Rotator Cuff Impingement

Rotator cuff is a group of four muscles which attach on the tuberosity of humeral head- suprapinatus, infraspinatus, teres minor and subscapularis. Together they act to provide dynamic stability to the glenohumeral joint during shoulder movements and ensure that the humeral head stays within the glenoid cavity at all times.

Activities that involve overhead upper limb movements such as throwing, painting, freestyle stroke in swimming and many repetitive activities of daily life such as putting the clothes out on the line may cause an imbalance in the stability. Patients that are symptomatic have pain with any and/or all of shoulder adduction, extension and internal rotation. These patients most notably present with a Painful arc syndrome (pain during 60-120 degrees of passive abduction). Patients that may present with this condition can be of any age but if not addressed may lead to further injury such has a rotator cuff tear and ongoing postural issues.

Goals of physiotherapy treatment involve reduction in pain, increasing shoulder range of motion, preventing muscle atrophy (wasting), re-establishing correct biomechanics and strengthening the shoulder musculature. Our physiotherapists address any issues that may be causing the problem, from posture, work stations, acitvity modification etc. The aim of treatment is to regain the dynamic stability of the joint by increasing the space within the joint allow freedom of the glenohumeral head to move within the joint, allowing pain free motion.

Dependant upon the pain and severity of the condition will depend on whether the patient may benefit from using NSAID’s and cold packs.

The physiotherapy techniques used may include, joint mobilisation (to create the space within the joint), soft tissue work to allow less pressure and tightness on the shoulder joint, and a home exercise program to correct posture and strengthen the rotator cuff dynamic stability. As the muscle action becomes pain free, progression of exercises to multi-angle isometrics and active shoulder movements with resistance. Shoulder strengthening with the help of resistance bands, must proceed in all directions. Sports personnel can embark on functional training once the daily activities are pain free. Our Clinical Pilates service also provides patients with a great option to rehabilitate with supervision and address multiple issues in a safe and independent manner. The entire rehab period may vary dependent on severity and further injury history.

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