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Shoulder Pain - The Rotator Cuff

One of the most common presentations to clinic is that of shoulder pain, which can often stem from injury to the rotator cuff.

The rotator cuff is a group of muscles and tendons that surround the shoulder joint, keeping the head of your upper arm bone (the humerus) firmly within the shallow socket (the glenoid) of the shoulder.

There is a lubricating sac called a bursa between the rotator cuff and the bone on top of your shoulder (acromion). The bursa allows the rotator cuff tendons to glide freely when you move your arm. When the rotator cuff tendons are injured or damaged, this bursa can also become inflamed and painful.

Rotator cuff injury can occur as the result of either an acute, substantial injury to the shoulder, or to progressive degeneration or wear and tear of the muscles / tendons. Repetitive overhead activity or heavy lifting over a prolonged period of time may irritate or damage the tendon.

The most common symptoms of a rotator cuff tear include:

- Pain at rest and at night, particularly if lying on the affected shoulder

- Pain when lifting and lowering your arm or with specific movements

- Weakness when lifting or rotating your arm

- Restriction of movement / loss of range of motion in the shoulder

- Pain travelling down the arm.

Many people with rotator cuff injury can manage their symptoms and return to activities with conservative treatment of physiotherapy and rehabilitation, to improve the strength and stability of the muscles surrounding the shoulder joint, aswell as the mechanics of the upper limb. The goal of physiotherapy is to reduce pain and restore function.

Occasionally, surgery may be necessary for large, debilitating tears in a rotator cuff tendon. Surgery to repair a torn rotator cuff most often involves re-attaching the tendon to the head of humerus (upper arm bone).

Physiotherapy and rehabilitation is a key component to maximise recovery after surgery, and return to pre-injury levels of activity.


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