What are the rotator cuff muscles?

The rotator cuff is a group of muscles which work together to provide the Glenohumeral (shoulder) joint with dynamic stability, helping to control the joint during rotation (hence the name).

The rotator cuff muscles include:

• Supraspinatus
• Infraspinatus
• Teres Minor
• Subscapularis

Due to the function of these muscles, sports which involve a lot of shoulder rotation – for example, bowling in cricket, pitching in baseball, swimming, kayaking – often put the rotator cuff muscles under a lot of stress.

Problems with the rotator cuff muscles can be classed into two categories – Tears of the tendons/muscles, and inflammation of structures in the joint.

Inflammation / Symptoms

• More common in women aged 35-50
• Characteristic ache in the shoulder which feels like it is coming from “deep inside”
• Tenderness over particular areas, less specific than a tear
• Usually a gradual onset of pain, which “flares up” if using the arms over the head or out to the side
• Can sometimes lead to a chronic tear if untreated

When should I seek medical attention for my Rotator Cuff Injury?

Seek medical attention if:

• The pain persists for more than 2-3 days
• You are unable to work due to the pain/limitations
• You are unable to reach up or to the side with the affected arm after 2-3 days
• You are unable to move the shoulder and arm at all
• For any acute injury where you are unable to move the injured shoulder as well as the uninjured shoulder

Stretching (Rotator Cuff strain)

The following guidelines are for information purposes only. We recommend seeking professional advice before beginning rehabilitation.

Pendulum exercises

1. Gently swing the arm forwards, backwards and sideways whilst lying on your front.
2. Gradually increase the range of motion.
3. It is important that range of motion exercises are done as early as possible.
4. Aim to reach 90 degrees of motion in any direction.

Front of the shoulder in a doorway

1. Place one arm in a doorway (or something similar if not tall enough) and move forwards leaving the arm behind to stretch the front of the shoulder.
2. Hold the position for 10 to 20 seconds and repeat 3 times.
3. The athlete should feel a gentle stretch in the front of the shoulder but not pain.

Front of shoulder against a wall.

1. Place one arm behind a fixed point and gently turn away from it to stretch the front of the shoulder.
2. Again, hold the position for 10 to 20 seconds and repeat 3 times.
3. The athlete should feel a gentle stretch in the front of the shoulder but not pain.

Back of the shoulder

1. Place one arm accross the front and pull it in tight with the other.
2. The athlete should feel a gentle stretch at the back of the shoulder.
3. Again, hold the position for 10 to 20 seconds and repeat 3 times.
4. The athlete should feel a gentle stretch in the front of the shoulder but not pain.

Stretching should be done as soon as pain will allow and maintained throughout the rehabilitation process and beyond. Little and often is generally better than a big effort for a few days and then forget it as soon as the athlete feels the injury has settled down.