Rotator Cuff and Impingement made simple!

30/06/2017

We treat several cases of rotator cuff injuries every week, but what exactly is it?

The shoulder, like the hip joint, is a ball in socket joint. But the shoulder can move far more than the hip and it achieves this by by having a very shallow socket. So rather than being a tight fitting ball in socket it’s more like having a tennis ball in a bowl.

And this is where the rotator cuff comes in. The rotator cuff (or RC) is a network of four muscles (infraspinatus, supraspinatus, subscapularis and teres minor) connecting the shoulder blade (scapula) to the arm bone (humerus) via some tendons,

The rotator cuff acts like a series of kite strings, controlling the flight, in this case controlling the movement of the ball in the socket. Effectively stopping the ball from rattling around in the socket.

The problems start when the rotator cuff is damaged. This can cause pain from the rotator cuff or an impingement where the ball pinches the lip of the socket or pinches a tendon.

Like with so many back and joint problems this can range from mild to severe.

Even a mild RC injury can be very painful, causing not just shoulder pain but also neck and arm pain. We see a lot of these, particularly from gardeners after reaching that little bit too far or spending just that little too long cutting the hedge.

A medium RC problem may start after a period of reduced movement-maybe you've been in bed with the flu-you get better, and return to work. Having driven to work you reach back to get your bag off the back seat of the car and experience a sharp shoulder pain. What’s happened? The RC has weakened through bed rest and then there has been an extreme twist and wrench which has forced the RC and caused an impingement.

Sometime we need to get confirmation of this injury by diagnostic ultrasound scanning (the same sort of machine used in pregnancy scanning), but with our osteopathic treatment (massage, ultrasound and rehab exercises) these can respond well.

Often people complain of a painful arc syndrome (pain halfway through movement that eases when your arm reaches the top). This can be a sign of an impingement, that is the ball pinching a tendon within the socket.

Severe problems can result in tears of the muscle or tendons, and while we can rehabilitate some, others are best left to the surgeon. We do provide advice under these circumstances.

Manual therapy has been shown to be very effective in the diagnosis and treatment of rotator cuff and impingement syndromes. We use a combination of massage, strapping, ultrasound and rehabilitation exercises that are graded to return you safely back to health and strength.

Our practitioners at the Trinity Practice have also attended several conferences specialising it the treatment and diagnosis of rotator cuff and shoulder impingement syndromes.

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