The rotator cuff is made up of four muscles that support the shoulder joint during movement.  The shoulder is a very unstable joint by nature and is therefore prone to injury if muscle imbalances are present.  These imbalances can be caused by tension in the neck muscles, poor posture, lack of movement in the thoracic spine (mid back), weakness in the muscles that stabilize the scapula, or shoulder blade, or incorrect movement patterns in the hip and lower extremity.  All of these scenarios can eventually cause overloading of the rotator cuff muscles and stress on the joint. 

Another common cause of rotator cuff injury is overdevelopment of the large muscles around the shoulder such as the pectorals, deltoids and trapezius.  This overdevelopment overpowers the small rotator cuff muscles, creating an imbalance and causing them to not activate effectively.  Scar tissue will now develop, further reducing the function of the cuff.  If the cuff muscles are not activating effectively, it is not stabilizing the shoulder joint effectively, leaving it at risk for injury.

Common injuries of the rotator cuff are impingement, tendonitis, trigger points, and strains.   Other injuries of the shoulder that are associated with rotator cuff injury are joint instability, labral tears and AC joint sprains.

Treatments

Shoulder injuries require assessment of the overall mechanics of the whole body.  For example, a baseball pitcher’s entire wind up and release must be assessed with careful attention paid not only to the shoulder, but to the hips, ankles and spine.  The cause of the stress factor must be identified and corrected. 

Treatment includes functional soft tissue therapy (A.R.T., Graston) to remove scar tissue and allow the tissue to move and function freely.  Functional rehabilitation is important to establish healthy movement patterns and to strengthen the cuff muscles.