About one third of us will have a rotator cuff injury at some time in our lives, I can't help thinking that if we all did shoulder exercises as part of our daily routine, that number could be greatly reduced.

Nearly Eight million Americans are going to complain of a rotator cuff problem this year alone. So what causes it and what is the best way to treat it?

The rotator cuff is a fairly small but important group of muscles that help to stabilise the shoulder joint. The shoulder joint consists of a very shallow ball and socket joint. The ball at the top of the humerus or upper arm rests on the socket of the shoulder joint that is on the outer edge of the shoulder blade. Think of it like a golf ball sitting on a tee. The rotator cuff muscles all run from the scapula to the head of the humerus holding it in place, surrounding the shoulder in a cuff of muscle which helps to keep the joint stable and stop it from dislocating every time that we lift our arm above shoulder height or lift something heavy.

Without the rotator cuff muscles it would be very easy to knock the ball off the tee, great in golf but not so good in a shoulder joint.

This group of muscles work hardest when there is a downward pressure on our shoulder. If you are working overhead, reaching out or lifting something they kick in to hold the shoulder together.

Which is why, if you injure any of them, you feel pain when you lift your arm up or out to the side.

As we get on a bit the rotator cuff start to weaken, usually through lack of use so we are more susceptible to this type of injury once we get past forty, although sportsmen are at risk as is anyone who is continually working above shoulder height, decorators, painters etc..

Fortunately the majority of rotator cuff injuries can be sorted out with exercise. The typical rotator cuff treatment will involve rest to allow the muscle to start healing, coupled with treatment of any inflammation or swelling with non steroidal anti-inflammatory drugs. A lot of the pain in a rotator cuff injury is down to the inflammation where swollen tendons can get impinged or trapped. It is vital to allow the muscles heal and the inflammation to reduce before beginning any exercise.

Working through a rotator cuff injury can only cause more damage and can even lead to you needing corrective surgery.

Once the inflammation has gone and everything has settled down you need to do some physical therapy aimed at strengthening the rotator cuff muscles. You will usually find that within about six weeks, you can get your shoulder joint back to movement without experiencing any pain simply by following a rotator cuff treatment programme.

Once you have, then it is essential to continue with the exercises to make sure that your shoulders stay fit, healthy and trouble free.