A common question that we get in the clinic
is can I heal my rotator cuff injury? Before we answer that question, let’s take a look
at what the rotator cuff is and then see what we can do about it. First of all, the rotator
cuff consists of 4 muscles that attach to the shoulder blade and that attach to the arm.
The shoulder blade is the bone in back of the shoulder. So if you are looking at my
right shoulder, this would be the shoulder blade. This is the arm bone or the humerus.
This is the collarbone or the clavicle going across. And this is a little bone called the
acromion. What the acromion is is a little extension that is right here off of the shoulder
blade. The rotator cuff is 4 muscles. One muscle is in the front. Three muscles are
on the back side of the shoulder blade. Why is that important? One of those muscle goes
through a small space right here. The big fancy term for that is subacromial space.
What happens is as we age or because of an injury of because we sleep like this, over
a period of time, that space can close down. What that does is that pinches on the tendon.
Over time that can cause a rotator cuff tear or with most people that we see in the
clinic, what happens is they get a condition called rotator cuff impingement. What the
person will say is either I have pain right here or perhaps out a little bit and especially
it will be aggravated with reaching behind the back, raising the arm up to the side, reaching
overhead or sleeping on my stomach or on my side with my arm like this. Some people
will also note if they are driving that the affected side their hand is on the wheel,
that they will experience some pain with that as well. Now, can we heal that? Well let me ask you
this question or let’s take a look at it like this: is there anything that we can do to
open up that space and relieve pressure on the rotator cuff? The answer is yes. Just looking
at it from the issue right here, what is the first thing that we can do? Well there are
manual, hands-on physical therapy techniques from a good Physical Therapist
that can pull the arm down and open up this space. It is very gentle. It is not rough.
There is no popping or cracking or anything like that. There is a series of movements that
a trained Physical Therapist can do to increase the space here. What does that do?
It decreases inflammation. It decreases pain. It allows the tendon to heal. In most
cases, the person gets their full range of motion back and they get full strength back.
Now as the listener, you are probably not interested in any of those things outside
of decreased pain. Well what that means is you can get back to the activities that you
want to do. Perhaps it is getting dressed. Perhaps it is reaching behind your back or
doing another activity without that pain and discomfort. You can get your life back. We
do hands-on techniques to open that up. Then we retrain the muscles that control that
joint, that control that area to keep it that way. So the answer to the question, can I heal
my rotator cuff injury is yes, for most people. If there is a full thickness rotator cuff
tear, can that be healed? That is a tough one. Some people who are relatively healthy and
work hard in physical therapy, what can happen is with all of the other muscles that
surround that joint, they can make that area strong enough that it compensates for the
tear that they have. Occasionally surgery is needed. Occasionally when good physical therapy
fails, a surgeon will go in and open up that space. What they do is literally they
cut away the bone here an open up that space where that tendon slides through. They
can also do a repair and a few other things. For most people, 90% of the time,
with a normal rotator cuff injury or a rotator cuff impingement, good physical therapy with
hands-on training and the right exercise, we can open up that space, keep it that way