Shoulder

Rotator Cuff-Related Shoulder Pain

Have you ever experienced a gradual onset of pain to the lateral/outside part of your shoulder and have been told you may have a shoulder impingement, or shoulder bursitis or tendinopathy/tear of your rotator cuff muscles. Rotator cuff-related shoulder pain (RCRSP) is a term used by medical professionals to diagnose your shoulder pain as.

RCRSP refers to your shoulder pain being related to either your rotator cuff tendons and/or associated structures in your shoulder. Just like other bodily structures, your shoulder is influenced by age, lifestyle, use and genetics. In most people under the age of 50 diagnosed with RCRSP, the most common contributing factor to their pain is a recent increase in shoulder use, and this use being repetitive in nature.

RCRSP

RCRSP can be caused by:

• Repeated shoulder use. This is due to the shoulder joint not being accustomed to the load of repetitive actions.
• A traumatic episode that has not resulted in a dislocation or subluxation of the shoulder joint.

A physiotherapist will use a subjective and physical examination to confirm the diagnosis of RCRSP. You may report in the subjective examination pain located to the anterolateral part of the shoulder, which is exacerbated when performing shoulder movements such as:

• Moving the shoulder overhead.
• Placing your hand behind your back.
• Being unable to lay on the painful shoulder in the evening/night.

On physical examination, your physiotherapist will assess your shoulder and this may include:

• Assessing shoulder range of motion with shoulder pain exacerbated on active range of motion, with full passive range of motion that may be painless.
• Resisted testing on the shoulder joint, with pain provocation with/without weakness present.

Management of RCRSP

Management of RCRSP can take up to 12 weeks minimum for full restoration of pain-free movement and function. Recent evidence has shown that non-surgical management is as effective as surgical intervention for RCRSP. Evidence has also universally recommended progressive exercise therapy using resistance training in the management of RCRSP. The goal of resistance training is to increase the capacity and tolerance of the shoulder to the activities and tasks you are performing that currently are aggravating.

A physiotherapist will guide and educate you through an exercise program that will focus on reducing pain, improving tolerance to the range of movement, restoring muscle strength and improving muscle function. They will also provide education on avoiding aggravating factors and provide alternative methods to current aggravating tasks. The physiotherapist may use symptom modification techniques such as taping and soft tissue massage to help desensitize areas of the shoulder that may be contributing to your RCRSP presentation.

RCRSP can occur in numerous sports such as Swimming, Basketball,  AFL, Rugby union, Rugby league, Volleyball, Cricket and many more. Sports participation is possible with a diagnosis of RCRSP, but may need guidance from a physiotherapist. This would include a resistance exercise program helping build shoulder strength, education around activity/training modifications that are causing pain exacerbation, and symptom modification through shoulder taping techniques and massage.