Rotator Cuff Injury
Among the most common injuries that athletes and non athletes alike suffer from is either a tear or impingement of the rotator cuff, including yours truly. The rotator cuff is a group of muscles that work together to provide the shoulder joint with dynamic stability during rotation (that’s why they are called the rotator cuff). The four muscles that make up the rotator cuff are:
- Supraspinatus
- Infraspinatus
- Teres Minor
- Subscapularis
also referred to as the SITS muscles. The most commonly injured rotator muscles are the Supraspinatus and the Infraspinatus. Because of the function of these muscles, sports that involve a lot of shoulder rotation, such as swimming, kayaking, or pitching in baseball, often put the rotator cuff under a lot of stress and strain, making it more susceptible to injury.
When an injury does occur in the rotator cuff, it can be classified into one of two categories. Tears of the tendons/muscles or inflammation of the tendons (tendonitis). There are two types of tears, acute and chronic. I’ve listed symptoms of each below:
Acute Tear
This kind of tear tends to happen as a result of a sudden, powerful movement. It might include falling, catching yourself with a flat outstretched hand, making a sudden thrust with the paddle in kayaking, or following a powerful pitch.
The symptoms will usually include:
- Sudden, tearing feeling in the shoulder, followed by severe pain through the arm.
- Limited movement of the shoulder due to pain or muscle spasm.
- Severe pain for a few days (due to bleeding and muscle spasm) which usually resolves quickly.
- Specific tenderness over the point of the rupture or tear.
- If there is a severe tear, you will not be able to raise your arm 0ut to the side without assistance.
Chronic Tear
A chronic tear develops over a period of time. They usually occur at or near the tendon, as a result of the tendon rubbing against the overlying bone and is commonly associated with impingement syndrome.
- Usually found on the dominant side.
- More often an affliction of the 40 age group.
- Pain is worse at night, and can affect sleeping.
- Gradual worsening of pain, eventually some weakness.
- Eventually unable to abduct arm (lift out to the side) without assistance or do any activities with the arm above the head.
- Some limitations of other movements depending on the tendon that is affected.
If you currently have, or have ever dealt with, a rotator cuff injury you know how painful they can be. The question I most often hear in association with any injury of the rotator cuff is
How long will it take to heal?
Good question, and one I’ve asked myself on more than one occasion. However, the answer isn’t as straight forward as those of us affected would like it to be. There are several factors that come into play where healing is concerned. Obviously, the extent of the injury is a huge factor to consider as well as age. Unfortunately, as we age, it takes longer to heal due to changes in our physiology. The good news here is that it is possible to rehab a rotator cuff injury. The success rate range isn’t as high as I wish it were, 40-90%. In severe cases, where a chronic tear is the source of the problem, surgery might be necessary. In that case, 94% of people who undergo the surgery are happy with the outcome, claiming that it gave them lasting pain relief and improved function.
Obviously the best thing to do is prevent an injury from occurring in the first place. So, what should you do to accomplish that? It really comes down to common sense. If you have a job that is rather physical and demands a lot of use out of your shoulders, take frequent breaks, or rest periods, to avoid over use and strain. Make sure to stretch your rotator cuffs to achieve, and maintain, a good range of motion (ROM). As always, drink lots of water (a gallon per day) to ensure that your muscles are all properly hydrated. Performing exercises to provide strength and stability to the joint as a whole, and the rotator cuff specifically is another way of avoiding an injury.