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A guide to Rotator Cuff Strains

The rotator cuff is a group of four muscles which attaches from the shoulder blade to the humerus in the upper arm. It is designed to support the shoulder joint as well as aid with elevation and rotation movements. The rotator cuff is a commonly injured area, the most common injuries are strains, tendinitis and bursitis. Rotator cuff injuries can range from mild to severe. Tendinitis is an injury caused by overuse of the rotator cuff, which causes it to become inflamed. For example, in sport tennis players who serve overhead or in work a painter who regularly reaches above their head may experience this injury. Bursitis is another common rotator cuff injury, caused by the inflammation of the bursa. These are fluid-filled sacs that sit between the rotator cuff tendons and the underlying bone. Rotator cuff strains or tears are either an overuse or acute injury. The tendons that connect muscles to bones can overstretch or tear causing intense and immediate pain. Rotator Cuff Strain Symptoms When a rotator cuff strain occurs, those suffering are likely to feel a pain in their shoulder which will become more apparent over time as the area is placed under further strain. In the incident the injury occurs as a result of sudden impact, the pain will come on suddenly at the point of injury and will prevent the individual partaking in any activity. Individuals are also likely to feel pain and stiffness in the shoulder even after activity is halted and will be most apparent in the morning. In severe cases, individuals may also feel pain in upper arm, shoulder blade and upper back and muscle weakness and even wasting can occur. Rotator Cuff Strain Diagnosis In order to diagnose a rotator cuff strain an individual will need to see a doctor or physiotherapist who can give an examination of the area and usually either an ultrasound or MRI scan will take place in order to confirm the amount of tearing and rule out any further complications. Rotator Cuff Strain Treatment To treat a rotator cuff strain, rest is crucial in order to allow the injury time to heal and preventing any further activity could cause damage or discomfort to the injury. Applying ice to the injury is an important aspect of the healing process as it will help reduce any swelling and inflammation as well as providing cooling pain relief to the injury. As always using the RICE (rest, ice, compression and elevation) method will be beneficial withing the first 72 hours of the injury occurring. Anti-inflammatory medications can also be taken in order to reduce swelling as well as relieving pain or aching from the injury. Once the injury has begun healing the individual will be advised by a physiotherapist or doctor to undergo a rehabilitation program such as strengthening and stretching exercises helping strengthen the area and increase mobility. If the individual is feeling pain from the injury the exercises will need to be halted. A physiotherapist will then be able to help create a more personalised exercise plan suitable foe the individual. If the injury is reoccurring, the individual may benefit from re-evaluating their technique depending on how the injury was sustained. For example, if the injury is caused through repeated heavy lifting it may be worth the individual looking to improve their posture and technique. In very severe cases such as a major or complete tear if other methods fail to help the injury heal surgery may be required to correct the injury followed by an intensive course of rehabilitation. SUMMARY Causes:

  • Excessive or awkward heavy lifting, pushing or pulling
  • Falling onto an out-stretched arm
  • Overuse injury commonly seen in throwing and racquet sports such as cricket, baseball and tennis


  • Sudden or gradual onset of pain deep in the shoulder joint
  • Patient may feel a tearing sensation at the point of injury
  • Pain when resuming activity
  • Weakness, aching and stiffness in the area
  • Pain may be felt in the upper arm, neck or shoulder blade


  • RICE method within first 72 hours
  • Physiotherapy
  • Strengthening and stretching exercises
  • Surgery may be required