Rotator Cuff-Related Shoulder Pain
Understanding Rotator Cuff-Related Shoulder Pain: Causes, Symptoms, and Treatment
Rotator Cuff-Related Shoulder Pain: An Umbrella Term for Multiple Shoulder Disorders
Rotator cuff-related shoulder pain is a broad, umbrella term that encompasses a variety of conditions that affect the rotator cuff, a group of muscles and tendons responsible for stabilizing the shoulder and facilitating its movement. When people refer to "rotator cuff pain," they could be describing several different disorders that involve the rotator cuff, including tendinopathy, impingement syndrome, and rotator cuff tears. Understanding these distinctions can help clarify the nature of the pain and the best treatment approaches.
The Role of the Rotator Cuff
The rotator cuff consists of four muscles and their tendons: the supraspinatus, infraspinatus, teres minor, and subscapularis. These muscles work together to stabilize the shoulder joint, allowing the arm to move freely in many directions. Damage to any of these structures can result in pain, weakness, and limited movement. Rotator cuff-related shoulder pain is often characterized by difficulty lifting the arm and pain when reaching overhead. However, the exact nature of the pain can vary depending on the underlying condition.
Prevalence
Approximately 18-26% of adults in the general population experience shoulder pain at a given point in time, with rotator cuff-related shoulder pain is known to be the most common finding.
Risk Factors
Age- The risk of developing rotator cuff related shoulder pain increases significantly with age and most commonly presents in ages 45-55.
Overhead Activities - Repeated overhead activities such as in sports like swimming, tennis, baseball and ect.
Occupational - Jobs that require frequent lifting, reaching, or forceful arm movements increased the likelihood of both conditions.
Other lifestyle related factors and comorbidities - poor sleep, diabetes, smoking, alcohol and ect.
Poor Biomechanics - Limited shoulder and kinetic chain related movement control that may predispose the RC structure to compressive loads and additional stress.
Prognosis
Recovery may take about 12 weeks, and may vary depending on different factors.
Treatment
Exercise is a key intervention when it comes to management of rotator cuff-related shoulder pain. Exercise was previously found to be as effective as surgery in improving key outcomes like pain reduction, disability, and quality of life. Exercise will most likely vary depending on the clinical presentation of the individual and the demand of the activities he/she would like to go back to. In general, combining motor learning related exercise, with strength training of shoulder and considering a kinetic chain with complex movement is required for a quality program to be efficient. It is recommended to ask your physical therapist more about it.
References
Luime J.J., Koes B.W., Hendriksen I.J.M., et al. Prevalence and incidence of shoulder pain in the general population; a systematic review. Scand J Rheumatol. 2004;33(2):73–81. doi:
Requejo-Salinas N, Lewis J, Michener LA, et al. International physical therapists consensus on clinical descriptors for diagnosing rotator cuff related shoulder pain: A Delphi study. Braz J Phys Ther. 2022;26(2):100395. doi:10.1016/j.bjpt.2022.100395
Fahy K, Galvin R, Lewis J, Mc Creesh K. Exercise as effective as surgery in improving quality of life, disability, and pain for large to massive rotator cuff tears: A systematic review & meta-analysis. Musculoskelet Sci Pract. 2022;61:102597. doi:10.1016/j.msksp.2022.102597
