The rotator cuff, something everyone always talks about and seems like just about everyone has had a problem with or even surgery on…. So what is it and what does it do?
The rotator cuff is a group of 4 muscles in your shoulder that help to hold and move your arm bone within your shoulder socket. When one or more of these muscles becomes irritated or torn it can lead to significant pain and limitation with any arm movement- which as you can imagine, has a huge impact on your day to day life.
The four muscles that make up the rotator cuff include:
The supraspinatus
The infraspinatus
The subscapularis
The teres minor
All four of these muscles start on the shoulder blade (AKA the scapula) and attach to the arm. Each muscle serves a different purpose- to move the arm in a different direction. As expected, these muscles rack up major use throughout the day, making it easy for them to be worn down and eventually, cause us problems or pain.
Shoulder impingement is typically the precursor to a problem with the rotator cuff (Check out the blog post on shoulder impingement here). When the shoulder is impinged it means that one of your muscles is getting pinched or pulled incorrectly over a bone. To visualize, think about putting a rope (you’re muscle), over a rock (you’re bone) and pulling that rope back and forth, again and again and again and again (moving your arm constantly during the day). Eventually that rope would start to fray if not eventually totally tear. This is the same concept with your rotator cuff. Therefore, it is important to ADDRESS PAIN EARLY!
If you work to fix the mechanics of your shoulder early on, you can prevent that muscle from being pinched and hopefully avoid rotator cuff problems all together. So just to make sure we are clear…..GET THERAPY IMMEDIATELY. We can fix your pain in just a few sessions if it’s early, compared to waiting months to years- our job and your success rate don’t look as great.
Making sure the rotator cuff muscles are all firing and pulling their equal weight is an important part of a therapist's assessment. If one muscle is working harder than another, or one muscle becomes too tight while another one stretches out, it can cause your arm bone to sit asymmetrically in your shoulder socket and lead to further pinching. A custom exercise program is crucial for recovery. The worst thing to do is to stop using your arm. This can lead to further muscle wasting or worse- a frozen shoulder.
If you continue to have shoulder pain with no improvement or you are in a traumatic accident causing shoulder pain, a doctor will most likely send you for an MRI which allows them to see the muscles and tendons to determine if there is a problem. From here they will discuss whether surgery is your next best option.
Every surgeon and person has a different surgical experience, preference and post operative protocol so it’s important you ask all the right questions in your appointment to know what to expect.
Use the below questions as a guide:
How many muscles need to be repaired?
How long should I expect to wear a sling for?
How long do you think I will be out of work for?
What is the total recovery time for a surgery like this?
How many times a week will I have therapy? How many months do you anticipate I will need therapy for?
Will I be able to sleep in my bed or do you recommend sleeping in a recliner?
What should my expectations be in regard to how much motion and strength I will gain back? How long until I can expect 80% of my strength back?
The rotator cuff plays a huge role on how we use our arm and therefore how we do just about everything in our daily life. Check out our exercise sheet for common exercises for the rotator cuff. If pain continues, see a therapist and get a customized exercise plan…in case you forgot, TREAT SHOULDER PAIN ASAP.
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