Other terms to describe the same condition
Rotator Cuff Related Shoulder Pain (RCRSP) is a commonly used term to describe this condition.
You may also hear it called:
- Sub-Acromial Shoulder Pain
- Sub-Acromial Bursitis
- Sub-Acromial Impingement
- Rotator Cuff Tendinopathy
- Rotator Cuff Tendinitis
Basically, it is an umbrella term relating to shoulder pain, mostly likely driven by the Rotator Cuff tendons and/or Sub-Acromial Bursa which sit in the space below the Acromion bone as shown below.
This condition is unlikely to be caused by a traumatic incident or ‘moment in time’ mechanism of injury.
It is more likely something that appears gradually or in the days following increased shoulder loading.
Why am I getting Rotator Cuff Related Shoulder Pain?
An important concept regarding Rotator Cuff Related Shoulder Pain is “Load vs Capacity”
Capacity refers to the amount of load you can tolerate. Your capacity may be influenced by many factors including:
- level of muscle strength and endurance
- age
- how long have you been doing the activity (training age)
- general health related factors such as sleep, stress, diet and smoking
Load refers everything you do with your shoulder including movement, exercise and daily activities like lifting and carrying. Examples of common activities which may lead to Rotator Cuff Related overload include:
- Repetitive overhead movements eg. shoulder press
- Sustained overhead movement eg. hanging out washing
- Repetitive shoulder tasks eg. painting
- Heavy pressing eg. bench press
- Vibrating power tools
- Heavy lifting
Most often, pain in this area is related to an increase or change in load.
More specifically, pain is more likely to occur when load exceeds capacity.
There may be other contributing factors to Rotator Cuff Related Shoulder Pain such as deficits in movement, strength and/or biomechanics which will be assessed by your physiotherapist.
So how do we treat it?
De-load = calm it down
Re-load = build it back up
That may seem like an over simplification, however keeping things simple is usually the best approach. This is particularly true, if this is the first time you have experienced shoulder pain or there was a clear increase/change in load that preceded the onset of your shoulder pain.
By listening carefully to your history, as well as thoroughly assessing your movement, strength and function your physiotherapist will use these assessment findings to:
- determine what things you should be limiting/avoiding in the short term to allow your shoulder to settle down
- identify any areas that require specific intervention be that manual therapy, exercise or other interventions such as taping
How long will it take to get better?
We would recommend a rehabilitation period of at least 12 weeks in most cases before considering alternative treatment options.
Many cases of Rotator Cuff Related Shoulder Pain improve much quicker than this but it very much depends on your specific presentation.
After your initial assessment, your physiotherapist should be able to give you a more accurate estimate regarding prognosis.