When I mention the words “Rotator Cuff” to people, I tend to get a blank look in return. Some people even think it’s to do with a car. They have absolutely no idea that they have two of them – one on each shoulder. But if they have a rotator cuff injury, then the term starts to make sense because of the pain they are in!

Your shoulder is a well-designed and nifty joint with a huge range of movement. You have 7 movements at the shoulder, which are as follows:-

• Flexion – Raising your arm in front of you to take a can from a shelf.
• Extension – Pulling a bell-rope down.
• Abduction – Moving your arms out to the side and up -. Imagine spreading your wings.
• Adduction – Bringing your arms back into your sides. Closing your wings!
• Medial Rotation – Bend your elbow and fold your arm into your body, as if performing a tennis forehand shot.
• Lateral Rotation – The opposite, i.e a backhand shot – your arm moves out to the side with elbow bent.
• Circumduction – A combination of all the other moves. Stretch your arm out and draw a circle in the air.

The downside of having all this movement is that the shoulder is not as stable a joint as some of the others in the body, such as the hip. It is quite hard to dislocate a hip, as the thigh bone sits deep into the hip socket. Not so with the shoulder – the arm bone (humerus) fits into a shallow socket (called the glenoid fossa for the Anorak in us all!).

This means that the shoulder relies heavily on its surrounding muscles for stability – so any injury to any of these muscles can cause untold problems that will give pain and loss of mobility – often for a long time. If you are an athlete, this spells disaster for your career; if you love going to the gym, it can keep you out of there for ages. Even everyday living becomes a problem when trying to lift your arm causes pain.

Shoulder therapy following an injury will involve ice and sometimes immobilization. This can lead to problems of its own as the shoulder joint stiffens and loses mobility – it’s terrible to start with a minor injury and end up with a frozen shoulder! Don’t panic; most rotator cuff injuries heal properly if managed properly.

If using your arm causes nerve-type pain (like an electric jolt down your arm), or pins and needles, suspect impingement. Shoulder impingement is caused when the nerves at the top of the shoulder are squeezed by inflammation there, or structural problems, as in the bone not being properly in the socket.
Sometimes repetitive – type actions can cause this, especially later in life. If you are an electrician, for example, and have spent most of your working life with your hands over your head fiddling with wires, shoulder impingement is common. To treat this, you need to see a doctor for proper diagnosis, as you may need anti-inflammatory injections to sort it out.

Your rotator cuff is a group of small muscles which help stabilize the shoulder joint and assist with movement there. They are not particularly strong, and benefit from specific exercises – the stronger your muscles, the less likely they are to tear. If you are recovering from an injury, doing correct therapeutic exercises is absolutely essential to regain full use of the shoulder. The wrong exercises can make things much worse; I have come close to tearing my hair out when a client does his own thing to try and treat an injury.

So what can you do?

Before you do any self medication get the shoulder looked at by a Physiotherapist and take professional advice. Then if the Physiotherapist clears you to exercise get yourself down to your nearest Beginners Pilates class taught by a qualified instructor to help mobilise and strengthen the muscles around the joint.

All the best,

Carol J Bartram
(Sports Therapist, Personal Trainer & Pilates Instructor)

Rotator Cuff Injury