Do You Have Shoulder Pain Or A Rotator Cuff Injury and Want to Know What You Can Do About It?

women doing yoga
Posted January 18, 2023
Ashlea Wilson
Physiotherapist
BKin(Hon), MSc(PT), Dip.Manip.PT, CMAG, FCAMPT

Shoulder pain and dysfunction is a very common condition we treat at Elora Physiotherapy and something you may be dealing with yourself! We know how frustrating, painful and debilitating it can be. There are various reasons why you may have shoulder pain and today we are going to review what the rotator cuff is and what you can do if you have tendonitis or tendinopathy of one or more of the rotator cuff muscles.

The rotator cuff is a group of four muscles that surround the shoulder. They are called

  1. supraspinatus
  2. subscapularis
  3. teres minor
  4. infraspinatus 

The muscles of the rotator cuff narrow into tendons and the tendons are what connect the muscles to the bone. The shoulder joint is a shallow socket that allows for a lot of movement and the muscles of the rotator cuff are important to provide support and stability for the arm. 

Rotator cuff injuries can occur from trauma (i.e.  a fall), but also from repetitive use injuries when the tendons are loaded beyond what they can tolerate. Sometimes this can cause the tendons to become inflamed as an acute or new injury (tendonitis), or the inflammation and irritation can linger and turn into a chronic condition (tendinopathy). The tendon can develop partial tears or sometimes complete tears where a surgical repair of the tendon may be needed. 

Physiotherapy is utilized in all the above cases to help settle the inflammatory response, mobilize restrictions of movement in the neck, upper back and shoulder, and most importantly strengthen and stabilize the shoulder, neck, back and core muscles. This helps to restore the resiliency of the shoulder to complete daily tasks, work duties, sports and extracurricular activities without irritating the rotator cuff.

What we often see with rotator cuff dysfunction is weakness in the muscles that help keep the shoulder blade in a strong position and allow it to move in a controlled way. We need the supporting and stabilizing muscles of the shoulder girdle to support your arm movement so the rotator cuff tendons can handle the load and not become impinged. For example, if the shoulder is resting in a forward and downwardly rotated position (i.e. slouched forward) and you start to move your arm or load your shoulder with weight sometimes the rotator cuff can take on more stress than it can accommodate and the tendons can become irritated and inflamed. 

Additionally, if you also have tightness in your neck, mid back area (thoracic spine), and shoulder (sometimes from poor posture, repetitive movements at work, sitting at a desk all day, etc.) this can also predispose the rotator cuff tendons to irritation due to excessive loads and increase the chance that the tendons become pinched or inflamed. 

We work with you to figure out what is the driver of your rotator cuff dysfunction and develop a plan of care to address it. We want to empower you to help sort out the triggers so when we settle down the rotator cuff inflammation it doesn’t creep back in because we have not addressed the underlying causes. 

Physiotherapy treatment for a rotator cuff injury will include things like:

  • Manual therapy (hands on treatment where your therapist helps mobilize stiff joints, release tight muscles, mobilize nerves that need more freedom of movement and circulation, etc.!)
  • Acupuncture to help restore balance to your nervous system. Acupuncture helps improve circulation, decrease pain and improve how your nerves are functioning
  • Modalities to help settle down pain and inflammation 
  • Mobility work (exercises to stretch and mobilize your joints, muscles, fascia, nerves, improve posture and shoulder mobility, etc.!)
  • Strengthening: this is where the real magic happens with rotator cuff injuries. Your therapist and you will figure out what movement patterns may be inadvertently stressing out the tendons in your shoulder. You will receive the exercises needed to address any patterns that are not serving you well and then exercises to strengthen all the supporting cast members! We want everyone working as a team and everyone doing their part. It takes time and focus, but it works.

Again, we know how painful and frustrating rotator cuff injuries and shoulder pain can be. It can start to affect every part of your day to day activities, work, sleep, sport, workouts, everything!! And we want you to know we have successfully helped many, many clients over the years overcome these injuries. You can get this shoulder pain under control and we can help. Call now to book or speak with a physiotherapist about your shoulder pain.