The rotator cuff muscles are a group of 4 muscles that attach the humerus (upper-arm bone) to the scapula (shoulder blade). The rotator cuff muscles help raise, rotate, and stabilize the upper arm. Causes of rotator cuff disorders include:

• Poor posture, such as rounded shoulders caused by leaning over a computer for long periods of time.
• Repetitive arm movements, such as those performed by a hair stylist or painter.
• Overhead shoulder motions, such as those performed by baseball pitchers or swimmers.
• Tight muscles and tissues around the shoulder joint.
• Weakness and muscle imbalances in the shoulder blade and shoulder muscles.
• Bony abnormalities of the shoulder region that cause the tendons to becomepinched (shoulder impingement syndrome).
• Neck and upper back stiffness.  

Rotator cuff pain is characterized by pain at the top of the shoulder that can occur gradually over time or start quite suddenly, and can sometimes radiate into the upper arm. At rest, you may be symptom free or have a mild, dull ache, however pain can be moderate to severe with certain shoulder movements. Reaching behind the body to perform a motion, as in fastening a seat belt, can be very painful. So can overhead activities, such as throwing, swimming, reaching into a cupboard, or combing your hair. The pain can worsen at night, especially when rolling over or attempting to sleep on the painful side. You may notice weakness when lifting and reaching for household items. Holding a heavy platter or taking a pan off the stove may become difficult.

A physical therapist will perform an evaluation and ask you questions about the pain and other symptoms you are feeling. Your therapist may perform strength and motion tests on your shoulder, ask about your job duties and hobbies, evaluate your posture including your mobility of neck and upper back joints, and check for any muscle imbalances and weakness that can occur between the shoulder and the scapular muscles. Your physical therapist will gently touch your shoulder in specific areas to determine which tendon or tendons are inflamed, and special tests may need to be performed to determine this.

It is important to get proper treatment for rotator cuff pain as soon as it occurs. A degenerated tendon that is not treated can begin to tear causing a more serious condition. Physical therapy can be very successful in treating tendinitis, tendinosis, shoulder impingement syndrome and rotator cuff tears. You will work with your physical therapist to devise a treatment plan that is specific to your condition and goals. 

Can this Injury or Condition be Prevented?

Rotator cuff pain can be prevented by:

• Maintaining proper shoulder and spinal posture during daily activities, including sitting at a computer.
• Performing daily stretches to the shoulder and upper back to maintain normal movement. Tightness in the upper back, or a rounded shoulder posture will decrease the ability to move your torso, and that makes the shoulder have to work harder to perform everyday activities, such as reaching for objects.
• Keeping your upper body strong, including the upper back and shoulder-blade muscles will help prevent pain. Many people work the muscles in their chest, arms, and shoulders, but it is also important to work the muscles around the shoulder blade and upper back. These muscles provide a strong foundation for your shoulder function. Without a strong foundation, muscle imbalances occur and put the shoulder at risk for injury.