Understanding the Rotator Cuff
Rotator Cuff Injuries
Whether it be from watching the footy on a Friday night; a grandparent having some shoulder scans or your mate falling over playing beach cricket, most of us have heard of the “rotator cuff” and that is been damaged, torn or that it is related to shoulder problems, but what exactly is the rotator cuff and what does it actually do?
The Rotator Cuff Muscle
The rotator cuff muscle is actually a combination of 4 muscles, Supraspinatus, Infraspinatus, Subscapularis and Teres Minor. Each of these muscles have their own function but work synergistically together to help stabilise, control and move our arm which is why they are commonly referred together as a unit.
If we look at the shoulder joint, being a ball and socket joint, the ball being our upper arm bone (the humerus) and the socket being part of the shoulder blade (the scapula and specifically the glenoid of the scapula) we want to keep the ball in a good position in relation to the socket. To visualise this, if you make a fist with one hand and slightly cup your other hand we want that fist to stay relatively central to that cupped hand. These rotator cuff muscles help keep the ball in a good position in relation to the socket. In addition to this, the rotator cuff muscles also help provide rotation of the humerus and provide stability.
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The Supraspinatus, Infraspinatus and Teres Minor can create external rotation with subscapularis creating internal rotation. To picture this, imagine your arms are by your side, elbows are bent and you are pointing forward ahead. Internal rotation would be that those fingers are starting to point towards each other and external rotation would be the fingers moving away from each other. Now thinking real world, think how often that rotation in the humerus occurs, washing your hair, swimming, tennis, hanging clothes on the line or even putting a belt on.
When looking at the nitty and gritty movements of shoulder biomechanics it can be complicated by lots of moving parts whether it be muscles, ligaments, tendons, bones, bursa and nerves. But, if we simplify it and understand that in comparison to our hip which is the same type of joint as the shoulder, we have far more range of motion in our shoulder than we do in our hips. How the body enables this is increased reliance on muscles to control and stabilise this joint than in our hip. As we move our shoulder into different positions whether it be in front, to the side, behind or above our head Supraspinatus, Infraspinatus, Subscapularis and Teres Minor work together with different positions requiring one or more of the muscles to work harder but always together to create strength and stability in all positions.
So who should do exercises to keep these muscles strong? Everyone. It doesn’t have to be in a gym, it can start as easy as holding a can of soup or bottle of water. Similarly, if you are thinking about getting back onto the field after a hiatus of sport or just some social games of tennis, why not some exercises that will help make sure you can play the best you can and feel confident about your shoulders. If you are unsure where to start Exercise Physiologists and Physiotherapists can give you a great place to start at your level and give you a pathway to go from there.
What happens if you have an injury to the rotator cuff or a scan says that you have a rotator cuff tear or tendinopathy?
We know that from the research investigating rotator cuffs, that as we age the prevalence of asymptomatic (no symptoms at all) rotator cuff tears increases and that those findings on imaging do not have to be all gloom and doom. Similarly, even for those with shoulder injuries that are acute or have had shoulder pain for a week, month, or even years, having a personalised tailored physiotherapy rehabilitation plan can help get the shoulder moving better and help you work towards the goals that you want to achieve.
Rotator Cuff Injury Treatment at Functional Health is carried out by highly skilled Physiotherapists. To book an appointment Click Here Now!