Shoulder Safety Part 4: rotator cuff injuries

Anders Hendricks, Aurora Sports Medicine Institute

Anders is a licensed athletic traininer at the Aurora Sports Medicine Institute in Burlington and at Badger High School in Lake Geneva.

Now that readers are familiar with the anatomy of the rotator cuff and shoulder joint, it is important to understand the signs and symptoms associated with a rotator cuff injury, and what can be done to prevent an injury to the rotator cuff.

The most common injury to the rotator cuff involves inflammation of the supraspinatus, which is termed supraspinatus (or rotator cuff) tendonitis.  This muscle originates above the spine of the scapula (in the supraspinatus fossa) and inserts on the humerus over the greater trochanter.  On its way from the scapula to the humerus, the supraspinatus passes under the acromion process through the subacromial space.  In addition to the supraspinatus tendon, the subacromial space also contains a subacromial bursa (a small fluid sac used to decrease friction) and the long head of the biceps tendon.  It is easy to see that with all of these structures passing through one area, inflammation to one structure will likely cause impingement of the other structures.  For instance, if one were to suffer from subacromial bursitis (an inflammation of the bursa sac), that inflammation would decrease the space available to the supraspinatus and biceps tendons, resulting in friction and eventual inflammation to the tendons.  An injury to the supraspinatus tendon like this is commonly referred to as “impingement”, which refers to the supraspinatus being pinched, or impinged, in the subacromial space.  To sum this up, damage to a structure in the shoulder may cause other structures in the shoulder to become pinched (impingement), which can lead to localized inflammation over the rotator cuff tendon (tendonitis).

Common signs and symptoms associated with impingement resulting in rotator cuff tendonitis include pain with overhead motion, tenderness over the top of the shoulder, and weakness in the scapular muscles.  Additionally, rotator cuff tendonitis and impingement can happen at any age, but is commonly seen in patients or athletes who are involved in vigorous overhead activities, such as swimming or throwing.  Another hallmark sign of rotator cuff injuries include patients complaining of pain at night, or pain that wakes them up at night.

As shown in the blog entry about rotator cuff anatomy, an excellent way to prevent impingement and rotator cuff inflammation is to strengthen the scapular stabilizers.  Rows, which are explained in the previous blog entry (Shoulder Blog #3 – Rotator Cuff Anatomy), will allow a person to properly strengthen the lower stabilizers of the scapula, allowing the rotator cuff to work more efficiently, as well as allowing the shoulder joint to exist in a position of better posture, resulting in more space in the subacromial space.

Additionally, controlling inflammation over the shoulder is also important in limiting rotator cuff injuries.  Using simple techniques such as icing the shoulder were one is

experiencing pain (15 minutes on, 2 hours off), will go a long way in controlling inflammation, as well as resting the shoulder and avoiding painful activities.  It is also important if one is experiencing these symptoms to contact a physician for an evaluation.

As always, if readers have any questions or comments about this topic, or past and future topics, please feel free to email me at anders.hendricks@aurora.org.  Thanks a bunch!

Follow the new Shoulder Series with weekly updates here at our fitness blog!

Part 1: Shoulders: An Introduction

Part 2: Bone Shoulder Anatomy

Part 3: Rotator Cuff Anatomy

Don’t give up the sport — give up the pain! Visit the Aurora Sports Medicine Institute at 13 Wisconsin locations, visit our website, follow us on Facebook, browse our YouTube channel, or call our hotline at 1-800-219-7776.

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