Know your Injuries – Part 6: Rotator Cuff Strain, Partial or Complete Tear

Dr Meenakshi presents the early management of rotator cuff injuries in Part 6 of her Sports Injury Management Series.

Here is another muscle group prone to common injury in physical activity, exercise and sports: rotator cuff muscles.

These are injuries to the muscles or tendons that attach to bones in shoulder. Contractile units comprising muscles, tendons and bones stabilize the shoulder joint while allowing a large range of motion. The strain will normally occur at the weakest joint.

The rotator cuff is a functional anatomical unit located in the upper extremity, in the shoulder area. It functions in relation to the glenohumeral joint, where the muscles of the cuff work both as the executors of the movements of the joint and the stabilizers of the joint.

As the name suggests, the rotator cuff plays a major role in the internal and external rotation of the arm in the shoulder joint. All the muscles mentioned above fulfill different functions. The subscapularis muscle is a powerful internal rotator which also supports the arm during abduction and adduction.

The injury – the strain, really – as expected, may take place at the weakest part of the shoulder unit. These strains are of three types:

• Grade I or minor: slightly pulled muscle without tearing muscle or tendon fibers. Loss of strength is not evident.
• Grade II or moderate: tearing of fibers in muscle or bone or at site og bone attachment.
• Grade III or severe: rupture of the bone – muscle – tendon attachment with separation of fibers.

Dr Meenakshi breaks down her explanation in terms of –

• symptoms
• causes
• prevention
• first aid
• basic rehab movements

• Prolonged overuse of muscle-tendon units in shoulder
• Acute, sudden impactful injury to the shoulder area

• Contact sport
• Throwing sports
• Cardiovascular problem that reduces blood circulation
• Medical history of bleeding
• Obesity
• Poor muscle condition
• Poor nutrition
• History of previous injury

Prevention is better than cure! The precautions to be taken are common to all sports and exercise injuries. But it is worth reminding the reader!

• It is essential to engage in a physical conditioning that involves appropriate strength and flexibility building movements prior to playing sports.
• Stretch the thigh and lower leg muscles as also the tendons prior to physical activity.
• Improve functional movement and dynamic stability of the knee joints.
• Improve technique of sports movement or exercise like “calf raises” with external resistance in the weight training studio.
• Try to be in shape to play your sport; don’t play your sport to get in shape!

Follow the P.R.I.C.E. drill –

• Protect the injured part, not allowing any further damage.
• Rest the injured part.
• Apply ice or cold treatment for 15-20 minutes.
• Compression: use of mild to moderate pressure to the injured area with bandages / crepe bandages is advisable.

Current international standards have replaced P.R.I.C.E. with P.O.L.I.C.E.

• P – Protection of injured part
• O/L – Application of Optimal load (local injury factors) / Training load
• C.E. – as mentioned earlier (ice + compression+ elevation)

• The doctors will perhaps recommend an elastic bandage or a splint or even a cast from the ankle to the groin in order to immobilize the injured knee.
• Continued use of ice packs three or four times a day, 15 to 20 minutes per session is advisable.
• After 72 hours, the doctors may recommend application of heat therapy, liniments or ointments.
• Massage therapies as also hydro-therapies will be certainly enable quicker recovery.

Nutrition plays a big role in the recovery process and the injured person must consult a certified sports nutritionist.

See your doctor if your symptoms persist over 10 days or pain worsens despite treatment.

Expect more in this informative and useful series of videos by Dr Meenakshi! You can also read a more detailed blog in this connection on www.gayofitnessacademy.com