Rotator Cuff Tears: Physiotherapy Ottawa

Rotator Cuff Tears: How Physiotherapy care can help

The rotator cuff muscles are a group of four muscles located in the shoulder that play a crucial role in stabilizing and moving the shoulder joint. Learn what causes rotator cuff tears and how physiotherapy services at CURAVITA Health Group in Ottawa can help.

Rotator cuff: the anatomy

1. Supraspinatus: This muscle runs along the top of the shoulder blade (scapula) and helps initiate the abduction (lifting away from the body) of the arm.
2. Infraspinatus: Located on the back of the shoulder blade below the spine of the scapula, the infraspinatus is responsible for the external rotation (rotating the arm outward) of the shoulder.
3. Teres Minor: Situated beneath the infraspinatus, this muscle also assists in the external rotation of the shoulder.
4. Subscapularis: Positioned on the front of the shoulder blade, the subscapularis muscle aids in the internal rotation (rotating the arm inward) and adduction (bringing the arm closer to the body) of the shoulder.

What Causes a rotator cuff tear?

Rotator cuff tears can occur due to a variety of reasons, which can broadly be categorized two ways, one related to acute injuries, and the other related to degenerative changes:

• Acute Injuries: These are sudden, traumatic events that can cause a tear in the rotator cuff muscles or their tendons. Examples include:
  • Fall: Landing on an outstretched arm can exert significant force on the shoulder joint, potentially causing a tear.
  • Direct Blow: Impact to the shoulder, such as in a motor vehicle accident or contact sports, can injure the rotator cuff.
  • Lifting Heavy Objects: Lifting something heavy improperly or with sudden force can strain or tear the rotator cuff muscles.
• Degenerative Changes: Over time, wear and tear can weaken the rotator cuff tendons, making them more susceptible to tearing. Factors contributing to degenerative tears include:
  • Age: As people get older, the tendons of the rotator cuff can degenerate and become more prone to tearing.
  • Repetitive Stress: Activities or occupations that involve repetitive overhead motions, such as painting, throwing sports (baseball, tennis), or certain jobs (construction work), can lead to gradual wear and tear on the rotator cuff tendons.
  • Poor Posture: Incorrect posture, especially over a long period, can contribute to abnormal wear and tear on the rotator cuff tendons.
• Other Factors: There are additional factors that can contribute to rotator cuff tears, including:
  • Genetics: Some individuals may have genetic predispositions that make their rotator cuff tendons more susceptible to tearing.
  • Smoking: Smoking has been linked to poorer tissue quality and slower healing rates, which may contribute to increased risk of rotator cuff tears.

The Role of Physiotherapy in rotator cuff tear management and prevention:

Physiotherapy plays a crucial role in the management and rehabilitation of rotator cuff tears, whether they are managed conservatively or post-surgically. Here’s how physiotherapy care can help:

Conservative Management (Non-Surgical Approach):

• Pain Management: Physiotherapists use various techniques such as ice or heat therapy, ultrasound, or electrical stimulation to alleviate pain and reduce inflammation around the shoulder joint.
• Range of Motion Exercises: Gentle exercises are prescribed to maintain and gradually improve the range of motion in the shoulder joint. These exercises help prevent stiffness and improve flexibility.
• Strength Training: Strengthening exercises focus on the rotator cuff muscles as well as other muscles around the shoulder joint (e.g., deltoids, scapular stabilizers). This helps improve stability and support for the shoulder, reducing strain on the injured rotator cuff.
• Posture Correction: Physiotherapists assess and correct any postural abnormalities that may contribute to shoulder dysfunction or aggravate the rotator cuff tear. Proper posture can help reduce stress on the shoulder joint.
• Manual Therapy: Techniques such as joint mobilizations and soft tissue massage can help improve joint mobility, reduce muscle tension, and enhance healing in the injured tissues.
• Functional Rehabilitation: Specific exercises are tailored to mimic daily activities or sports movements to ensure the shoulder can function optimally once healed. This includes integrating strength, flexibility, and neuromuscular control.

Post-Surgical Rehabilitation:

• Protection and Early Motion: Physiotherapy begins soon after surgery to protect the repair while gradually restoring the range of motion. Initially, passive exercises may be used to avoid stressing the repaired tissues.
• Gradual Strengthening: As healing progresses, exercises to strengthen the rotator cuff and surrounding muscles are introduced progressively. The intensity and resistance are increased gradually to avoid re-injury.
• Functional Training: Similar to conservative management, functional exercises are incorporated to regain the strength and coordination necessary for daily activities and sports-specific movements.
• Education: Patients are educated about proper posture, body mechanics, and strategies to prevent future injuries or re-tears of the rotator cuff.
• Monitoring Progress: Physiotherapists closely monitor the patient’s progress, adjusting the rehabilitation program as needed based on healing, pain levels, and functional improvements.

If you are experiencing shoulder pain or have a rotator cuff tear and want to discover how our physiotherapy services at CURAVITA Health Group can help, please visit our website for more information or to book an appointment by visiting our clinic websites at Curavita Byward and Curavita Glebe.