Rotator Cuff Related Conditions
What is it?
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The rotator cuff is comprised of 4 muscles that help move and stabilise the shoulder.
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Rotator cuff related pain is one of the most common causes of shoulder pain.
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There are many different reasons why rotator cuff pain may occur. These can include:
- Rotator cuff tendinopathy.
- Rotator cuff tears (Can be traumatic or non-traumatic).
- Calcific tendonitis.
Typical Symptoms/features:
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Pain generally at the front and side of the shoulder. It may radiate down the arm a bit.
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Can occur after trauma or overuse (overload).
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Pain can come on slowly over time or quickly.
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Pain may be present with certain positions or following activity/exercise.
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Limitations in function e.g. putting on coat, reaching behind your back or brushing hair.
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Inability to lie on the shoulder.
Management:
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Activity modification
- When you first start noticing shoulder pain, it may help to reduce your activity for a short amount of time to allow the pain to settle.
- However, there is strong evidence that says keeping active and slowly returning to your normal levels of activity can actually help the pain to settle quicker.
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Ice or heat.
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Pain relief.
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Physiotherapy including range of movement exercises and a graded strengthening programme.
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In cases with severe and/or prolonged symptoms, other options such as steroid injection may need to be explored in addition to physiotherapy.
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In absence of trauma, surgery is generally only considered if other treatments have not been successful.
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For calcific tendonitis, surgical removal or Barbotage may be offered to break up the calcium deposits.
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In traumatic rotator cuff tears, orthopaedic referral may be indicated and include further imaging and sometimes surgical repair.
Do I need imaging?
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Imaging (X-rays or scans) is rarely required to diagnose non traumatic rotator cuff related pain.
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In cases where calcific tendonitis is suspected, X-ray and ultrasound can both pickup on calcium deposits in the tendon.
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Ultrasound or MRI may be used after a significant trauma or when it will guide treatment.
