Kinesis Physical Therapy South Hills, Pittsburgh, PA

Rotator Cuff Problems

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The rotator cuff (RTC) is made up of a four tendon-muscle unit that helps to stabilize the shoulder and move the arm.1 Rotator cuff problems are usually associated with changes in the tendon that begin in the early decades of life.2  The frequency of partial and full thickness tearing increases as we age.2 Tears are occasionally caused by trauma, and in some cases are associated with boney spurring.2

Physical Therapy May Help to Avoid Rotator Cuff Surgery

Physical Therapy May Help to Avoid Rotator Cuff Surgery

Risk factors may include3 :

  • Increasing age 
  • History of trauma
  • Hand dominance (RTC tear more likely on the dominant side)
Symptoms may include 4 :
  • Shoulder pain
  • Shoulder weakness
  • Inability to lift arm
  • Disturbed sleep

_______________________________________Prevalence

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Up to 18 million adults in the United States reported shoulder pain in 2005.5  A study including 1,366 patients found that more than a third of those with shoulder symptoms had rotator cuff tears.3  The researchers found the prevalence of full-thickness rotator cuff tears to be 20.7% in the general population.6  It is common to have a rotator cuff tear without symptoms, but a tear may become symptomatic over time.6, 7

Physical Therapy Treatment of Rotator Cuff Tears

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A patient may be treated conservatively with physical therapy and medical care.1  In some cases, surgical management may be considered.1,8

Physical therapy treatment may consist of:

  • Prescriptive Exercise 9,10
  • Manual physical therapy 10,11
  • Modalities such as ice and moist heat
Physical therapy after surgical management tends to be progressed in phases,  from immobilization to range of motion and finally to strengthening. Progression is in accordance with the type of surgery and the surgeon’s recommendations. In some cases, improvements in pain and function can be expected for a year or more after surgery.2 
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Author: Christopher (C.J.) Eberley, PT, DPT
Board Certified Orthopedic Physical Therapist
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Disclaimer: The views discussed on this website are for educational purposes only. Should you have any questions please consult your physician or physical therapist. Copyright© Kinesis Physical Therapy. All Rights Reserved.

References
 
1. Seida JC, Schouten JR, Mousavi SS, Tjosvold L, Vandermeer B, Milne A, et al. Comparative effectiveness of nonoperative and operative treatments for rotator cuff tears. Comparative Effectiveness Review No. 22 . Rockville, MD: Agency for Healthcare Research and Quality; July 2010.
2. Pedowitz, Robert A., et al. “American Academy of Orthopaedic Surgeons Clinical Practice Guideline onOptimizing the Management of Rotator Cuff Problems.”The Journal of Bone & Joint Surgery 94.2 (2012): 163-167.
3. Yamamoto A, Takagishi K, Osawa T, et al. Prevalence and risk factors of a rotator cuff tear in the general population. J Shoulder Elbow Surg 2010;19:116-20.
4. Boykin, R.E., Heuer, H.J., Vaishnav, S., Millett, P.J.  Rotator Cuff Disease: Basics of diagnosis and  treatment. Rheumatology Reports. 2010(2:e1): p. 1-125.  American Academy of Orthopaedic Surgeons. The Burden of Musculoskeletal  Diseases in the United States. American Academy of Orthopaedic Surgeons; 2008.
6.  Sher JS, Uribe JW, Posada A, Murphy BJ, Zlatkin MB. Abnormal findings on  magnetic resonance images of asymptomatic shoulders. J Bone Joint Surg Am 1995;77(1):10-15.
7. Moosmayer, S., et al. “Prevalence and characteristics of asymptomatic tears of the rotator cuff AN ULTRASONOGRAPHIC AND CLINICAL STUDY.”Journal of Bone & Joint Surgery, British Volume 91.2 (2009): 196-200.
8. van der Meijden, Olivier A., et al. “REHABILITATION AFTER ARTHROSCOPIC ROTATOR CUFF REPAIR: CURRENT CONCEPTS REVIEW AND EVIDENCE-BASED GUIDELINES.” International Journal of Sports Physical Therapy 7.2 (2012): 197.
9. Lombardi IJr, Magri A, Fleury A, da Silva A, Natour J. Progressive resistance  training in patients withshoulder impingement syndrome: a randomized controlled  trial. Arthritis & Rheumatism (Arthritis Care & Research) 2008;59(5):615-622.
10.  Bang MD, Deyle GD. Comparison of supervised exercise with and without  manual physical therapy for patients with shoulder impingement syndrome. J  Orthop Sports Phys Ther 2000;30(3):126-137.
11.  Bergman GJ, Winters JC, Groenier KH, et al. Manipulative therapy in addition to usual medical care for patients with shoulder dysfunction and pain:a randomized,controlled trial. Ann Intern Med 2004;141(6):432-9.
12 Baumgarten, K.M., Vidal, A.F., Wright, R.W. Rotator Cuff Repair Rehabilitation: A level I and II Systematic Review. Sports Health: A Multidisciplinary Approach. 2009. 1: p. 125. 1