Rotator Cuff Injury

Rotator cuff injuries are a common cause of shoulder pain, affecting people of all ages, activity levels, and backgrounds. Whether caused by overuse, trauma, or degenerative changes, rotator cuff injuries can significantly impact mobility and quality of life. At Peak Osteopathy in Stanmore, we specialise in the diagnosis and treatment of rotator cuff tears, providing personalised osteopathic care designed to reduce pain, restore function, and promote long-term recovery.

This page provides an overview of rotator cuff injuries, their causes, symptoms, how they are diagnosed, and how osteopathy for shoulder pain can help in their treatment and rehabilitation.

What is the Rotator Cuff?

The rotator cuff is a group of four muscles and their associated tendons that stabilise and move the shoulder joint. These muscles are crucial for the shoulder's mobility and strength. They include:

  • Supraspinatus: Lifts the arm and helps stabilise the shoulder.

  • Infraspinatus: Responsible for rotating the arm externally.

  • Teres Minor: Works with the infraspinatus to externally rotate the arm.

  • Subscapularis: Internal rotation of the shoulder.

These muscles work together to stabilise the humeral head (the top of the arm bone) in the shallow shoulder socket (glenoid), allowing a wide range of motion while maintaining joint stability. When these muscles or tendons become damaged, it can lead to shoulder pain, weakness, and limited shoulder movement.

Causes of Rotator Cuff Injuries

Rotator cuff injuries can arise from two primary causes:

  • Acute Injuries: Traumatic events, such as falling on the shoulder, lifting something heavy, or a sports-related injury, can lead to tears in the rotator cuff muscles or tendons.

  • Degenerative Changes: Over time, repetitive overhead motions (e.g., in swimming, weightlifting, or throwing), aging, and poor posture can cause wear and tear on the tendons, leading to conditions like tendinitis, partial tears, or full-thickness tears.

Rotator cuff injuries are common among people who engage in activities requiring repetitive arm movements or lifting, but they can also occur due to natural age-related changes in the tendons.

Signs and Symptoms Of Rotator Cuff Injuries

Signs and Symptoms of Rotator Cuff Injuries

Common symptoms of a rotator cuff injury include:

  • Pain in the Shoulder: Often felt as a dull ache, especially when reaching overhead or lifting objects.

  • Weakness: Difficulty lifting or rotating the arm, particularly in overhead motions.

  • Limited Range of Motion: The injury may cause stiffness or pain that reduces shoulder mobility.

  • Pain at Night: Many people experience worsening pain at night, particularly when lying on the affected shoulder.

  • Clicking or Popping Sounds: A sensation of grinding, clicking, or popping when moving the shoulder, which may indicate tendon irritation.

If you’re experiencing any of these symptoms, it’s important to seek professional help. Early intervention can prevent further damage and improve recovery outcomes.

How to Identify a Rotator Cuff Injury: The Osteopathic Way

Identifying a rotator cuff injury typically involves a combination of history taking, a physical examination, Orthopaedic testing and a range of strength testing and movement testing. In some cases, imaging may also be needed to confirm the diagnosis. Here’s how the process typically unfolds:

1. History Taking

The first step in identifying a rotator cuff injury is a detailed discussion of the patient's medical history and symptoms. An osteopath will ask questions such as:

  • When did the pain start?

  • Was there any trauma, such as a fall or heavy lifting, associated with the onset of pain?

  • Does the pain increase with certain movements, such as reaching overhead or lifting?

  • Is the pain constant, or does it worsen at night?

A thorough understanding of the patient’s activities, medical history, and specific symptoms will guide the diagnosis.

2. Physical Examination

Next, a physical examination is conducted to assess the shoulder's range of motion and muscle strength. The osteopath will look for signs of pain, weakness, or stiffness. They may assess:

  • Active range of motion (how well the patient can move their shoulder independently)

  • Passive range of motion (how well the shoulder moves when assisted by the examiner)

  • Tenderness in specific areas, such as the rotator cuff tendons or the bursa

  • Strength testing ( how the muscles respond to movement against resistance)

3. Orthopaedic Testing

Several orthopaedic tests can help identify a rotator cuff injury. These tests are designed to isolate specific muscles or tendons to see how they respond to certain movements. Common tests include – but not limited:

  • The Empty Can Test: The patient raises their arm in front of them with the thumb pointing down (as if emptying a can). The examiner applies downward pressure to the arm while the patient resists. Pain or weakness during this test may suggest a supraspinatus injury.

  • Hawkins-Kennedy Test: The examiner brings the patient’s arm into a position where the shoulder is flexed at 90 degrees and then rotates the arm internally. Pain during this movement may indicate impingement or irritation of the rotator cuff tendons.

  • Drop Arm Test: The patient is asked to lift their arm above their head and then slowly lower it. If the arm drops quickly or the patient is unable to control the movement, this may indicate a tear in the rotator cuff.

  • External Rotation Resistance Test: The patient is asked to rotate the arm outward against resistance. Weakness or pain during this test can suggest injury to the infraspinatus or teres minor muscles.

4. Imaging

In some cases, if the symptoms are severe or if conservative treatments aren’t effective, imaging such as X-rays, Ultrasound, or MRI may be necessary to assess the extent of the injury. Imaging can help confirm the presence of:

  • Rotator cuff tears (partial or full-thickness)

  • Tendinitis or tendinopathy (inflammation or degeneration of the tendons)

  • Bone spurs or other structural issues that may be contributing to the injury

An MRI is particularly useful for visualizing soft tissue structures like tendons and muscles and can provide a clear picture of any tears or damage in the rotator cuff.

Osteopathic Treatment For Rotator Cuff Injuries

Osteopathy offers a comprehensive approach to treating rotator cuff injuries, focusing not only on the site of pain but also on the entire musculoskeletal system. Our osteopaths at Peak Osteopathy use a variety of techniques to help manage pain, reduce inflammation, restore movement, and promote healing.

What an Osteopath Will Do:

  • Pain Relief and Inflammation Reduction: Osteopathic techniques such as soft tissue massage, joint mobilizations, and trigger point therapy are used to reduce inflammation and relieve pain in the shoulder joint.

  • Restoring Mobility: Gentle stretching, joint manipulation, and mobilization techniques help improve shoulder mobility and flexibility, which is often restricted in rotator cuff injuries.

  • Strengthening the Muscles: Osteopaths provide guidance on rehabilitation exercises that target the rotator cuff and surrounding muscles to build strength and stability in the shoulder.

  • Posture and Movement Correction: Poor posture and movement patterns can exacerbate shoulder injuries. Our osteopaths assess your posture and provide exercises to help correct alignment, which reduces strain on the shoulder joint.

Treatment Duration & Sessions

Treatment for rotator cuff injuries varies depending on the severity of the injury and the individual’s progress. On average, osteopathic treatment typically involves 6 to 8 sessions spread across 4 to 12 weeks.

During the first few weeks, the focus will be on reducing pain and inflammation, restoring basic mobility, and relieving tension in the surrounding muscles. As you progress, your osteopath will introduce strengthening exercises and rehabilitation techniques aimed at improving shoulder function and preventing future injury.

Typical Treatment Timeline Example:

  • Weeks 1-2: Initial sessions focus on reducing pain and inflammation, with gentle joint mobilizations and soft tissue techniques.

  • Weeks 3-4: Mobility exercises and stretches are introduced to help restore the range of motion. Strengthening exercises targeting the rotator cuff and supporting muscles may begin.

  • Weeks 5-8: Emphasis shifts to rehabilitation, strengthening, and improving shoulder stability. Advanced strengthening exercises, such as resistance training, will be introduced.

Common FAQ’s

  • While some mild rotator cuff injuries can improve with rest and avoiding aggravating activities, most injuries require some form of intervention to fully recover. Without proper treatment, such as osteopathic care, strengthening exercises, or specific rehabilitation techniques, the injury may worsen, leading to chronic pain or loss of shoulder function. Seeking early treatment helps avoid long-term issues and ensures proper healing.

  • A partial tear means that the tendon is damaged but not completely torn, while a full-thickness tear involves the tendon being completely ruptured. A partial tear might cause pain and weakness but still allow some function of the shoulder, whereas a full tear can severely limit shoulder movement and cause significant pain.

    The treatment for both types can differ, with full tears sometimes requiring surgery to repair the tendon, while partial tears may respond well to conservative treatments like osteopathy and Strength rehabilitation

  • Yes, rotator cuff injuries are common not only in athletes but also in people who engage in repetitive daily activities that involve overhead motions. This includes tasks such as lifting, reaching, or even certain work-related activities.

    Older adults are also more prone to rotator cuff injuries due to age-related tendon degeneration. Osteopathy can help people of all activity levels manage pain and restore function, not just athletes.

  • Certain sports, especially those involving repetitive overhead motions, are associated with a higher risk of rotator cuff injuries. These include:

    • Swimming (particularly the freestyle stroke)

    • Tennis (especially in players who serve often)

    • Baseball (pitching)

    • Weightlifting (especially overhead lifts)

    • Volleyball and basketball (due to repetitive overhead actions) If you participate in these sports, it’s important to engage in regular shoulder exercises to prevent overuse injuries and maintain shoulder health.

  • Weakness is one of the early tell tale signs of a rotator cuff injury. The levels of weakness can also indicate the severity of the injury and the treatment and management required,

    With proper rehabilitation, most people experience significant improvement in 4 to 12 weeks. Severe tears may take longer to heal, but osteopathy, strengthening exercises, and proper care can help restore shoulder function and reduce weakness over time.

Common FAQs About Rotator Cuff Injuries

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Common FAQs About Rotator Cuff Injuries *

Why Choose Peak Osteopathy in Stanmore?

At Peak Osteopathy, we are committed to providing comprehensive care for rotator cuff injuries. Our experienced osteopaths specialize in diagnosing and treating shoulder conditions, offering personalized treatment plans designed to reduce pain, restore function, and improve overall mobility. Whether you’re recovering from a recent injury or managing a chronic shoulder condition, our team is here to guide you through your rehabilitation journey.

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