Rotator Cuff Tear and Surgery

The shoulder joint itself is surrounded by muscle, and in fact, most of the structural support is provided by these muscles. The rotator cuff is comprised of four muscles that run from the shoulder blade to the top of the arm bone, which act to support and move the shoulder joint. A rotator cuff tear is when the tendons which connect these muscles to the bone become irritated and painful. This typically occurs from two mechanisms, either a traumatic event (lifting something too heavy, falling) or an overuse injury resulting in repeated microtrauma. This can occur from months to years of use over time.

The pain generally will be felt gradually and around the front of the shoulder. Typically, the pain and soreness will increase with overhead activities or moving your arm away from your body. You may find you are pain-free when your arm is by your side, however, as you serve in tennis or catch a ball it can come back with sharp pain.

Rotator cuff tears usually heal successfully with appropriate physiotherapy management and a graded exercise program. If you have a sore and irritable shoulder it is worth seeing a physiotherapist begin early rehabilitation and avoid prolongation of painful symptoms. Rotator cuff injury can further deteriorate if you return to painful activities too quickly. One early pain management technique includes ice therapy. Such as icing the area immediately after an aggravating activity by pressing crushed ice wrapped in a towel against the painful area.

Here are my top three techniques for releasing tight muscles around a painful shoulder.

1. Your lats cross over the back of your shoulders, so releasing them can help you gain flexibility, reduce pain, and increase range of motion in your shoulder ·

2. Chest muscles such as your pecs are powerful pullers of the shoulder. Pec minor attaches to the scapula and can pull your shoulder forward. Releasing it with a trigger ball can help lengthen the muscle to restore posture.

3. Releasing these tight structures at the back of the shoulder can be helpful with a ball against the wall or even lying against the ground

To return to pain-free and a full range of movement, gradual exercise inclusion focusing on shoulder strength and rotator cuff tendon capacity is important. Aiming to allow the tendons the appropriate time to heal and recover stronger than before.

Here are my top 3 exercises for shoulder strengthening:

1. External rotation – can be a great way to strengthen the muscles of our shoulder

2. Walking up the walls: Walking your fingers up the wall can be a really nice way for a stiff shoulders to loosen up.

3. Weighted shoulder shrugs – The upper traps can often get tight and sore. One of the common things we see is to ease this with a massage. This combined with the strength exercises can promote strength in the future. Shoulder shrugs can be a good way to do this (+/- weights).

If you have found that conservative management has not worked with your shoulder, your orthopedic surgeon may suggest a rotator cuff repair surgery.

Read also: Shoulder injury, what are your options?

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