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Rotator Cuff Syndrome

Rotator cuff syndrome, high impact sports, and what you need to know

rotator cuff syndrome

With the Australian Football League season kicking off soon, you may be hearing announcers and sportswriters talking about the various injuries players earn (we like to think of them as badges of honor).

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One of the most common physical problems in this sport is various types of rotator cuff injuries, including rotator cuff syndrome. In fact, shoulder, upper arm pain and injuries account for 11.5 missed games per club per season, and these injuries are largely the result of tackling and contact.

Of course, you don’t have to be an AFL player who’s playing a high impact sport sans shoulder padding to suffer from shoulder issues or injuries, including rotator cuff syndrome.

If you think you may have an injury to your rotator cuff or are suffering from rotator cuff syndrome, then read on and of course, consult an orthopaedic surgeon.

What Is Rotator Cuff Syndrome?

The rotator cuff muscles are the main ones that stabilise the ball and socket shoulder joint. They control its movement, and allow it to turn or rotate and otherwise work properly.

You may already know that your shoulder joint is a ball and socket joint that is made up of four muscles that combine to make the rotator cuff.

These are the subscapularis, supraspinatus, infraspinatus, and the teres minor. They control the shoulder blade or the scapula bone (the socket), and form a cuff around the head of the humerus bone (the ball).

rotator cuff injury

The term rotator cuff syndrome encompasses a variety of shoulder problems, including minor strain injuries, partial tendon or muscle tears, complete tears, or even the loss of shoulder function.

Rotator cuff injuries and rotator cuff syndrome are fairly common shoulder problems for highly active individuals, especially amongst athletes who play sports like the aforementioned Australian Rules Football, rugby, American football, and other high impact endeavors.

What Causes Rotator Cuff Syndrome?

Your rotator cuff is an essential group of muscles that provide control and stability for your shoulder joint, keeping the shoulder ball centralized over the socket and preventing problems like shoulder dislocations, shoulder impingements, and shoulder subluxations.

Any of the structures that make up your rotator cuff can be damaged through acute or sharp injuries, like those that occur during high impact, high speed sports, a significant fall, or other accident.

afl injury list

Rotator cuff syndrome can also be caused by repetitive motion (think overhead movements like throwing a baseball).

Normally, the tendons and muscles that form your rotator cuff are protected from damage by the bones and ligaments that create a stabilizing arch at the top of your shoulder along with the subacromial bursa sac.

This fluid-filled sac provides a smooth surface for your tendons to glide over, preventing them from rubbing directly against the bone and allowing for complete shoulder movement. In addition, your scapula bone serves as the main dynamic but stable base plate attaching your arm to your chest wall.

Any or all of these structures can be injured or damaged and result in rotator cuff syndrome, rotator cuff pain, or related injuries.

What Are the Signs and Symptoms of Rotator Cuff Syndrome?

Every individual will experience a rotator cuff injury differently, but there are some common symptoms.

These include pain or a clicking feeling when your arm is over your head or at shoulder height or higher as well as placing your hand behind your back or head, pain while lying on the hurt shoulder, pain that radiates from the top of the shoulder to the elbow, pain or weakness when attempting to reach for something high up or when lifting even lightweight objects, or pain when reaching across your body (for instance, when buckling your seatbelt).

what is rotator cuff syndrome

If you experience shoulder pain even when you are at rest and your arm is down or propped on something (e.g. a pillow or armrest), then you may have a more severe rotator cuff injury and you should see an orthopaedic surgeon as soon as possible.

Of course, while the type of acute shoulder injuries and rotator cuff damage that you’ve seen when watching the AFL and similar sports may seem obvious, you should know that these players – and athletes who participate in similarly high risk and high impact sports – may experience less visible injuries as a result of combined hits, bumps, and knocks over time.

So, if you play Australian Rules Football, rugby, or participate in similar high impact activities and you start experiencing shoulder pain, be sure to get any shoulder pain or rotator cuff pain checked out by a surgeon who understands how these sports affect the human body as soon as possible before it has the chance to escalate.

An ounce of prevention is worth a pound of cure!

How is Rotator Cuff Syndrome Diagnosed?

If your trainer, physiotherapist, sports doctor, or orthopaedic surgeon thinks you may have a rotator cuff injury or other shoulder injury, they will start with physical clinical tests and imaging in order to determine the type and extent of the damage.

They should also look at your history (if any) of shoulder, arm, or back injuries, along with the type of sports and activities you regularly participate in.

Ultrasound scans are typically considered one of the more accurate diagnostic tools for rotator cuff syndrome; MRIs may also be performed, along with X-rays if broken bones or similar issues are suspected.

Physical tests such as moving your arm and body in specific ways to assess the location, type, and level of shoulder pain you are suffering from will likely be utilized as well.

If your physician suspects that rotator cuff syndrome is a possibility, they will work to establish the specific type of injury or combination of injuries along with their location, since the necessary treatment may be significantly different depending on the exact diagnosis.

What Shoulder Issues or Injuries are Similar to Rotator Cuff Syndrome?

The shoulder joint is a rather delicate joint that can be unstable, especially if you participate in high impact sports.

The rotator cuff muscles and tendons are especially vulnerable to full and partial tears, bursitis, tendonitis, impingement, and similar injuries, as well as general inflammation. All of these can be comorbid with rotator cuff tears and similar shoulder problems.

Some of these types of injuries – including rotator cuff syndrome and other injuries – require surgery, especially more severe cases such as the type of rotator cuff damage caused by acute injury or trauma to the shoulder joint.

weak rotator cuff

Non-Surgical Treatment Options for Rotator Cuff Syndrome

For more minor rotator cuff injuries, you may not require surgical intervention. Partial or incomplete rotator cuff tears can heal on their own with rest and proper treatment.

Physiotherapy, icing the joint, pain relief medications, and other anti-inflammatory methods may be all that you need in order to regain the full range of motion and restore scapular control, rotator cuff strength, normal neck-scapulo-thoracic function, power, proprioception, and agility.

As always, consult with your orthopaedic surgeon and do not return to your standard sport or work activities without their okay.

All of this said, if you are a high-level athlete, you may be a likely candidate for surgery, especially if you want to continue in a relatively risky sport.

Surgical Treatment Options for Rotator Cuff Syndrome

For more significant or acute rotator cuff injuries, surgery may be required, particularly if the individual suffering from the issues is younger and an athlete.

For example, AFL players would be more likely to undergo various types of shoulder surgeries due to the high impact nature of the sport and the desire to get back out there and play again as soon as possible.

There are a range of surgical options depending on the damage to the shoulder and the type of injury or syndrome, many of which are outpatient procedures. Naturally, consult with your orthopaedic surgeon as to the best course of action for your specific rotator cuff injuries and your goals for the outcome.

rotator cuff muscles

Recovering from Rotator Cuff Surgery

Once you’ve had surgery or other treatment for a rotator cuff injury, you’ll likely need time off from work and be required to do physiotherapy to strengthen the damaged joint and get your full range of movement back (or at least as much as possible).

These are gentle and low impact exercises that help to stabilize your shoulder joint and are performed under the supervision of a physiotherapist. If you are an athlete or treating an athlete, these exercises can be designed with a specific sport and role in mind with the goal of getting back on the field as soon as possible.

Some techniques that physiotherapists or trainers commonly use include joint mobilizations (moving the shoulder joint through a series of positions that are meant to improve rotation and flexibility), therapeutic massage, ultrasound treatments, icing the joint, applying heat to the joint, stability exercises, and strengthening exercises.

All of these are aimed at preventing your shoulder from getting stiff while stretching the muscles in a natural way – and getting you back in the game.

Under the advisement of your doctor and therapists, you may also be assigned an exercise regimen to perform at home. You should also avoid other activities and sports that might cause you to aggravate the injury or otherwise get in the way of the healing process.

It’s essential to understand that once you’ve injured your rotator cuff, it’s more likely to happen again in the future. Be realistic about your capabilities and how quickly your shoulder is healing, and follow the advice of your doctor, trainers, and physiotherapists.

How to Prevent Rotator Cuff Syndrome

Proper warm-ups and stretching along with strength training can go a long way towards preventing rotator cuff injuries and rotator cuff syndrome, as well as consulting your trainer and doctor at the first sign of nagging shoulder pain.

While sometimes rotator cuff injuries can be obvious in the case of an acute tear from an impact on the field or at work, rotator cuff syndrome can also creep up slowly over time as the damage accumulates.

This is where having things checked out at the first sign of a problem and engaging in preventative nonsurgical treatment can help decrease rotator cuff pain, strengthen your rotator cuffs, and help prevent greater problems in the future.

One Comment

  1. Carollyne Jewall

    Hi Doctor I’m a 72yo female I work as a nurses aide I was attacked on my way to work and ended up with rotator cuff tears I had the surgery October 30 2018 Having read your article on shoulder impingement I think that is the problem I am having If it is why would I have the impingement 6 months post surgery Does it mean the surgery was not successful When I saw the surgeon prior to April 1 He told me I had frozen shoulder and he gave me a cortisone shot I would appreciate any suggestions

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