Ask the Expert –Rotator Cuff

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Q: I have played softball for over 30 years and could always throw a ball fast and far. In August, I threw a long ball to second base and immediately after my throwing arm felt dead. I haven’t been able to throw since then. Our unit PA assessed my injured shoulder, told me I damaged my rotator cuff and sent me to physiotherapy. I am slowly getting better, but would like to know what a rotator cuff actually is.

—Sgt Chuck

Dear Sgt Chuck:
Glad to hear that your throwing arm is improving. The rotator cuff is a group of four muscles and their tendons that surround the shoulder joint and keep the head of the upper arm bone firmly held within the shallow socket of the shoulder joint. Your rotator cuff helps to provide your shoulders with stability and mobility. Unfortunately rotator cuff injuries are very common and can result in your shoulder being painful, having excessive movement (instability) or having reduced movement.

Rotator cuff injuries range from simple tendon inflammation to a complete tear of the tendon. These injuries can result from a single event such as pulling a heavy suitcase out of a trunk or from the repetitive wear and tear you see in someone who does a lot of overhead work. Your risk of experiencing a rotator cuff injury increases with age.

People with rotator cuff injuries experience pain in their shoulder – often on top of the shoulder and running down the side of their upper arm. They often cannot sleep on their injured side because this is painful. They may experience a loss of power in their affected arm. They may even have a clunking sensation in their shoulder with certain movements. When a rotator cuff becomes stiff we call this a frozen shoulder and shoulder movement can be very restricted.

Most rotator cuff injuries respond well to rest, ice, anti-inflammatory medications and physiotherapy. More severe rotator cuff injuries may require a corticosteroid injection or surgical repair. Restoring the strength of your rotator cuff muscles is critical to recovering from these injuries. However, doing the wrong kinds of exercises during the healing process can cause additional damage, such as converting a partial tendon tear into a complete tear.

The bottom line is that a strong and healthy rotator cuff is essential to the effective functioning of your shoulder. Keep working hard with your physiotherapist, and hopefully you will be able to return to throwing fast and far next ball season.

—Dr. Darrell Menard, MD Dip Sport Med

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