Rotor Cup or Rotator Cuff?
Here’s a scenario I hear often: My shoulder started hurting one day for no reason. I woke up and it was bothering me and it is getting worse. Every time I lift my arm it sends a sharp pain down my upper arm. I’m having trouble washing my hair, putting on a coat, even wiping myself after using the toilet. Forget about clasping a bra behind my back! I can’t reach for a cup in the cabinet without it hurting! It’s been getting so bad that I can’t sleep on that side. My doctor said I hurt my rotor cup, but I didn’t fall or injure it. It just started hurting!
Sound familiar?
It’s a common complaint we hear in a physical therapy clinic. The truth is, sometimes it does just start hurting without any obvious injury. But really, the injury itself could be years in the making or it could have been an awkward move the day prior that stressed and irritated it, though it didn’t hurt at the time.
Let’s set the record straight. It’s called the rotator cuff, not the rotor cup. The rotator cuff is a group of four muscles in the shoulder. Those muscles are called the Supraspinatus, Infraspinatus, Subscapularis, and Teres Minor. Together, they perform multiple functions:
Stabilize the shoulder joint by keeping the humeral head secure within the relatively shallow socket of the shoulder
Move the shoulder (glenohumeral) joint. Movement is into abduction (moving the arm out to the side and up/away from the body), as well as internal and external rotation (reaching up behind your back or reaching up behind your head to put your hair in a ponytail)
Assists other larger muscles (ie: deltoid, pectorals, latissimus dorsi) with control of fine motor movements of the shoulder joint, especially during some overhead, reaching, and lifting activities.
Basically, if you’re experiencing a problem with the rotator cuff you’ll likely know since it is involved in a lot of movement and can really hinder a person’s ability to do basic every day tasks.
Most rotator cuff injuries don’t typically occur as a result of a fall, blow to the shoulder, or other trauma. Most injuries are from repetitive overuse and can occur over time. A good example is that of a 45 year old person whose job is painting houses. The repetitive overhead or reaching involved in painting can cause the rotator cuff to wear down with time, leading to pain or even tearing.
The rotator cuff generally tends to wear down with time and age, too, which is why we, as physical therapists, typically see people in their forties with complaints of rotator cuff problems. There’s a natural decrease in blood supply to the tendons and years worth of micro-tears that lead to a reduced ability to heal and that results in pain.
Posture plays a huge role in the overall health of the rotator cuff. Tight chest muscles, weakness in the muscles surrounding the shoulder blades, and generally weak rotator cuff muscles can alter body mechanics, such as allowing larger muscles (ie: the deltoid) to overpower the rotator cuff, allowing the humeral head to shift upward and potentially pinch the rotator cuff against the underside of the acromion (bone on top of the shoulder). When this happens repeatedly the rotator cuff can wear down and may eventually lead to pain or even a tear in the tendon.
Adults aged 40-60 years old are the most likely to experience a problem with the rotator cuff. The cuff is aging, this demographic is still working, and with repetitive overuse of these muscles, pain can occur.
What can be done to either prevent a problem from occurring or address a problem if it has already started, then?
Posture, POSTURE, POSTURE!
Stretch out those pectoral muscles, strengthen those upper back muscles, strengthen the rotator cuff, and focus on good sitting and standing postures!
Gone are the days when we rested a hurting joint for weeks on end, just hoping it would one day get better! We know better now. But to know exactly what you need to do if you’re already experiencing pain here, will require you to be assessed by a knowledgeable professional, like a physical therapist who specializes in orthopedics.
And for the last time… it is called the ROTATOR CUFF, not the rotor cup!
