Injury to the rotator cuff is common among all age groups and is characterised by a pain or ache from the top of the shoulder that typically spreads down the middle of the upper arm. Most of the time pain is brought on by trauma or a sudden movement causing a strain and damage to the rotator cuff muscle or tendon. Symptoms can also develop gradually over time through repetitive movements or overuse.
What makes up the rotator cuff?
The rotator cuff is made up of 4 muscles (supraspinatus, infraspinatus, teres minor and subscapularis), starting from the shoulder blade (scapula) and attaching onto the long bone of the arm (humeral head). The shoulder joint has a wide range of movement, which can make it prone to injury in certain positions if excessive force is applied.
What are the symptoms?
Pain is typically intermittent or only present when making certain movements with the arm, though in more severe cases pain can be there most of the time. Reaching out for things at waist to shoulder height tend to produce a sudden catch, particularly with added weight. Carrying bags on the affected side if often uncomfortable too.
What can I do to improve my symptoms?
Non-steroidal anti-inflammatory drugs (NSAIDs) can be useful in the early stages when taken 48 or more after the symptoms started. It is always wise to check with your GP or local pharmacist if you would like advice or guidance on taking a course of NSAIDs. Often within 4-6 weeks symptoms can spontaneously resolve with general activity, but if they persist you should attend a physiotherapy consultation, either through your GP or self referral.
What can physiotherapy do to help?
A Physiotherapy consultation will help to determine an accurate diagnosis and put together an appropriate management plan to improve symptoms. Applying tape and using massage or acupuncture can be used for relieving pain. These can be used along with a graded exercise programme to build strength back into the shoulder. The exercises provided will be tailored to your particular goals, e.g. some may want to get back to high level sport, and for others day to day function.
How long does it take to get better?
For mild cases 4-8 weeks, for moderate strains 8-16 weeks and more severe injury can take six months or more to resolve.
What if my shoulder pain doesn’t improve?
It is important to keep a healthcare professional posted on the progress you make with your symptoms. If you do not make the expected progress it may be appropriate to be referred for a specialist opinion with an Orthopaedic Consultant. A chartered physiotherapist or GP will be able to provide advice on this.
Don’t put up with symptoms – get the injury checked out!
Whatever you do, don’t just sit and rest the injury. Rest on its own is never useful for persistent shoulder pain, and if anything can lead to making symptoms worse as the muscles loose strength and the shoulder gets stiff which makes the road back to health even longer. So don’t delay, book an appointment and get the shoulder checked out.
Specialist MSK Physiotherapist - Anthony Cahill
Physio Three Sixty, Hitchin