Dr. Grant Lum, MD, CCFP, Dip Sports Med, Sports Medicine Physician, discusses rotator cuff injuries, diagnosis and common treatment options.

The shoulder joint is a ball and socket joint, but the ball is actually much larger than the socket. It’s a bit like a golf ball sitting on a tee.

The reason it’s built like that is to give the shoulder a lot of mobility, so unlike a hip joint where the ball and socket fit very tightly together and are very stable where range of motion is not as important, you’ve got lots of range of motion in a shoulder, but as a consequence, it’s inherently unstable.

There are two different structures that help to stabilize the shoulder. The main one would be the capsule, so this is the ligament that wraps around and holds the ball and socket together, and along with that you’ve got the rotator cuff muscles.

So there are four different muscles. There’s one rotator cuff muscle in the front, and then three rotator cuff muscles on the back, and their job is to hold onto the ball and socket and stabilize it.

You can think of them like a sleeve muscle that goes around to control that movement. The other structure that’s in the shoulder that stabilizes things is the capsule. So that wraps all the way around like a ligament and holds onto the ball and socket.

It’s when that capsule’s been damaged that people can have dislocations of the shoulder. If you have a tear in a rotator cuff muscle, and it’s a relatively small tear, then those kinds of injuries are typically treated just like rotator cuff tendonitis with things like physiotherapy and muscle retraining.

With very large rotator cuff tears, they sometimes may require surgery to repair. Tears of the capsule, so the ligament again that wraps around the ball and socket, would lead to subluxations or dislocations of the shoulder, so where the shoulder actually pops out of joint. If that happens frequently, then we can go in and repair the capsule surgically.

Rotator cuff injuries typically happen as a consequence of repetitive movements, and the most common repetitive movement that would lead to it would be anything overhead. So in throwing sports like baseball or football, in overhead racket sports like tennis, squash, even in swimmers, so people doing freestyle bringing the hand over the top, that type of repetitive constant use of these muscles leads them to become fatigued, sometimes overstressed and that’s what leads to injuries.

The best way to prevent these kinds of injuries is to consult with a health professional like a physiotherapist or a fitness professional who understands how these muscles work, and to be put on a proper rotator cuff strengthening program in association with the training you’re doing for your sport.

If you think you have a rotator cuff injury, or you have more questions, you could consult a sports medicine physician or physiotherapist.

Video shot in conjunction with //www.aesmphysiotherapytoronto.ca/

Presenter: Dr. Grant Lum, Sports Medicine Physician, Richmond Hill, ON

Local Practitioners: Sports Medicine Physician