Treatments Classes

Rotator Cuff Tendinopathy

The rotator cuff is a group of four muscles surrounding the shoulder blade and humeral head that provide mobility and stability of the shoulder joint. Rotator cuff tendinopathies are defined as pain and weakness of the shoulder muscles due to an overload of the tissues. Occupations involving awkward postures, repetitive arm movements, overhead movements, heavy lifting, static postures and lack of rest can increase the likeliness of developing a shoulder injury. Extrinsic factors can compress the rotator cuff tendons such as decreased space in the shoulder joint, alterations in the scapular kinematics, postural abnormalities or rotator cuff weaknesses. Intrinsic factors such as age, tendon degeneration, overuse and trauma to the shoulder can additionally cause rotator cuff injuries.

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Symptoms

1. Shoulder pain, usually a dull ache
2. Tenderness in the shoulder joint
3. Pain increased with overhead reaching, reaching behind the back, lifting and sleeping on the affected side.
4. Weakness of the shoulder
5. Reduced range of movement, particularly elevating the arm forwards or to the side.

Treatments

Strengthening exercises are key to recovering from a rotator cuff tendinopathy [1]. Usually they will begin with isometric (static) strengthening exercises which are effective at reducing and controlling pain [2]. After pain is controlled, more advanced exercises can begin. Range of motion exercises may be needed if shoulder mobility is reduced [1] [3] [4]. Massage and dry needling can be effective at releasing off tight muscles and preparing tissue for mobilisation and strengthening [5][6]. Additionally, postural retraining and increasing upper back mobility has been found to have a positive impact on reducing symptoms and increasing shoulder mobility [7].

References

1.https://www.sciencedirect.com/science/article/abs/pii/S0031940616300591 Heron, S.R., Woby, S.R. and Thompson, D.P., 2017. Comparison of three types of exercise in the treatment of rotator cuff tendinopathy/shoulder impingement syndrome: A randomized controlled trial. Physiotherapy, 103(2), pp.167-173.

2. https://bjsm.bmj.com/content/49/19/1277.short Rio, E., Kidgell, D., Purdam, C., Gaida, J., Moseley, G.L., Pearce, A.J. and Cook, J., 2015. Isometric exercise induces analgesia and reduces inhibition in patellar tendinopathy. Br J Sports Med, 49(19), pp.1277-1283.
3. Landry M. Brukner & Khan's Clinical Sports Medicine. 4th ed. Australia: McGraw-Hill. 2014.

4. https://www.hindawi.com/journals/jar/2012/486930/abs/ Drummond, M.J., Marcus, R.L. and LaStayo, P.C., 2012. Targeting anabolic impairment in response to resistance exercise in older adults with mobility impairments: potential mechanisms and rehabilitation approaches. Journal of aging research, 2012.

5. https://www.jospt.org/doi/full/10.2519/jospt.2015.5455 Desjardins-Charbonneau, A., Roy, J.S., Dionne, C.E., Frémont, P., MacDermid, J.C. and Desmeules, F., 2015. The efficacy of manual therapy for rotator cuff tendinopathy: a systematic review and meta-analysis. journal of orthopaedic & sports physical therapy, 45(5), pp.330-350.

6. https://www.tandfonline.com/doi/abs/10.1080/00913847.2015.1004296 Lewis, J., McCreesh, K., Roy, J.S. and Ginn, K., 2015. Rotator cuff tendinopathy: navigating the diagnosis-management conundrum. journal of orthopaedic & sports physical therapy, 45(11), pp.923-937.

7. https://www.jospt.org/doi/full/10.2519/jospt.2015.5941 Krey, D., Borchers, J. and McCamey, K., 2015. Tendon needling for treatment of tendinopathy: a systematic review. The Physician and sportsmedicine, 43(1), pp.80-86.
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