Rotator cuff injury is one of the most common causes of shoulder pain. The 3 types of rotator cuff injuries are rotator cuff tendonitis, rotator cuff impingement and rotator cuff tear. What exactly are rotator cuff muscles? They are a group of 4 muscles that work together around the shoulder (ball and socket) joint. Namely, supraspinatus, infraspinatus, subscapularis and teres minor. Complicated as they might sound, all 4 work as a unit to stabilise the shoulder joint.

So, let us talk about the anatomy of the shoulder joint. The shoulder joint is made up of 3 bones, the clavicle bone (collar bone), scapular bone (shoulder blade) and the humerus (upper arm bone). And these bones are joint together by tendons and ligaments. Muscle tendons link muscle to bone , while ligaments link bones to bones together. And all the 4 rotator cuff tendons joint together to form 1 large tendon called the rotator cuff tendon.

Let me explain the 3 types of rotator cuff injuries.
1. Rotator cuff tendonitis
This common cause of shoulder pain is due to the inflammation or irritation of the rotator cuff tendons. It can happen to people who overuse their shoulder joint, repetitive shoulder joint movement resulting in excessive wear and tear. Athletes with history of heavy weight lifting and throwing sports are highly susceptible to rotator cuff tendon inflammation.

2. Rotator cuff impingment
The rotator cuff tendon passes through a small space between the collar bone and the shoulder blade bone, also known as the subacromial space. in the impingement syndrome, the tendon is trapped in the subacromial space. Repeated scraping of the tendon leads to fraying and eventually weakens and more likely to tear. Rotator cuff impingement is more likely to cause a chronic pain and pain is worst when arm is raised above the head. Long term pain without proper treatment can lead to arthritis and bony spurs.

3. Rotator cuff tear
Weak shoulders, reduced range of movement and clicking/catching of the shoulder joint are symptoms of a tear. Pain tends to be over the front and outer part of the shoulder. Usually acute shoulder injury or a bad pull might cause a tear.

So what are the treatments for the above injuries? Firstly, seek medical help if pain persist and affects daily life. Get a MRI scan to diagnose it. Painkillers, anti-inflammatories and ice packs will help to reduce the pain. Steroid injections may be done by surgeons for minor tears. For large and complete tears, surgery is usually needed.

After enough rest (usually couple of weeks), pain will subside. Exercise rehab or physiotherapy should be done to strengthen the joint. A proper strength and conditioning rehab program is essential for a complete recovery. However, there is no definite cure or best treatment for shoulder pain. It all depends on the correct exercise prescription from a rehab specialist.

If u want to find out more about what are the exercises for rotator cuff injuries, feel free to drop us an email or give us a call. No obligations as we are always keen to share!!!

Stay healthy and train the safe way! See ya soon!

Sean Lee
Bsc exercise and sports science
Edith Cowan University