ROTATOR CUFF INJURIES
Rotator cuff injuries are a common cause of shoulder pain and dysfunction, affecting individuals of all ages and activity levels. The rotator cuff is a group of four muscles and their tendons that surround the shoulder joint, providing stability and facilitating movement. Injuries to the rotator cuff can result from acute trauma, chronic overuse or degenerative changes over time. Physiotherapy plays a crucial role in the management of rotator cuff injuries, aiming to alleviate pain, restore shoulder function and prevent future complications.
Understanding Rotator Cuff Injuries:Â
Rotator cuff injuries encompass a spectrum of conditions, including:
1.     Rotator Cuff Tendinitis: Inflammation of the rotator cuff tendons, often due to repetitive overhead activities.
2.     Rotator Cuff Tears: Partial or complete tears of one or more rotator cuff tendons, which can occur traumatically or degeneratively.
3.     Impingement Syndrome: Compression of the rotator cuff tendons and bursa between the bones of the shoulder, leading to pain and restricted movement.
4.     Rotator Cuff Calcific Tendinopathy: Deposition of calcium deposits within the rotator cuff tendons, causing pain and stiffness.
Physiotherapy Management:
1.     Pain Management: Initially, the focus is on reducing pain and inflammation through modalities such as ice therapy, heat therapy, or electrical stimulation. Non-steroidal anti-inflammatory drugs (NSAIDs) may also be recommended.
2.     Range of Motion Exercises: Gentle exercises to improve shoulder mobility and flexibility are prescribed, focusing on movements such as shoulder flexion, abduction, external rotation and internal rotation.
3.     Strengthening Exercises: Gradual strengthening of the rotator cuff and surrounding shoulder muscles is crucial for restoring function and stability. Exercises may include resistance band exercises, dumbbell exercises and isometric contractions targeting specific muscle groups.
4.     Scapular Stabilisation: Addressing scapular dyskinesis and promoting proper scapular movement is essential for optimal shoulder function. Exercises to strengthen the muscles that stabilize the scapula such as the serratus anterior and lower trapezius, are incorporated into the rehabilitation program.
5.     Manual Therapy: Hands-on techniques such as soft tissue mobilisation, joint mobilisations and myofascial release are used to address muscle tightness, joint stiffness and biomechanical dysfunctions.
6.     Modalities: Additional modalities such as ultrasound therapy or laser therapy may be utilised to promote tissue healing and reduce pain.
7.     Functional Rehabilitation: Emphasis is placed on functional activities and sport specific movements to facilitate a safe return to activities of daily living and recreational or athletic pursuits.
8.     Patient Education: Educating patients about proper posture, ergonomic principles, activity modification and home exercise programs empowers them to take an active role in their recovery and prevent re-injury.
9.     Progressive Return to Activity: As symptoms improve and shoulder strength and stability are restored, a gradual return to sports or physical activities is guided by the physiotherapist to minimise the risk of recurrence.
Conclusion: Rotator cuff injuries can significantly impact shoulder function and quality of life. Physiotherapy plays a vital role in the comprehensive management of these injuries, focusing on pain relief, restoration of function and prevention of future complications. By implementing a tailored rehabilitation program that addresses pain, mobility, strength and functional deficits, physiotherapists help individuals with rotator cuff injuries regain optimal shoulder health and return to their desired level of activity. Early intervention, adherence to treatment protocols and ongoing patient education are key components of successful outcomes in the management of rotator cuff injuries.