The shoulder joint is one of the largest and most complex joints in the body. The shoulder joint is formed where the humerus (upper arm bone) fits into the shoulder blade like a ball and socket. Your shoulders do a lot of important things such as reaching off a high shelf, combing your hair, or playing a game of tennis or catch. The rotator cuff plays a big role with all these movements.
The rotator cuff is made up of muscles and tendons that keep the ball of the humerus into the shoulder socket. It also helps raise and rotate your arm. There are four muscles that make up the rotator cuff. The supraspinatus holds the humeral head in place and keeps the upper arm stable along with helping lift your arm. The infraspinatus is the main muscle that lets you rotate and extend your shoulder. The teres minor is the smallest rotator cuff muscle that assists with external rotation, or rotation away from your body. Finally, the subscapularis holds your humerus to the shoulder blade and helps rotate your arm, hold it straight out, and lower it. The humerus fits relatively loosely into the shoulder joint. This gives the shoulder a wide range of motion, but it also makes it vulnerable to injuries.
There are several injuries that can happen to the shoulder joint, which includes the rotator cuff. A rotator cuff tear is a tear in one of the rotator cuff muscles or tendons. It can be the result of wear and tear from daily use or a sudden injury. It is a common injury in sports like tennis and baseball, and with occupations that require repetitive overhead movements. Shoulder tendonitis is when one of the rotator cuff tendons gets inflammation. Shoulder impingement happens when the edge of the shoulder blade presses on the rotator cuff as the arm is lifted. If there is inflammation or an injury present in the rotator cuff, then the impingement causes pain. Sometimes the bursa, a small sac of fluid that cushions and protects the rotator cuff, get inflammation resulting in shoulder bursitis. All of these injuries can be treated.
Injuries to the rotator cuff may feel like pain over the top of the shoulder or down the outside of the arm, shoulder weakness, and loss of shoulder movement. The injured arm often feels heavy, weak, and painful. You may be limited in your daily activities or even raising your arm.
Physical therapy is a cheap, nonsurgical treatment for shoulder injuries. Your physical therapist can determine the cause of pain and injury and develop an exercise program to strengthen your shoulder muscles and improve flexibility and range of motion in the shoulder. Without surgery, a physical therapist will work with you to return to your regular activities. In some cases, your therapist may help you learn to modify your physical activity so that you put less stress on your shoulder. If surgery is necessary, your therapist can help you both before and after the procedure. Regardless of which treatment is needed, early treatment can help speed up healing and avoid permanent damage.