Rotator cuff muscles are our shoulder stabilizer muscles that also assist with shoulder movement. Our rotator cuff is made up of 4 muscles (supraspinatus, subscapularis, infraspinatus and teres minor). We often see patients with shoulder pain that come in with imaging showing a tear in one or more of the rotator cuff muscles. Some patients are able to recall a specific incident or injury that may have caused the tear and some can’t. It is important to recognize that the pain experienced may or may not be due to the rotator cuff tear as some people have rotator cuff tears and have no pain! A study found that out of 96 individuals that had no shoulder pain: magnetic resonance imaging (MRI) identified 33 of them that had rotator cuff tears including full- and partial- thickness tears1. The study stated that the participants were able to do functional activities without any pain1. From clinical experience people with rotator cuff injuries sometimes have pain related to other muscles that have been compensating for the initial injury and are being overused. After an injury, it is natural for us to guard and protect our shoulder from painful activities but sometimes that can turn into a habit. That’s when we notice a loss of strength, range of movement, pain and various compensation strategies. Physiotherapy treatment is focused on decreasing pain, improving your range of movement and strengthening your shoulder to regain any functional limitations experienced. Remember that even patients with pain associated with a shoulder tear can return to pain-free activities. It’s important for patients to realize that they may have always had a rotator cuff tear and shoulder pain may or not be associated with the tear. Imaging is a valuable tool however we have to use and interpret findings carefully as structural changes picked up through imaging doesn’t always directly correlate with symptoms.
Reference: 1. Sher J.S, et al. Abnormal findings on magnetic resonance images of asymptomatic shoulders. The Journal of Bone and Joint Surgery. American volume. 1995 Jan; 77(1):10-5