Rotator Cuff

Causes, Symptoms, Diagnosis, Treatment and Prevention

Your rotator cuff is made up of four muscles and their tendons which allow you to move your arm away from your body. These muscles and tendons connect your upper arm bone with your shoulder blade and help to hold the ball of your upper arm bone firmly in your shoulder socket.

Rotator cuff injuries often occur as a result of microtrauma caused by repetitive movement in occupational or sporting activities. The rotator cuff muscles are put under a great deal of strain during racquet sports and other activities where the arm is frequently above the head.

Rotator Cuff Injuries May Occur:

  • Suddenly, by a single traumatic event – lifting a heavy weight or performing sports and activities that put a strain on the shoulder.
  • Tissue degeneration as you age – especially after your 40s, in occupations that require frequent arm movement. Over time, the rotator cuff suffers tiny tears which make it weaker and more prone to larger tear that may develop even without notable trauma.
  • Shoulder Impingement Syndrome – the term describes painful pinching of muscles or other soft tissues when they are squeezed in between the bottom part of scapula’s acromion and the top of the glenohumeral joint. The impingement can be caused by structural and functional issues in the shoulder area.

Risk Factors

The following factors may increase your risk of having a rotator cuff injury:

  • Working conditions– long hours of computer usage or sitting at a desk puts undue stress on the neck and shoulders.
  • Age – as you get older, your risk of suffering a rotator cuff injury increases, rotator cuff tears are most common in people over 40. Studies show that 15-30% of people over the age of 70 have rotator cuff injuries.
  • Exercise – Athlete who regularly use repetitive motions, such as racquetball players, hockey players, etc. are at greater risk of having a rotator cuff injury.
  • Working in construction – Carpenters and painters, who also use repetitive motions, have an increased risk of injury.
  • Poor posture– Poor posture over many years can allow nerves, muscles or tendons to become pinched in your shoulder region.
  • Previous injuries– Previous injuries irritate the surrounding joints, nerves and ligaments making them susceptible to pain or restricted movement.
  • Shoulder arthritis – this condition causes shoulder instability and muscle weakness which put more stress on the rotator cuff, making it more susceptible to injuries.

Based on the above risk factors, if you are at risk of rotation cuff injury, the best way to prevent it is with regular shoulder stretches and strengthening exercises. Visit your nearby KKT clinic and get a comprehensive exercise plan from our doctors, to help you effectively prevent further injury.

Symptoms of Rotator Cuff Injuries

Shoulder pain. The pain is especially bad at night, during racquet sports and activities involving throwing, and when bending the arm and rotating it outwards against resistance. The pain may be felt on the outside of the shoulder and at times radiating down the arms.

  • Stiffness in the shoulder joint. This symptom is felt the most when you get out of bed in the morning.
  • Limited range of motion. You can’t lift your arm overhead or hold it away from the body.
  • Swelling and tenderness.
  • Cracking and popping sensations.

Diagnostic Process for Rotator Cuff Pain

Examination and Assessment

The diagnostic process of rotator cuff pain starts with a patient consultation and assessment. Your doctor will ask you about your history of pain, types of activities that may cause the pain and range of shoulder motion as a result of the pain. After asking about your history, the doctor will physically examine the rotator cuff and test its muscles in isolation. The doctor may perform some maneuvers and based on the results, without taking further imaging tests, can determine whether or not the pain is caused by a rotator cuff injury.

Diagnostic Tests

Before estimating a rotator cuff injury, the doctor will rule out other causes of pain such as cervical spine disease, shoulder arthritis, and shoulder bursitis. An X-ray can’t diagnose the injury to the rotator cuff itself, but show previous shoulder injury, degenerative tears or some risk factors. Ultrasound, this type of test uses sound waves to produce images of structures within your body, particularly soft tissues such as muscles and tendons. It allows dynamic testing, assessing the structures of your shoulder as they move. It also allows a quick comparison between the affected shoulder and the healthy shoulder. MRI is a procedure that takes approximately 30 minutes to perform, during which the patient needs to be completely still. The results of the MRI will provide a detailed, cross-sectional view of the shoulder that can’t be seen on ultrasound. The only things that can’t be seen on MRI are changes in the soft tissue during shoulder movement because the patient is not allowed to move.

Treatment of Rotator Cuff Injuries

There is range of treatments available for rotator cuff injuries, which depending on the severity of the injury are divided in invasive and non-invasive treatments.

  • The non-surgical treatment includes three phases: pain control and rest, restorative and integrative phase. The patient is given anti-inflammatory medications or cortisone injections to alleviate the pain, while having their shoulder immobilized to limit movement. Immobilization lasts for a brief time because low range of motion can further lead to more complications. In the restorative phase, the patient undergoes physical therapy that focuses on strengthening the rotator cuff, add stability and flexibility. In the last, integrative phase, the patient gets back to the normal activities but incorporates small changes in lifting motions that are designed to prevent further injuries. If these treatments don’t work, the patient may be recommended other non-invasive treatment or injections, which are still being researched.

The KKT process plays an integral role in stimulating the connective tissues of the spine to promote cellular regeneration. KKT utilizes “Quantum Waves” which can gently restore your rotator cuff to its original position. This will allow many of the muscles, ligaments and nerves which have been abnormally positions, due to the shift from your injury, to return to their normal positions. KKT is an evidence-based treatment that addresses the underlying cause of pain, rather than masking the symptoms.

  • Surgery – in case the rotator cuff is completely torn, surgery might be the only option. The surgical repair should relieve the pain and restore the function to the shoulder. However, the results of surgery are notable after several months and the patient needs to continue the healing with physical therapy, which also adds to the recovery process.

All of these treatments are used to possibly alleviate the pain of rotator cuff injury. But, many of them provide temporary relief or merely mask the symptoms. These treatments don’t work towards the goal of reversing the underlying conditions that are the source of the pain. KKT is the only treatment modality that has been proven through careful and systematic research and clinical studies to provide proven and lasting results to back pain, neck pain, and shoulder pain.

Clinically relevant factors to keep in mind with the treatment of the shoulder, are that treatment not only requires rest, but also requires that the neck and its nerve supply be restored.

If you are concerned about any of the signs and symptoms above, a comprehensive diagnostic assessment by a KKT physician will show if you require treatment.  Click here to find your nearest KKT clinic and book an appointment.




I first injured my shoulder when I fell on it eight years ago. Over the past year the shoulder pain began to radiate into my arm and neck. I also felt tightness in the neck. Despite lots of physio and injection therapy and medication, I wasn’t progressing. Within the first few minutes of the


KKT treatment, the strength and movement started returning to my arm and shoulder. What a great feeling. I have continued to progress week after week. What was unique about the KKT process was that it addressed my entire body. I can now move my neck smoothly and even my legs are now equal in length.

-Mrs. A. Patel.

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