Rotator Cuff Tears

If you’re one of the many that are suffering from a rotator cuff tear, you have two options for treatment; surgery and physiotherapy. There is enough clinical evidence to support that physiotherapy can get the vast majority of people the same results without going under the knife. 

 

The key to achieving the best results is to have a physiotherapist in your corner who is experienced in rotator cuff tears. At Global Health Physiotherapy Clinic we thoroughly evaluate your condition and develop an effective program that eliminates pain and restores strength, flexibility and mobility to your shoulder.

Rotator cuff tear view by ultrasound

What is a rotator cuff tear?

A rotator cuff tear is one of the most common injuries treated. It happens when the muscles in your shoulder tear partially or completely. This typically happens in one of two ways; degenerative tear and traumatic tear.

Degenerative tear

A degenerative rotator cuff tear is that from a repetitive motion such as that required in your job or sport. Painters, window cleaners, baseball players and tennis players are examples of sports and occupations that require the heavy use of the rotator muscle. In these situations, the muscle is overused and frays over time.

Full tear/traumatic tear

A traumatic tear or full tear is when the tear goes through all the way. A full tear goes all the way through through the tendon or pulls the tendon off the bone. This can be the result of a bad motion, sudden motion, lifting something too heavy or sudden impact (like falling).

 

Did you know that many people don’t even know they have a tear in their rotator muscle? Not all tears will cause pain, as they can be the result of a long degenerative process. Roughly 30% of undiagnosed tears will eventually become painful and require treatment.

Full rotator cuff tear

Common symptoms of a tear in your rotator cuff

It may not always be apparent, however here are a few common symptoms you‘ve sustained a tear in your rotator cuff:

 

  • Weakness in the shoulder.

  • Unable to lift objects.

  • Pain when you lift your arm.

  • Pain when you sleep on your shoulder.

  • Unable to move arm using specific movements.

  • The shoulder makes clicking or popping noise.

person holding his shoulder in pain

Common causes of a degenerative tear

While you may not have done anything to bring on instantaneous pain a degenerative rotator cuff tear can develop over the years. Here are some of the most common causes:

 

  • Repetitive motions: whether it’s a sport or your job, repeating the same motion can increase your risk of developing a rotator cuff tear.

  • Poor blood circulation: This is more common when you get older (starts around 40 for most people). Lack of blood supply means more recovery time for micro-tears and small injuries. This can result in more serious tears and chronic pain.

  • Ageing: It’s just a fact that the older you get, the greater the risk of a tear. In fact, a 2013 study indicated age was a direct correlation with the frequency of the injury.

  • Genetics: You could be predisposed to rotator cuff injuries, as studies seem to point to the fact that it happens more frequently to certain families.

  • Imbalanced muscles: If there is an imbalance in your shoulder muscles, you are likely compensating for and overworking the muscles in the area.

  • Posture: If you have poor posture your shoulder blade position and stability can contribute to tears.

Age chart showing the corelation between rotator tears and ageing

How we assess rotator cuff injuries

The list of common causes (above) suggests that there can be a number of factors that contribute to a tear. For this reason, it’s vital that you get an experienced physiotherapist to assess your shoulder. A thorough and accurate assessment of your shoulder allows a therapist to develop the most effective rehabilitation program for recovery.

 

Depiction of the rotator cuff tear in the shoulder viewed by xray

Our shoulder assessments include but are not limited to the following:

 

  • An interview that covers any previous conditions or shoulder-related injuries.

  • A physical stress test that eliminates the possibility of other potential injuries.

  • Assessment of posture while standing, walking and sitting.

  • A countenance of potential activities, motions and behavioural patterns that could be contributing to the degenerative process.

  • A series of tests to evaluate the functional ability of your shoulder (lifting, pulling and pushing).

  • Evaluation of your rotator cuff itself in terms of flexibility, strength, and control.

  • Evaluation of the larger muscle groups in the area, the shoulder blades, the rib cage and the spine.

Our thorough examination process gives us the necessary information needed to identify the root source of your problem. We use this information to develop the best rehabilitation program possible to address and reverse those problematic issues.

Physiotherapy for rotator cuff tears

Using the information from your assessment and evaluation we develop the necessary program that addresses the issues specific to your tear. We periodically reevaluate your rotator cuff to make necessary adjustments according to your progress. 

 

Your physiotherapy treatment is based on the 5 Levels Program of Care and will consist of a combination of the following:

 

  • Manual therapy is a regular aspect of your recovery. This will address any inflammation, pain and mobility issues. We use a combination of manual therapy techniques and any number of modalities to accelerate soft tissue repair in the torn muscles and tendons (laser therapy, shockwave, etc).

  • An exercise program will correct any muscle imbalances or lack of strength. This also contributes to correcting poor postures by making it easier for you to hold the correct body positions for longer periods of time.

  • Stretching is considered part of your exercise program especially in cases where the muscles are stiff and short.

  • Our team makes education a priority. We make sure you understand the source of your problem to limit poor behavioural habits and integrate new, modified activities and motions.

  • Shoulder stability exercises are common along with other exercises to improve spinal health and stability.

 

It’s crucial to have an experienced team of physiotherapists to develop the most effective program. At Global Health Physiotherapy Clinic we make sure your program is custom-tailored to your needs.