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Shoulder Pain: The Rotator Cuff

The rotator cuff is a group of four muscles that are responsible for both rotation and stabilization of the upper arm bone. It’s often improperly termed the “rotor cuff”, “rotator cup”, or “rotary cuff” by our patients.

Repetitive overhead motion, throwing, or lifting can all increase your risk for shoulder injury. Symptoms can develop immediately or over the course of days. Some patients can point directly to a mechanism of injury, while others are uncertain of how they injured their shoulder. We’ll usually dig into the history to find that the latter group was painting a ceiling (repetitive motion) or cleaning the garage (repetitive lifting) prior to symptom onset. Still, some patients have no rhyme or reason for their shoulder pain. Like any other muscle in your body, the rotator cuff can strain, tear, or even rupture.

The Rotator Cuff

Front of Shoulder

Back of Shoulder

  • 1. Subscapularis Muscle
  • 2. Teres Major (not consider a Rotator Cuff Muscle)
  • 3. Supraspinatus Muscle
  • 4. Infraspinatus Muscle
  • 5. Teres Minor Muscle

Your knee jerk reaction to shoulder injury is to schedule an appointment with your primary or orthopedic seeking an MRI; however, be forewarned most insurances will not authorize an MRI until a minimum of four weeks of rehabilitation is completed.  We know what you’re thinking, “What Gives?”  A nuisance at first, it’s an important & required step.  First, MRI’s are expensive and typically won’t influence your course of conservative treatment.  Second, a fair amount of rotator cuff injuries can be successfully treated with physical therapy.  For those seeking surgery: be aware that a rotator cuff repair is hardly a quick fix. Rotator cuff surgery can take upwards of 7-12 months for a full recovery. Hang tight and give physical therapy a chance.

Signs, Symptoms, & Limitations Associated with Rotator Cuff Strain:

Pain with overhead activity (reaching, grasping, lifting, etc.)
Sharp pain with lowering of arm.
Grasping objects out of the fridge.
Pain with overhand throwing
Raising arm out to the side (think snow angel motion)
Pain is typically located on top of the shoulder and may radiate to the lateral shoulder or elbow.

Training the rotator cuff is often overlooked in most weight training programs. Overhead presses, lateral raises, and rowing are often the focus of most shoulder workouts; however, the rotator cuff trump’s all. Adding a few simple rotator cuff-specific exercises can add tremendous value not only to your workout, but life. A stronger rotator cuff means better stabilization when you reach, grasp, or lift at home. Better stabilization yields improved function and decreased likelihood for injury.

When it comes to your rotator cuff, prevention is the name of the game.  Occupation, posture, and habits all influence your shoulder.  Your exercise program should cover all facets.  Specific strengthening exercises and postural re-education can be performed to keep you strong and living well. For some, simply adding a few exercises to your workout routine can effectively manage symptoms and prevent injury. For others, avoiding specific activities that place a large strain to the rotator cuff is required. A licensed physical therapist can help you develop a safe, yet effective program to either prevent future injury or heal prior damage.