Rotator Cuff Recovery

The Rotator Cuff consists of 4 muscles ( Subscapularis, Supraspinatus, Infraspinatus and Tires Minor). The Rotator cuff is responsible for stabilising the glenohumeral joint. The muscles that bring about the 'rotator cuff' are responsible for an array of movements, such as initiation of abduction, adduction, external rotation and internal rotation. Thus making the rotator cuff, very important to the glenohumeral joint.

Rotator cuff lesions represent the vast majority of shoulder injuries in adult patients. They are a common contributing factor to shoulder pain and occupational disability (Randelli et al 2014). The mechanism of a rotator cuff injuries has long been a topic of discussion. Neers, study on "Chronic shoulder impingement" in 1972, suggests that impingement can be caused due to "extrinsic" factors, of which he suggests is due to changes at the acromion. There is also the "intrinsic" theory, which looks at the rotator cuff tears from a degenerative perspective. We then of course, can not forget secondary causes, such as overuse, fatigue, adhesive capsulitis just to list a few.

When looking at treatments, we must first ensure we are establishing the cause rather than just treating the "symptoms". When we only focus on symptoms, the likelihood of re injury is great. With that being said, there are two main approaches for rotator cuff injuries. The first is Conservative and the other is surgical. When opting for the conservative route, it is imperative that the treatment is balanced, specific, and timely. Why? Well there are a few reasons but, it has been well documented that rotator cuff injuries can deteriorate with time, making the treatment program less effective. Many studies have said to of found no difference between surgical and conservative treatments. A researcher named 'Frederik Lambers Heerspink' looked at "Degenerative full thickness rotator cuff tears: Towards optimal management" in 2016, he too concluded that there was no difference observed a year later between the two groups however there was a small difference in pain and disability in function found in favour of surgery. This being said, there is limited evidence to suggest that surgery is not more effective in treating symptomatic rotator cuff tears specifically than conservative treatment alone. This therefore leaves most opting for the conservative approach as an initial treatment option (Ryösä et al, 2017)

In conclusion, the rotator cuff is extremely key to what is one of the most complex joints in the body. There are various movements and ROM at the joint and therefore an injury to the rotator cuff, can be debilitating and negatively impact a persons quality of life. More research is needed in concluding the best way of treating such injury, however conservative treatment seems to be a cost effective as well as a results effective way to start.