Rotator Cuff
- rotator cuff is a group of four muscles and tendons
- used for strength and stability in the shoulder and scapula
Muscles of the Rotator Cuff
Supraspinatus:
-Helps the deltoid abduct the arm at the shoulder
Infraspinatus:
-Extends the arm and rotates it laterally
Teres minor:
-Helps hold the humeral head in the glenoid cavity of the scapula
Subscapularis:
-Rotates the head of the humerus medially (internal rotation) when the arm is raised
-Helps the deltoid abduct the arm at the shoulder
Infraspinatus:
-Extends the arm and rotates it laterally
Teres minor:
-Helps hold the humeral head in the glenoid cavity of the scapula
Subscapularis:
-Rotates the head of the humerus medially (internal rotation) when the arm is raised
Rotator Cuff Tear
A tear of one or more of the tendons of the 4 rotator cuff muscles
Types of tears:
-Acute Tear- falling down on an outstretched arm or lifting something too heavy
- Degenerative Tear- result of a wearing down of the tendon that occurs slowly over time
Tears can either be:
-Partial- This type of tear damages the soft tissue, but does not completely sever it
-Complete- It splits the soft tissue into two pieces.
Types of tears:
-Acute Tear- falling down on an outstretched arm or lifting something too heavy
- Degenerative Tear- result of a wearing down of the tendon that occurs slowly over time
Tears can either be:
-Partial- This type of tear damages the soft tissue, but does not completely sever it
-Complete- It splits the soft tissue into two pieces.
MOI
Falling on your shoulder
Using an arm to break a fall
Lifting heavy weights
Overuse in sports
Everyone who plays a sport is at some risk for a rotator cuff strain
Using an arm to break a fall
Lifting heavy weights
Overuse in sports
Everyone who plays a sport is at some risk for a rotator cuff strain
Signs and Symptoms
Pain in the front of the shoulder, it may radiate to the front of the arm.
weakness or tiredness in the shoulder
“arm is heavy”
Most of your pain will be at night
Pain will be tolerable during the day, but may hurt with certain movements
weakness or tiredness in the shoulder
“arm is heavy”
Most of your pain will be at night
Pain will be tolerable during the day, but may hurt with certain movements
Special Tests
Drop Arm Test
Passively abduct the patient's shoulder, then observe as the patient slowly lowers the arm to the waist.
If there is a tear the arm will drop to the side
Patient may be able to lower arm slowly to 90 degrees but will be unable to continue the maneuver as far as the waist.
If there is a tear the arm will drop to the side
Patient may be able to lower arm slowly to 90 degrees but will be unable to continue the maneuver as far as the waist.
Empty Can Test
Theempty can position:
-90 degrees of abduction
-30 degrees of horizontal flexion
-full internal rotation of the arm
-Thumbs are pointed down
If there is painin the shoulder this can indicate a supraspinatus tear
-90 degrees of abduction
-30 degrees of horizontal flexion
-full internal rotation of the arm
-Thumbs are pointed down
If there is painin the shoulder this can indicate a supraspinatus tear
Treatment
Rest
Activity modification
Physical therapy
Anti-inflammatory medication
Ice application
-15-20 min
-Three times a day
Cortisone injections
If injury doesn’t heal and is sever enough surgery is required
Activity modification
Physical therapy
Anti-inflammatory medication
Ice application
-15-20 min
-Three times a day
Cortisone injections
If injury doesn’t heal and is sever enough surgery is required
Prevention
Strength exercises
Frequent breaks at your job or sport
Rest your shoulder regularly during sports
Apply cold packs and heat pads when you feel pain
Frequent breaks at your job or sport
Rest your shoulder regularly during sports
Apply cold packs and heat pads when you feel pain