The rotator cuff is a group of four muscles that surround the shoulder joint. These muscles are essential to the correct functioning of the shoulder complex. Injuries to the shoulder often involve one or more of the rotator cuff muscles, leaving the injured to deal with pain and limited shoulder function.

The rotator cuff may be injured in various ways, most commonly through overuse. Overuse injury stems from repetitive, usually overhand motion, classically found in athletes such as freestyle swimmers and baseball pitchers, or in workers such as painters and auto mechanics. The rotator cuff may also be injured as the result of trauma. Quite often, however, the individual suffering from this type of injury can recall no specific mechanism of injury, complaining of shoulder pain that seemingly came from nowhere.

Typical signs and symptoms usually include pain with reaching types of motions, the inability to lie on the affected side, and the inability to lift heavy objects. When the rotator cuff is injured, the individual often has pain and restricted motion when reaching above and behind the head, and/or when reaching behind the back.

Injuries to the rotator cuff range in severity from tendonitis/impingement (inflammation of the overworked rotator cuff tendons), to a partial or complete tear.

Dr. J. Winslow Alford, an orthopaedic surgeon specializing in Sports Medicine at West Bay Orthopaedics in Warwick, Rhode Island, says that the effect of an injury to the rotator cuff tendons will vary greatly depending on the type and severity of the injury. "A minor strain or inflammation can resolve completely with physical therapy and anti-inflammatory treatments," Alford says. "Symptoms of pain and weakness from degenerative tears can be greatly improved with conservative measures as well. Some rotator cuff injuries, however, require surgical repair followed by supervised physical therapy. Rotator cuff tears can be repaired arthroscopically as an outpatient. It is important to have rotator cuff injuries evaluated by a specialist to categorize the injury along the spectrum of possible injury types, so that proper treatment can be provided."

In physical therapy, a thorough evaluation of the injury is performed, and a plan of care established. Goals are set that may include, but are not limited to, managing pain and inflammation, regaining any loss of range-of-motion, increasing strength and stability of the shoulder and improving function with daily activities.

Active Release Technique® (ART) is a manual therapy technique used to reduce soft tissue restrictions in the muscles, tendons and connective tissue. It is an effective treatment for rotator cuff injuries to increase pain-free range of motion and restore symmetry of movement at the shoulder, as well as the neck.

Bill Burns is a physical therapist at Choice Physical Therapy of Westerly. You can contact Bill with your questions at (401) 348-1010.