Welcome back! We often hear about how someone we know tore their rotator cuff while shoveling snow, playing a casual athletic event, or fell awkwardly while grabbing onto something stable. This is one of those injuries that everyone needs to know something about due to how prevalent it is.
One of the hallmarks of this condition is that it is typically a sudden onset of intense pain that can include pain down the arm. There will be a severe lack of ability to utilize this shoulder or have pressure applied to it. Without proper treatment, this pain will continue to worsen because the muscles/tendons will continue to become inflamed and damaged. Prolonged inflammation leads to additional damage of the tissues, not to mention increasing the amount of scar tissue that could be laid down once healing does start to take place.
The image above demonstrates the locations of the muscles that are a part of the “rotator cuff”. As we read last week about the Supraspinatus, this muscle can often become impinged. It has the action of raising the arm above shoulder level. The supraspinatus plays a role in rotator cuff tears by preventing the arm from being raised above the head. Infraspinatus and Teres Minor have the main action of external rotation of the arm. The easiest way to assess this motion on your own is to pin your elbow into the side of your rib cage/abdomen and rotate your hand away from your body. The inverse of this action (rotating your hand toward your midsection with elbow pinned is internal rotation and that is where the Subscapularis operates.
The Supra and Infraspinatus are the most commonly injured of the four muscles, somewhat from impingement and otherwise from excessive rotation with overhead motion. Like stated before, reducing inflammation is a large part of the treatment and healing process for this injury. Once pain and inflammation has reduced, then treatment shifts to strengthening, increasing range of motion, and increasing function in the positions that the shoulder will find itself in based on your specific needs. This is assuming surgery to repair is not required beforehand.
A big part of this condition is preventative strengthening, stretching, and care/maintenance. Monitoring and maintaining control of your shoulder during activity is one of the best ways to prevent this type of injury. Do not disregard minor pains like this. Chiropractic care can help maintain proper mobility to the area and assist the muscles by encouraging proper firing patterns.
Check back next week when we discuss Anterior and Posterior Dislocations!