Rotator Cuff - Click for a larger imageThe shoulder joint is the most mobile joint in our body, relying primarily on muscles, tendons and ligaments for it’s stability.

The rotator cuff is a group of four muscles and their tendons and they control shoulder rotation and elevation. They are situated on the scapula (shoulder blade) and come together to run under the clavicle (collar bone) to attach onto the humerus (upper arm).

These tendons can become irritated or inflamed with activities involving repetitive overhead shoulder movements such as painting or cleaning or with sports that use repetitive shoulder movements such swimming or baseball.

Prolonged habitual slouching postures could also cause weakening of the rotator cuff which can predispose one to rotator cuff tendonitis. Particularly, the downward tilt of the shoulder blade (scapula) which occurs with a slouched posture, leads to a smaller space for the tendons of the rotator cuff to glide under the top bony process of the shoulder blade (acromion). This over time leads to a pinched or inflamed rotator cuff tendon and over time results in repeated mincro-trauma to these tendons.

If this progresses, the tendons may fray and the muscles weaken. Occasionally there may be a gradual loss of movement in the shoulder. Tendonitis persisting longer than 3 months can lead to a painful build up of calcium in the rotator cuff itself, which further inhibits movement and strength.

Tendonitis which results in this type of degeneration or micro-trauma can progress to a full or partial tear of the rotator cuff tendon.

Early intervention is the key to good recovery. Physiotherapy is an important part of the treatment. Treatment initially consists of:

  • educations to avoid irritating the inflamed or injured tendon
  • pain reduction through various modalities
  • mobilizations to the shoulder to regain the range
  • strengthening exercises to regain strength and restore scapula control with arm movements
  • restore neck and upper back function as the neck and upper back are very important in complete rehabilitation of shoulder dysfunction

Each program is tailored to the individual client with the goal of getting the person back to a normal painfree lifestyle.


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