What is a Rotator Cuff and have I torn it? WHAT IS IT? The rotator cuff is a group of four small muscles that surround the shoulder joint. Their tendons attach to the humerus, close to the joint line and act as a cuff that provides support and control to the shoulder. They also play a primary role in creating rotational movements of the shoulder. Rotator cuff tears are common injuries and can occur in any of the four muscles, usually at their weakest point, which is the junction between the muscle and tendinous tissue. These tears are common in racket and throwing sports and are one of the leading causes of shoulder pain. The prevalence of rotator cuff tears increases as we age due to age related degenerative changes in the tissues. What are the symptoms? Many people have rotator cuff tears with no symptoms at all, and are unaware of the injury. However, for others, these tears can be very painful and lead to difficulty moving the shoulder, particularly with overhead activities. They may find their range of movement is restricted and the arm feels weak. They often experience pain that radiates down to the arm and pain at night, which can cause sleep disturbances. It is interesting to note that the size of a tear is not necessarily related to the amount of pain and dysfunction experienced, with small tears sometimes creating large problems and large tears going unnoticed. What are the causes? Movements that create a rapid twisting motion or overstretching of the shoulder often cause rotator cuff tears. The most common mechanism of injury is a fall onto an outstretched hand. These tears can be acute or chronic, developing over a period of time or related to degenerative changes, where tendon tissue is damaged by everyday activities due to reduced strength and elasticity. Other causes of rotator cuff tears include overuse, lifting or carrying heavy objects and repetitive overhead activities. Poor biomechanics can cause weakening of the shoulder’s tendons with insufficient blood supply to the rotator cuff over a long period of time. This can leave the tendon more susceptible to injury as is a significant contributing factor to the development of tears and the outcomes of recovery. How can physiotherapy help? The primary objectives of physiotherapy treatment are to reduce pain, increase range of motion and strength and improve shoulder function. Your physiotherapist will work with you to help set goals assist to reach them with a targeted rehabilitation program, manual therapy and education on how to achieve the most from your recovery. While severe tears are often repaired surgically, research is increasingly showing that even in severe tears, a comprehensive rehabilitation program under a physiotherapist leads to similar outcomes to surgery. For this reason, a conservative approach guided by a physiotherapist is often recommended to patients as the first option for treatment. The exact time frame of treatment and recovery will vary from person to person and is affected by a variety of factors including if surgical repair was chosen, the severity of the injury and function prior to injury. For more information or to make an appointment, you can BOOK ONLINE or call your local clinic. None of the information in this article is a replacement for proper medical advice. Always see a medical professional for advice on your individual injury. What does your tennis technique say about you? Have you ever wondered how the big names like Federer and Djokovic get as much power as they do and make it look so easy? Lachlan Hough, Physiotherapist from our Rosebud Clinic tells us how. The answer of course, is technique and timing. What you may not know, is that whilst working on your technique can improve your game, it also reduced the likelihood of you getting pain and frustrating injuries like ‘tennis elbow’and tears of the ‘rotator cuff’ in the shoulder. HOW CAN YOU AVOID INJURY ON THE COURT? 1. Move your feet! The benefit of having sound timing and good footwork is easy power. By shifting your weight forwards through the shot and hitting the ball on the rise, you rely far less in your racquet arm to create power. Instead you use your opponent’s power against them. Less reliance on your shoulder, elbow and wrist to create power means less chance of injury. 2. Bend your Knees! If you have had tennis lessons, you know coaches love this catch cry. Bending you knees does not just help you get down to that low ball, it also forms the first link in a crucial chain of movement. The ‘kinetic chain’ is the sequence in which the different parts of your swing combine to generate power. For example, in the serve, the most power should come from the largest muscles. Starting from the ground up by bending the knees, then powerfully launching upwards extending the knees and hips, rotating through the trunk, before finally throwing the racquet upwards and forwards to connect with the ball. If even one link in the chain is faulty or insufficient, it results in a ‘catch up’ effect, where the later segments of the chain try to compensate. Playing catch up almost always eventually leads to injury with repeated excess strain on the elbow and shoulder in particular. 3. It’s NOT Squash! Tennis racquets are bigger and heavier than the squash equivalent. Adopting a technique of slapping or swatting the ball using the wrist and elbow results in excess stress on forearm muscles leading to painful and often persistent tennis elbow. The odd squash shot is good for getting out of trouble but use too often at your own peril. In particular, be careful to maintain a strong wrist position on that classy single handed backhand to avoid elbow injuries. A droopy wrist is no good for your shot, or your elbow. WHO CAN HELP? 1. Your tennis coach Your coach is an expert in all things tennis. At your next lesson, ask your coach to closely assess your technique, particularly the serve. You may just fix an issue before it becomes a problem. 2. Your Physiotherapist If you’re injured on the court, then a visit to your physiotherapy for treatment and advice will allow you to have a quicker road to recovery and be back on the court faster. If you can, take a short video of your serve/forehand/backhand and bring it in to your appointment when you’re nearing a return to play. It may just help to design a tailored strengthening program to improve the parts of your swing that you need most! For more information or to make an appointment, you can BOOK ONLINE or call your local clinic..