Perspective of a Physiotherapist on the Causes and Management of Rotator Cuff Tears

Rotator cuff tears are a common shoulder injury that can lead to significant pain and functional impairment. Understanding the causes and exploring the available treatment options from a physiotherapy perspective can aid in effective management and recovery from rotator cuff injury. It is generally believed that these tears result from a combination of intrinsic factors, as suggested by Codman, and extrinsic factors, as theorised by Neer.

What Causes Rotator Cuff Tears?

Intrinsic Factors:

• Age-Related Degeneration: As we become older, the rotator cuff tendons may deteriorate and become more prone to tears.
• Vascular Supply: The rotator cuff tendons’ capacity to mend themselves may be hampered by decreased blood flow to them.
• Genetics: A genetic susceptibility to rotator cuff tears may exist in some people.

Extrinsic Factors:

• Trauma: Acute injuries can result in tears right away, especially from falls or heavy lifting.
• Repetitive Stress: Microtrauma and eventual ripping can result from repetitive overhead actions, which are frequently observed in athletics and specific professions.
• Impingement: Over time, rotator cuff tears may result from structural anomalies such as bone spurs impinging on the tendons.

 

Diagnosis:

While Magnetic Resonance Imaging (MRI) remains the gold standard for diagnosing rotator cuff tears, the use of ultrasound has revolutionised the diagnostic process, providing a less expensive and more accessible option. We at Southgate Physio provide ultrasound diagnosis of rotator cuff tears.

Physiotherapy plays a vital role in the non-surgical management and post-surgical rehabilitation of rotator cuff tears.

Pain Management:

• Manual therapy: Methods like joint and soft tissue mobilisation can assist increase mobility and lessen pain.
• Modalities: You can control pain and inflammation by applying heat, cold, ultrasound, or electrical stimulation.

Improving Range of Motion:

• Passive Range of Motion exercises (PROM): These workouts first support maintaining joint flexibility without putting undue strain on the rotator cuff.
• Active Range of Motion exercises (AROM): Patients move to active activities gradually to increase shoulder mobility.

Strengthening Exercises:

• Isometric Exercises: These exercises involve contracting the muscles without moving the joint, helping to build strength without risking further injury.
• Resistance Training: As healing progresses, resistance bands or weights may be introduced to strengthen the rotator cuff and surrounding muscles.

Postural Re-education:

• Ergonomic Advice: Rotator cuff strain can be minimised throughout daily activities by teaching appropriate posture and making ergonomic changes.
• Scapular Stabilisation: Shoulder mechanics can be improved overall by performing exercises that target the muscles surrounding the shoulder blade.

Functional Rehabilitation:

• Activity Modification: Teaching patients how to change their activity to prevent aggravating their injury.
• Sport-Specific Rehabilitation: For athletes, a safe return to activity can be facilitated by customising the rehabilitation programme to their particular sport.

Post-operative Rehabilitation:

• Following surgical repair, physiotherapy is essential to restore function. This typically involves a phased approach starting with gentle mobilisation, progressing to strengthening, and eventually returning to full activity.

In summary:

Comprehending the cause of rotator cuff injuries and putting a thorough physiotherapy treatment plan into action is essential for the best possible outcome. At Southgate Physio, we’re committed to giving each patient individualised care that is catered to their specific needs in order to help them restore function and enhance their quality of life. Please get in touch with us to get an assessment and start your road to recovery if you think you may have a rotator cuff tear or if you are having shoulder pain.

If you want to know more, feel free to get in touch with us by calling 0208 3686767 or emailing us at info@southgatephysio.co.uk

Physiotherapy Services We Offer

Our clinic offers a wide range of treatments that are all recommended and tailored to everyone who comes and visits us. Our range of treatments complements the body and mind, helping to keep you pain and injury-free, delivering preventative measures to maintain your well-being and enhance your performance levels.

Our main aim is to restore your personal well-being so you can enjoy an active, healthy, and pain-free life. Click on any of the services to find out a little more about each treatment and understand if it might be right for you.

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• Theraflex
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