The rotator cuff is a group of muscles and tendons that surround the shoulder joint, stabilising the humerus in the joint. Injury to these muscles or tendons is a common cause of shoulder pain. This article covers common causes, symptoms, treatment and prevention of rotator cuff injuries, as well as how shoulder massage can help.
Used with permission: Dr. Joe Muscolino. www.learnmuscles.com – art work Giovanni Rimasti)
Causes of rotator cuff injuries
There are several ways the rotator cuff muscles can get injured. The most common ones are:
Overuse
Repetitive overhead motions, such as those used in sports like baseball, tennis, or swimming, can cause wear and tear on the rotator cuff muscles and tendons, leading to injury.
Trauma
Injury could be caused by a direct blow to the shoulder, or by twisting, stretching or over-exerting the muscles.
Impingement
When the rotator cuff tendons become pinched between the bones in the shoulder joint, it can cause inflammation and lead to injury.
Symptoms of Rotator Cuff Injuries
Image credit: Injuyrmap
The symptoms of a rotator cuff injury can vary depending on the severity of the injury. Common symptoms include:
Pain
The most common symptom is pain in the shoulder, which can be a dull ache or a sharp, shooting pain. The pain is often felt when lifting the arm or when lying on the affected side.
Weakness
A rotator cuff injury can cause weakness in the shoulder, making it difficult to perform everyday activities like brushing your hair or reaching for something on a high shelf.
Stiffness
Injury can also cause stiffness in the shoulder joint, making it difficult to move the arm freely.
Clicking or popping
Sometimes clicking and popping when moving the shoulder joint can mean there is a rotator cuff injury, although healthy joints can also sometimes click and pop.
Treatment of rotator cuff injuries
Rest
In the acute (first few days) of any injury, it’s important to rest the affected area.
Rehabilitation
As with all muscle injuries, steps should be taken to prevent recurrence of the injury and loss of function/range of movement of the muscle. This can happen due to scar tissue and wasting of the muscle while injured.
Minimising scar tissue
When a muscle is injured, the body’s natural response is to initiate a healing process.
Cells called fibroblasts begin to lay down collagen fibres at the injury site. Collagen is the primary structural protein in the body and is essential for providing strength and stability to tissues. However, fibres may be laid down in a haphazard manner during injury repair, which results in a dense, fibrous, and often inflexible tissue. Scar tissue can impede muscle function and mobility and can be a continuing source of pain and discomfort.
There are several steps we can take in order to minimise the formation of scar tissue and encourage healthy healing of the muscle:
Engaging in gentle movement and exercise as soon as possible after an injury can helps to prevent excessive collagen deposition and promote healthy muscle tissue formation. It will also help to preserve muscle strength (see muscle weakness below).
Regular massage of the injured area helps to break down scar tissue and promote healthy blood flow and tissue healing.
Stretching maintains the range of motion in the injured area, which can help prevent the formation of scar tissue. It can also assist the healing process by promoting blood flow to the injured tissues, thereby improving delivery of oxygen and nutrients.
Maintaining muscle strength
Damaged muscles are painful to use and using them usually impedes the healing process. It’s inevitable that some strength will be lost due to injury and in order to restore full functionality to the muscle and prevent further injury, rehabilitation exercises should be done as soon as is appropriate. These should include both stretching and strengthening exercises.
Prevention of Rotator Cuff Injuries
While accidents and injuries are always a possibility, having strong, flexible muscles and healthy shoulder joints will reduce the risk. The main ways of preventing injury are:
Having good posture and movement control
Poor upper body posture is the cause of a range of issues, including tension, pain and injury. When upper body posture is good, movement control is also improved, due to better stability in the spine and shoulders.
Stretching
Exercises to keep muscles strong and flexible should be done routinely, not just as part of a rehab program.
Avoiding overuse
If you do sport or an occupation that involves a lot of shoulder movement, ideally you should allow proper rest and recovery. However, if your occupation involves repetitive shoulder movement, then rest is obviously difficult. You can minimise the risk of injury by
- Ensuring your posture and movement control are good
- Doing stretching and mobilising exercises for your shoulders
- Having regular massage to assist in muscle repair
How shoulder massage can help
Regular shoulder massage helps to keep the muscles supple and healthy, by breaking down muscle fibre adhesions and encouraging blood flow through the muscles. It can prevent problems caused by poor posture and overuse from becoming increasingly worse and causing injury. It also breaks down scar tissue from previous injury, allowing the muscles to function more smoothly, which reduces the risk of re-injury. With recent injuries, massage encourages healthy healing of muscles with minimal scar tissue.
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