Most people don’t give much thought — if any at all — to their “rotator cuff”. That is, not until it starts giving them trouble, and by trouble, we mean pain and restricted movement. So what exactly is the rotator cuff, and what can happen to make it hurt?
Getting Acquainted with Your Shoulder Joint
Your shoulder is made up of three main bones, plus muscles, tendons, and bursa. The head or ball of your upper arm bone, known as the humerus, fits neatly into a socket in a second bone known familiarly as your shoulder blade (and known in medical circles as the scapula). The third bone that makes up your shoulder as a whole is your collarbone (medically known as the clavicle). So where does the rotator cuff come into play?
The rotator cuff is the name given to four muscles that come together to hold the head of the humerus bone inside the socket of the scapula, where it belongs. These muscles also provide a protective covering around the head of the humerus bone. And topping the whole thing off is a lubricating sack known as the bursa, which allows the rotator cuff to glide and move freely between the bones, including the small bone that caps off the shoulder, which is known as the acromion.
When Something Goes Wrong
Because the rotator cuff is made up of muscles, it’s possible to sprain it, and it’s also possible to tear it. In addition to those things being the result of injuries, it’s also possible that overuse (common in athletes whose sports involve repetitive overhead motions) and simply aging can cause it to wear, and become problematic.
An extensive tear is especially serious since all four of the muscles that make up the rotator cuff need to work together in order to hold the humerus in place and allow the shoulder to move freely. It’s also interesting to note that a tear needn’t happen all at once, and can often begin with some fraying, which weakens the muscle and makes it more susceptible to tearing when under just the right amount of pressure.
An injured rotator cuff can manifest as a dull ache in the shoulder, and that ache can worsen at night, especially when you try to sleep on the affected joint. You may also experience an inability to reach behind your back (as in combing or styling your hair), and your arm may feel weak.
Repairing and Recovering From a Rotator Cuff Injury
You might think that the only way to repair a torn rotator cuff is through surgery, and you’d be at least partly right. Many rotator cuff tears won’t heal on their own, but that is not to say that the condition can’t be improved non-surgically through anti-inflammatory medications, injections of steroids, and a good program of physical therapy. Of course, for those whose jobs require repetitive reaching, surgery may be required in addition to the other treatments mentioned here.
The Role of Physical Therapy in Recovery
You find out exactly how much you use your shoulder when it becomes impossible to perform simple tasks that you once took completely for granted. Surgery may have “fixed” the tear in your rotator cuff, but that doesn’t mean that life goes immediately back to “normal” in terms of movement and even in terms of less pain and discomfort.
A physical therapist will prescribe a program of exercises designed to strengthen the affected (and adjoining back and chest) muscles with the goal of restoring flexibility, improving range of motion, and easing pain. You might wonder why this is necessary. Wouldn’t just resting your shoulder until it heals bring the best result? Unfortunately, that approach can lead to a thickening and tightening of the connective tissue surrounding the shoulder joint, resulting in a condition known as “frozen shoulder”.
A physical therapy program is a crucial part of your successful recovery from a rotator cuff injury. If you’re in the Northeastern Pennsylvania region, be sure to check out the services available at Cawley Physical Therapy and Rehab, where you’ll have access to an extensively trained team of doctors of physical therapy, as well as state-of-the-art equipment, exercise machines, and a caring staff.
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