Rotator Cuff Injury

What are the rotator cuff muscles?

The rotator cuff is a group of muscles which work together to provide the Glenohumeral (shoulder) joint with dynamic stability, helping to control the joint during rotation (hence the name). The rotator cuff muscles include:

• Supraspinatus
• Infraspinatus
• Teres Major
• Subscapularis

Due to the function of these muscles, sports which involve a lot of shoulder rotation – for example, bowling in cricket, pitching in baseball, swimming, kayaking – often put the rotator cuff muscles under a lot of stress.

Problems with the rotator cuff muscles can be classed into two categories – Tears of the tendons/muscles, and inflammation of structures in the joint.

Acute Tear

This tends to happen as a result of a sudden, powerful movement. This might include falling over onto an outstretched hand at speed, making a sudden thrust with the paddle in kayaking, or following a powerful pitch/throw.

The symptoms will usually include:

• Sudden, tearing feeling in the shoulder, followed by severe pain through the arm
• Limited movement of the shoulder due to pain or muscle spasm
• Severe pain for a few days (due to bleeding and muscle spasm) which usually resolves quickly
• Specific tenderness (“x marks the spot”) over the point of rupture/tear
• If there is a severe tear, you will not be able to abduct your arm (raise it out to the side) without assistance

Chronic Tear

• Usually found on the dominant side
• More often an affliction of the 40+ age group
• Pain is worse at night, and can affect sleeping
• Gradual worsening of pain, eventually some weakness
• Eventually unable to abduct arm (lift out to the side) without assistance or do any activities with the arm above the head
• Some limitations of other movements depending on the tendon affected

Inflammation

• More common in women aged 35-50
• Characteristic ache in the shoulder which feels like it is coming from “deep inside”
• Tenderness over particular areas, less specific than a tear
• Usually a gradual onset of pain, which “flares up” if using the arms over the head or out to the side
• Can sometimes lead to a chronic tear if untreated

Please see the Virtual Sports Injury Clinic for more information on how to treat a Rotator Cuff Injury and other causes of shoulder pain.