The rotator cuff is a group of 4 muscles and their tendons (tissues that attach muscles to bones), which connect the upper arm bone, or humerus, to the shoulder blade. The role of the rotator cuff is to keep the shoulder joint stable. Sometimes, the rotator cuff becomes inflamed or irritated due to heavy lifting, repetitive arm movements, or trauma such as a fall. A rotator cuff tear occurs when injuries to the muscles or tendons cause tissue damage or disruption.
Rotator cuff tears are called either "full-thickness" or "partial thickness," depending on how severe they are.
- Full-thickness tears extend from the top to the bottom of a rotator cuff muscle/tendon.
- Partial-thickness tears affect at least some portion of a rotator cuff muscle/tendon, but do not extend all the way through.
There are a series of movement tests that can be performed by a physical therapist to differentiate between a full thickness and partial thickness tear. If you have a partial-thickness rotator cuff tear, you should be able to rehabilitate this type of injury with a specialized physical therapy program.
In order to overcome a rotator cuff problem, the first common-sense recommendation is to take a short break from activities that are aggravating your shoulder. These may include overhead lifting, horizontal pressing (e.g. bench press and pushups), and high speed or high-impact upper body exercises. This allows for pain and irritation to settle down. If pain persists, receiving hands-on therapy can be effective in helping pain subside faster. Once your pain is under control, you can now address the root of your rotator cuff problems. In many cases, rotator cuff problems are associated with poor mobility of the lats and the t-spine. You may also have weakness of the lats, rhomboids, rotator cuff, and lower and middle trapezius muscles. In addition, if you have imbalances at your core and buttock muscles, your posture may be affected. All these factors can lead to movement compensations and place excessive stress on your rotator cuff. The best way to know what is contributing to your rotator cuff problem is to have a movement assessment performed.
If you have weakness, learning how to engage muscles that are not firing well is critical for shoulder health. Common muscles that may need extra attention include the serratus anterior, lower trap, lats, and rotator cuff. Exercises that can be beneficial during this stage include the side-lying shoulder rotation, serratus punch, prone I, and supine pullover.
Once your muscles engage better, the next step is restoring movement. The shoulder is a ball and socket joint and should move in three dimensions through large ranges of motion. Exercises that can be helpful to restoring normal shoulder movement include the reach, roll, and lift, lying handcuffs, and shoulder rotations at 90 degrees.
Once you have developed a good base of movement, you need strength to achieve lasting results. Strength is best achieved through functional movements like pushes and pulls. Some of the best strength exercises for the shoulder include the kettlebell armbar, Turkish get-ups, military press, and pull-ups (or pull-downs). If you can generate tension and maintain good technique, these types of exercises will enable you to enjoy a rock-solid shoulder for a long time.
Most of the aforementioned exercises can be found in our video library.
When addressed with a specialized physical therapy program, overcoming a rotator cuff tear is possible. However, ignoring pain and engaging in repetitive activity can result in a further decline of your shoulder health. If you're worried about shoulder pain, the physical therapists at Movement Solutions would be glad to help you.
We invite you to request a shoulder consultation with one of our specialists. This is an opportunity to ask questions, obtain clarity about your shoulder pain, and foster confidence that we can help you. If you’re certain that we’re a good fit to work together, you can decide on the next step.
If you’re in pain but unsure about what you should do, call us at (864) 558-7346 and ask how we can help.