Rotator Cuff Tears are very common in a wide variety of sports such as Cricket, Swimming, Football, Hockey, Water Polo, Baseball, Gymnastics and Rock Climbing. In fact, any sport where shoulder use is high, Rotator Cuff injuries or tears will be commonplace. This tends to be due to the unstable nature of these sports and the lack of attention the Rotator Cuff muscles get as an aspect of injury prevention.
These injuries tend to happen when the shoulder is shock loaded in an awkward position therefore overloading one of the Rotator Cuff muscles. Or they can happen from repetitive movements, where there is some imbalance in shoulder muscle load (eg. swimming). This load can cause a small tear or irritation to occur in the tendon of the Rotator Cuff muscle. These injuries sound a lot more scary than they are in reality. There are many people who have significant tears or ruptures to their Rotator Cuff Tendons that have no pain and completely normal function.
Up until recently it was thought that the gold standard for treatment of Rotator Cuff Injuries was surgical repair of the tear in the tendon. However, research is now showing conservative management with physiotherapy has greater short and long term outcomes than surgical intervention. If surgery has been recommended to you, I would strongly advise getting a number of opinions as well as doing your own research into the surgery before going ahead.
How can I identify it?
You can identify a Rotator Cuff Tear or injury with an acute event of pain in the shoulder combined with consistently painful range of movement. It can be quite a strong ache at rest with less consistent pain patterns than other types of shoulder injuries. Usually, it will feel like an isolated event where the shoulder was injured and have the typical markers of an acute injury.
What Can I Do?
Often it can be easy to avoid using your shoulder at all for fear of making the tear worse. However, more research is indicating that tendons need load and use to heal properly. The most important part of recovering from Rotator Cuff injury is consistency. Consistent load throughout the process is very important.
Step 1: Deload – in the first week or two it is important to allow the shoulder to calm down and to get the inflammation under control. This simply means, don’t do anything that hurts the shoulder significantly for the next week or two. This doesn’t mean don’t do anything, any movement that is less than a 3/10 pain, treat it as fine and keep doing it. Try to use the shoulder as normally as possible.
Step 2: Spikey Ball the Culprit – Often the specific muscle that has been injured will be very tight and sensitive to touch. It can be helpful to release this muscle with a spikey ball. This will take some pressure off the tendon that is trying to heal and relieve some of the resting pain.
Step 3: Specific tendon Load – Tendons love static load to help stimulate healing without overloading and increasing the inflammation. My favourite two exercises to help stimulate the tendon are: