Rotator Cuff Injuries
Rotator cuff injuries (RCIs) are extremely common amongst athletic population sand non-athletic populations. RCIs include rotator cuff tendonitis, supraspinatus tendonitis, biceps tendonitis and rotator cuff tears. Incident rates indicate that 10-30% of individuals will sustain a rotator cuff tear in a lifetime. The majority of these tears are degenerative meaning repetitive micro trauma occurs overtime leading to erosion of the tissue. Individuals with these injuries wake up with shoulder pain for no apparent reason, not having experienced a specific traumatic event.
Why are RCIs so common?
The rotator cuff is flawed by design. Anatomically, the rotator cuff is vulnerable, having only a one centimetre space to avoid compression at the front of the shoulder. The space is referred to as the Rotator Cuff Interval (RCI). Several factors can obliterate the RCI, causing compression of the tendon and ultimately cellular damage that may even progress to a tear.
What is the solution?
The majority of injuries, 90% in fact, are managed conservatively with physical therapy, meaning a minority of cases proceed to surgery. Physical therapy consists of 2 phases.
Phase 1: Managing pain and inflammation
Repetitive micro trauma to muscle or tendon invokes an inflammatory response, or an outpouring of chemicals into the tissue. The function of these chemicals is first to signal pain and second to attract chemical mediators and building blocks to restore damaged tissue. The negative effects of inflammation however, are pain and muscle spasm.
Clinical trials have proven that acupuncture is an effective solution for mitigating pain and muscle spasm due to inflammation. Individuals receiving acupuncture are better able to perform rehabilitative exercise and report less pain and greater function given the same injury.
For some individuals a cortisone injection is also beneficial.
Phase 2:Restoring RCI
A biomechanical assessment must be performed to determine which factors are compromising the RCI for each particular case. Based on this assessment, appropriate treatment is implemented which may consist of manual therapy/muscle release techniques to unwind tight muscles that are feeding into a muscular imbalance as well as strengthening exercises.
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