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The rotator cuff is a group of muscles which work together to provide the glenohumeral (shoulder) joint with dynamic stability, helping to control the joint during rotation (hence the name).
The rotator cuff muscles include:
- Teres Minor
Supraspinatus and Infraspinatus are the most commonly injured rotator cuff muscles. Due to the function of these muscles, sports which involve a lot of shoulder rotation – for example, bowling in cricket, pitching in baseball, swimming, kayaking – often put the rotator cuff muscles under a lot of stress.
Problems with the rotator cuff muscles can be classed into two categories – Tears of the tendons/muscles, and inflammation of the tendons (often called tendinopathy or tendonitis).
This tends to happen as a result of a sudden, powerful movement. This might include falling over onto an outstretched hand at speed, making a sudden thrust with the paddle in kayaking, or following a powerful pitch/throw.
The symptoms will usually include:
- Sudden, tearing feeling in the shoulder, followed by severe pain through the arm
- Limited movement of the shoulder due to pain or muscle spasm
- Severe pain for a few days (due to bleeding and muscle spasm) which usually resolves quickly
- Specific tenderness ( “x marks the spot” ) over the point of rupture/tear
- If there is a severe tear, you will not be able to abduct your arm (raise it out to the side) without assistance
A chronic tear develops over a period of time. They usually occur at or near the tendon, as a result of the tendon rubbing against the overlying bone. This is usually associated with an impingement syndrome.
- Usually found on the dominant side
- More often an affliction of the 40+ age group
- Pain is worse at night, and can affect sleeping
- Gradual worsening of pain, eventually some weakness
- Eventually unable to abduct arm (lift out to the side) without assistance or do any activities with the arm above the head
- Some limitations of other movements depending on the tendon affected
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