What the cuFF is wrong with my shoulder?
Shoulder pain is very common, both in the active population, and those who are more sedentary. Over the past 2 years of lockdowns, there has been an increase in those with shoulder pain. One cause of shoulder pain, may be an injury to the rotator cuff complex.
What is the rotator cuff complex?
The rotator cuff complex is a group of four muscles (infraspinatus, supraspinatus, teres minor, and subscapularis) that work together in theshoulder. Their role is to connect our arm bone (humerus) to our shoulder blade (scapula). These muscles working efficiently, allows us to achieve the large ranges of motion our shoulders can achieve, compared to less mobile joints such as the elbow.
Have I injured my rotator cuff?
A wide range of terms get used to describe pain in this area. Sometimes a specific muscle is blamed, or the condition is called SAPS (subacromial pain syndrome). A far less catchy, but more inclusive term that we at MVMNT use is RCRP (rotator cuff-related pain). This term is more encompassing of the entire rotator cuff complex, as without imaging, it is very difficult to specify one muscle as the primary cause of pain. As a matter of fact, it is often unimportant which muscle is the primary or “most” injured muscle, as we train them all in unison during the rehab process. Shoulder pain can be caused by tendons, nerves, joints, or a combination of these, so thorough history taking and examination is crucial. A common presentation of someone with RCRP is pain during lifting tasks, overhead movements, lying on shoulder, and a loss of end range of motion.
Why did I get RCRP?
Shoulder pain can be after a traumatic event. This can be a rugby tackle, lifting something heavy in the gym, having a fall onto an outstretched arm, or even during an innocuous accident at home. In the case of a traumatic shoulder injury, assessment by a health professional is important. Structures in the shoulder can be injured, without needing further imaging such as an MRI, or referral to a surgeon. However, in some more serious cases, or when someone plays a very high level of sport, onward referral may be necessary.
Shoulder pain can also be gradual, slowly building in pain levels during your sporting or work activities. This may be a sign that you are doing more with your shoulder, than the muscles that support the joint can handle. Some factors that predispose people to shoulder injuries may be working in heavy manual jobs, taking up a new sport, being slightly older in age, being a smoker, or having an injury to the other arm, meaning that this shoulder has to compensate.
Why Physiotherapy might help my shoulder?
Initially, physiotherapy assessment can triage the severity of the injury, and ascertain whether onward referral or imaging may be required. Physio assessment will also try to form a picture of why this injury happened. Is it referred pain from the neck? Is there an underlying weakness? Is there an issue with your form in the gym? A detailed physiotherapy rehabilitation program can guide you to perform your activities pain-free. Gradually, we aim to build the whole upper body to be able to handle more weight, for longer periods of time. This may also involve some focus on building your core and lower limbs.
What are my other options?
It is recommended that prior to trying invasive procedures such as injections, shockwave therapy, or surgery, that resistance/strength training is used to build up a strong foundation. In the case that invasive treatment is still needed down the line, this means that you will be in a stronger starting position to recover form the procedure.
If you are currently experiencing shoulder pain and you would like a a plan to get back to your activities pain-free, click here to book an assessment with one of our physios.