a pinch on them from the bones. As a result, use of the shoulder becomes painful. Remember, the Rotator Cuff controls the stability of movement. So, without this stability, lifting your arm can really hurt!

Symptoms of a Rotator Cuff injury (primarily a strain or impingement) can include:

  • shoulder pain, especially in the front
  • pain with raising your arm above 90 degrees
  • radiating pain to the upper arm
  • pain reaching behind your back (putting on a coat)
  • unable to sleep on effected side
  • weakness of the shoulder
  • pain when reaching across the front of you

A Physical Therapist can complete special tests to verify a Rotator Cuff injury. True confirmation of the severity of the injury comes through imaging studies.

Possible Treatment...

  • Over the Counter Anti-inflammatory medication
  • Injections
  • Surgery
  • Physical Therapy. A Physical Therapist can perform an evaluation to involve mobility, stability and strength testing. Treatment programs are designed to be individualized for your specific needs. The Rotator Cuff is the shoulder stabilizer. Treatment can involve stretching, rest: avoid excessive overhead movement, gradual strengthening and stabilization exercises. Modalities such as ice or ultrasound can also be helpful. Education is a HUGE component of treatment, avoiding re-injury is key!
Written by Mary Smith.

Mary Smith, PT is currently practicing as a Physical Therapist in our Baldwinsville office. She specializes in (and enjoys) treating injured runners to get them back to their craft, or simply reaching their best.

Topics: shoulder, pain between shoulder blades, shoulder pain