Rotator Cuff Injuries

Anatomy of the Rotator Cuff

The rotator cuff is composed of four muscles and tendons that originate on the scapula (shoulder blade) and attach to the humerus (upper arm bone). They move and stabilize the shoulder as it travels through various ranges of motion. The rotator cuff performs two main functions: primarily initiating movement of the shoulder when the arm is moved away from the body, secondarily pulling the humerus and scapula together, keeping them in close contact as the shoulder moves.

The four muscles of the rotator cuff are the subscapularis, supraspinatus, infraspinatus and teres minor. The most commonly injured rotator cuff muscle is the supraspinatus.

What causes rotator cuff injuries?

A rotator cuff tear may result from an acute injury such as a fall or may be caused by chronic wear and tear with degeneration of the tendon. It can also be caused by lifting heavy objects over your head, stress from repetitive activities, and bone spurs.

What are the symptoms?

  • Pain in the shoulder and during the night
  • Painful clicking and/or popping
  • Pain and/or weakness with certain movements
  • Possibly pain that radiates into the upper arm
  • Inability to rotate the arm & hand behind the back

How are rotator cuff injuries diagnosed?

A discussion of your symptoms, a physical examination, and X-rays are useful for a diagnosis. Your specialist may recommend having an MRI or CT scan as well.

How are rotator cuff injuries treated?

Many rotator cuff tears can be treated nonsurgically. Anti-inflammatory medication, steroid injections, and physical therapy may improve symptoms of a cuff tear. The goals of treatment are to relieve pain and restore strength to the involved shoulder.

If a nonsurgical approach doesn’t provide satisfactory function, or if you are active and use your arm for overhead work or sports, then surgery is most often recommended because many tears will not heal without surgery. Most of the time arthroscopic (minimally invasive) surgery is appropriate. However, some large rotator cuff tears may require traditional surgery, necessitating a long incision to repair the torn tendon.

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