The shoulder is a very shallow ball and socket joint, which makes it naturally unstable and therefore depends heavily on muscular support. The upside of the shallow socket is that it gives the shoulder an amazing amount of movement.
The rotator cuff is the name for the tendons that surround the shoulder joint. The rotator cuff is the most important group of muscles giving it support and stability allowing the shoulder to function through a wide range of motions. In part due to the rotator cuff, the shoulder joint can move and turn through a wider range than any other joint in the body. This motion of the shoulder joint allows us to perform an amazing variety of tasks with our arms.
The rotator cuff is part of this mechanism that functions very well when healthy, but when injured can be a difficult and frustrating problem. Unfortunately, rotator cuff tears are common problems and these injuries make many routine activities difficult and painful. Many therapists, including chiropractors, would say that is one of the most difficult problems to treat.
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The rotator cuff is a group of four muscles and their tendons that wraps around the front, back, and top of the shoulder joint.
The muscles are the supraspinatus, infraspinatus, teres minor and subscapularis, which help to provide stability for the shoulder joint.
Like most musculoskeletal conditions, the most common mechanisms of a rotator cuff tear are separated into ‘repetitive micro-trauma’ and ‘traumatic injuries’. There are always exceptions to the rule, but the following is generally true for both types of injuries.
A rotator cuff tear is seen both in the young and old, but a complete tear is much more common if you are older.
In younger people, there is usually either a traumatic injury such as a fall, or the person is putting the tendon under significant load, as seen in athletes involved in throwing. Swimming is also a common source of shoulder injuries.
As you age, the muscle and tendon tissue of the rotator cuff loses some elasticity, and due to the inherent poor blood supply to the mid part of the tendon healing is slow and degenerative changes are often found.
Therefore the rotator cuff becomes more susceptible to injuries and is often damaged while performing everyday activities. This is the reason that rotator cuff tears are more commonly seen in older people.
Not every rotator cuff tear causes significant pain or disability. In fact, autopsy studies have shown rotator cuff tears in up to 70% of people over the age of 80 and 30% of the population under the age of 70.
Clearly, all of the people with rotator cuff tears are not complaining of painful symptoms. However, in many individuals, a rotator cuff tear can cause significant disability, and prompt diagnosis and chiropractic treatment can have a profound improvement in symptoms and shoulder function.
Chiropractic treatment is very effective for grade I and II tears, but complete tears will need surgery.
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