The shoulder is a very shallow ball and socket joint, which makes it naturally unstable and therefore depends heavily on muscular support. The upside of the shallow socket is that it gives the shoulder an amazing amount of movement.The rotator cuff is the name for the tendons that surround the shoulder joint. The rotator cuff is the most important group of muscles giving it support and stability allowing the shoulder to function through a wide range of motions. In part due to the rotator cuff, the shoulder joint can move and turn through a wider range than any other joint in the body. This motion of the shoulder joint allows us to perform an amazing variety of tasks with our arms.
Unfortunately, a rotator cuff tear is not an uncommon problem and these injuries make many routine activities difficult and painful. The rotator cuff is part of this mechanism that, when healthy functions very well, but when injured can be a difficult and frustrating problem. Many therapists, including chiropractors, would say that is one of the most difficult problems to treat.
What makes up the rotator cuff?
The rotator cuff is actually a group of four muscles and their tendons that wraps around the front, back, and top of the shoulder joint. The muscles are the supraspinatus, infraspinatus, teres minor and the subscapularis.
What is a rotator cuff tear?
Like most musculoskeletal conditions, the most common mechanisms of a rotator cuff tear are separated into 'repetitive use' and 'traumatic injuries.'
- Repetitive Use Injury
In repetitive use injuries to the rotator cuff, repeated activities cause damage to the rotator cuff tendons. Over time, the tendons wear thin and a rotator cuff tear can develop within the tendons. Patients with repetitive use injuries to the rotator cuff often have complaints of shoulder bursitis prior to developing a rotator cuff tear through the tendons.
- Traumatic Injuries
Traumatic injuries to the rotator cuff are seen after events such as falling on to an outstretched hand. The traumatic event can cause a rotator cuff tear by injuring the rotator cuff tendons. This mechanism is much less common than repetitive use injuries, but when a rotator cuff tear occurs in a patient younger than 60 years old it is usually a traumatic injury.
Who is most susceptible to a rotator cuff tear?
A rotator cuff tear is seen both in the young and old, but they are much more common in the older population. Usually in younger patients, there is either a traumatic injury such as a fall, or the person is putting the tendon under significant load, as seen in athletes involved in throwing.
As people age, the muscle and tendon tissue of the rotator cuff loses some elasticity, and due to the inherent poor blood supply to the mid part of the tendon healing is slow and degenerative changes are often found. Therefore the rotator cuff becomes more susceptible to injuries and is often damaged while performing everyday activities. This is the reason that rotator cuff tears are more commonly seen in older patients.
How common are rotator cuff tears?
Not every rotator cuff tear causes significant pain or disability. In fact, autopsy studies have shown rotator cuff tears in up to 70% of people over the age of 80 and 30% of the population under the age of 70. Clearly, all of the people with rotator cuff tears are not complaining of painful symptoms. However, in many individuals, a rotator cuff tear can cause significant disability, and prompt diagnosis and chiropractic treatment can have a profound improvement in symptoms. Chiropractic treatment is very effective for grade I and II tears, but complete tears will need surgery.
Call Advanced Healthcare today and have Dr. Pisarek evaluate your shoulder. If your problem is within the scope of chiropractic, then he will be able to help you with your shoulder!