The rotator cuff is comprised of the tendons of four muscles: the supraspinatus, infraspinatus, teres major and and subscapularis. These muscles all surround and attach to the shoulder, allowing for increased mobility and flexibility of the joint. At the same time, these muscles help to stabilize the shoulder by keeping the humeral head properly aligned inside the glenoid fossa of the scapula. The dual functions of the rotator cuff permit proper mechanics at the ball and socket joint, but can also make the cuff prone to muscle tears and tendonitis due to overuse and trauma.
A rotator cuff tear can occur if the tendons of the cuff are continuously inflamed and weakened through a repeated motion of the shoulder. Over time, an already compromised tendon can eventually sustain a partial or a full thickness tear. These injuries are common in athletes who perform overhead activities, such as swimmers, quarterbacks, and baseball players. In addition, women over 40 years old have an increased risk of developing a tear. A direct trauma to the shoulder may also lead to a tear, as in falling on an outstretched arm. Symptoms of a rotator cuff injury may include pain, swelling and restricted movement of the shoulder joint.
In most cases, conservative management of a rotator cuff tear, involving rest and physical therapy, will be sufficient for a return to normal function. However, in severe cases, surgical repair may be indicated. Physical therapy will include modalities, strengthening/stretching exercises, and postural assessment so that the patient will not compensate for their injury and risk straining other muscles.
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