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 and heal.