Injuries to the rotator cuff and its tendons are very common. Injuries are usually caused either by repetitive actions of the shoulder (overhead or reaching movements) or by sudden trauma (landing from a fall with the arm extended or a blow to the shoulder). Some injuries are caused by an age-related decrease in the elasticity of muscles/tendons, as well as degenerative changes in the shoulder joint.
Effective resolution of injuries to the rotator cuff require a combination of manual treatments, an ability to evaluate biomechanical impacts of the injury upon other structures in the body, and a rehabilitative exercise strategy that addresses all the structures in the shoulder, neck and torso.
Anatomy of the Rotator Cuff
The rotator cuff is made up of four major muscles and their associated tendons:
- Teres minor
The rotator cuff muscles serve several key functions including:
- Generating torque for shoulder movement.
- Acting as dynamic stabilizers of the shoulder joint (glenohumeral joint).
- Aiding in lowering and stabilizing the humeral head (end of the humerus bone) that fits into the shoulder joint.
Resolving Rotator Cuff Injuries with ART
Many rotator cuff tears can cause significant disability in the shoulder if left untreated. Conservative treatments such as Active Release Techniques® (ART®) and exercise rehabilitation can be effective in relieving pain and restoring function in the shoulder.
PARTIAL TEARS: Partial rotator cuff tears have an excellent prognosis with ART. The adhesions that form around the tear site are the main cause of pain and dysfunction in the shoulder. ART can release these adhesions and help reduce pain. Releasing the restrictions will increase in the strength and flexibility of the rotator cuff. Once pain is diminished, proper stretching and exercise is key in the rehabilitation of the rotator cuff.
COMPLETE TEARS: The usual cases from a complete tear will most likely need surgery to repair the damaged rotator cuff. However, during post-surgery recovery most people will still feel residual tightness and achiness in the shoulder. In those cases, the remainder adhesions and scar tissue must be released. ART and an individualized rehabilitation program will help the shoulder with full recovery.
OLD TEARS: ART directed to the site of the tear can usually resolve many of the symptoms associated with a torn rotator cuff. The formation of adhesions at the site of a healed tear is what causes the weakness, poor biomechanics, and pain within the shoulder. Even if the adhesion formed years ago, it can still be removed with ART.
In most cases, rotator cuff injuries can be easily treated with a combination of ART procedures and therapeutic exercise.
Lance Cooper is the only Physical Therapist that is a full-body certified Active Release Techniques® provider in the Rogue Valley.