The rotator cuff consists of four muscles in the shoulder called the supraspinatus, infraspinatus, subscapularis and teres minor. These four muscles move, stabilize and control the shoulder. Muscles are attached to bones by tendons. A rotator cuff tear is a tear to one or more of the rotator cuff tendons. Rotator cuff tears can occur from an injury or trauma, as well as from wear and tear over time through repeated micro traumas. Injuries or traumas to the rotator cuff usually occur immediately for example from a fall or lifting a heavy object. More commonly rotator cuff tears occur from repeated micro trauma over time, which can occur over several weeks, months or years. Rotator cuff tears can be partial, or full thickness.
Physiotherapy Treatment for Rotator Cuff Tears
Physiotherapy can help manage and heal a rotator cuff tear, however with large tears, surgical repair may be necessary. A Physiotherapist will take a detailed history and complete a comprehensive assessment, to determine the severity of your rotator cuff tear. If you have not already, your physiotherapist may refer you to your doctor for diagnostic imaging, which is typically done with a diagnostic ultrasound. With the information gathered from the assessment, the physiotherapist will develop an individualized treatment plan to treat your rotator cuff tear. Based on your assessment and your symptoms, your individualized treatment plan may include:
- Manual therapy techniques such as soft tissue release, mobilization or manipulation
- An individualized exercise program including range of motion exercises, muscle strengthening and stretching. As you heal, the physiotherapist will progress your exercises to make them more functional to help you reach your goals.
- Education activity modification, posture, sleeping positions, and prevention of re-occurrence.
- Modalities such as acupuncture, TENS, ultrasound, heat or ice
Symptoms of a Rotator Cuff Tear
Individuals with rotator cuff tears will typically experience shoulder pain and weakness, in varying degrees depending on the severity of the tear. Some people with rotator cuff tears may also present with clicking in the shoulder when they elevate their arm. Partial rotator cuff tears usually present with milder shoulder pain and weakness, especially with lifting your hand above shoulder height and behind your back. Full thickness rotator cuff tears usually present with more severe shoulder pain, and individuals may have difficulty lifting their elbow away from their body.
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