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Rotator Cuff Injury, Dislocated Shoulder, AC joint Sprain, Impingement Syndrome, Subacromial Impingement, Clavicle Frature, Frozen Shoulder, Winging of the scapula, Swimmers Shoulder, sternoclavicular dislocation

Rotator Cuff Injury

Anatomy of the rotator cuff
The anatomy of the shoulder is complex and comprises of four joints. The obvious one is the glenohumeral and this allows movement of the arm, then you have the acromio-clavicular joint, the sternoclavicular joint and the scapulothoracic joint/articulation.

Joints of the shoulder:
• Glenohumeral
• Scapulothoracic
• Sternoclavicular
• Acromio-clavicular

Like the hip the glenohumeral joint is a ball and socket joint but unlike the hip, which is designed for stability and weight bearing, the shoulder joint is designed for flexibility and movement. Evolutionary development has allowed the shoulder to provide us with the ability to lift ourselves up, to throw things and catch things and to evolve into successful hunter-gatherers.

The downside of all this flexibility is that the shoulder is prone to injury and one area particular prone to injury is the rotator cuff. The rotator cuff comprises of four muscles that are blended into the capsule of the glenohumeral joint to reinforce the shoulder during movement providing stability to the glenohumeral joint in the process. Namely:
• Supraspinatus
• Infraspinatus
• Subscapularis
• Teres minor

The tendons of these muscles wrap around the shoulder joint, forming a cuff around the ball of your humerus providing stability.

Types of rotator cuff injuries
The rotator cuff is susceptible to three types of injuries:
• Rotator cuff tendonitis
• Rotator cuff impingement syndrome
• Rotator cuff tear

Rotator cuff tendonitis
This is caused by inflammation in the tendons of the rotator cuff. It can be acute, following activity and injury or it can be chronic due to repetitive activity or overuse. Acute injuries can occur during sport such as from throwing injuries. Chronic sports related rotator cuff injuries can occur through too much tennis serving practice or poor swimming technique. Away from sports occupations that rely on repetitive shoulder movement such as painting and decorating or plastering can cause rotator cuff tendonitis.

Symptoms of rotator cuff tendonitis can be sudden pain on lifting the arm up above shoulder height. There may also be pain at night.

Rotator cuff impingement syndrome
The rotator cuff passes under the acromium in the subacromial space. It is here that the movement of the shoulder blade can damage the rotator cuff tendon and this can lead to the tendon tearing. This tends to be a chronic problem and can be secondary to arthritis of the acromium and wear and tear.

Symptoms of rotator cuff impingement are more chronic and follow activities that involve the arm above the head.

Rotator cuff tear
This often starts as sudden onset of pain at the front outside aspect of the shoulder. There is often pain on certain movements such as reaching forward or raising your hand above your head. There may also be pain on movement and restricted movement of the shoulder.

If you have shoulder pain whether it is acute or chronic from daily activities or sport arrange to see the physiotherapist in Wicklow Physiotherapy Clinic and prevent it from deteriorating further. If you want to arrange an appointment please click below.

Swimmers Shoulder
Chances are you’ve experienced shoulder pain or discomfort at some point in your swimming life. If this has ever prevented you from swimming, you will appreciate just how frustrating this can be.

Swimmers shoulder is inflammation in the tendons of the muscles you use to swim. These muscles become inflamed from repetitive strokes, whether that be in the pool, or the ocean.

The more powerful pulling muscles cause an imbalance with the straightening technique muscles and this imbalance can cause the tendons to become inflamed from pinching against the bone surface.

There are two different types, and determining which type is very important as it will guide your treatment and rehab.

Type 1- is pain on the pull through phase, when the hand is in the water.

Type 2- is pain on the recovery phase, when the hand is out of the water.

The most common reasons why swimmers shoulder occurs is poor technique and fatigue.

Poor technique leads to using the wrong muscles to swim. What happens is that the larger, more powerful muscles cause the smaller rotator cuff muscles to fatigue quicker as they have been working harder to stabilise the shoulder. When a muscle fatigues it is at a greater risk of injury, and as the swimmer continues to train with fatigue they cause further damage and inflammation.

Many people spend a lot of money every year visiting a physiotherapist in an effort to manage a shoulder injury but overlook what is actually causing that pain in the first place. 9 times out of 10, this will be your stroke technique.

Correcting your technique is not actually that difficult, but you do need to know what to look out for and, just as importantly, work diligently to improve in these areas. At Wicklow Physiotherapy we have in depth knowledge of swimming strokes and what is needed for correct technique to prevent injury. Our knowledge of the shoulder girdle muscles places us in the best position to be able to advise you just where you are going wrong.

A good swimming technique will have the following factors in place, consistently:

  1. Bilateral breathing for at least 80% of your training sessions. There are many times (especially in the open water) when unilateral breathing is the better option, but for a healthy, balanced freestyle stroke technique, bilateral breathing is the way to go in training.
  2. Good, symmetrical body rotation. This can be worked upon through a range of different body rotation drills, often employing fins for support.
  3. Hand entry into the water is finger tip first, not thumb first despite what you may have been taught when you learnt to swim!
  4. Avoiding midline cross over at the front of the stroke.
  5. Developing and maintaining of good upper body posture.
  6. Targeting a high elbow (bent arm) catch and pull through.

Frozen Shoulder /Adhesive Capsulitis
Frozen shoulder is a very common condition seen at Wicklow Physiotherapy Clinic.   With our many years clinical experience in treating shoulder problem we are well equipped to offer the best possible service to aid your recovery.   Frozen shoulder can most often be diagnosed on examination, no special tests are required.   see more information about frozen shoulder / adhesive capsulitisSo if you have a persistent shoulder injury that is affecting your performance please contact us today.

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Wicklow Primary Healthcare Centre, Knockrobin, Wicklow, A67 K5C7, Ireland

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