Rotator Cuff

by Mandy Bane

What is the Rotator Cuff?

The term “rotator cuff” refers to a group of four tendons that attach four shoulder muscles to the upper arm. The four muscles are: Supraspinatus, Infraspinatus, Subscapularis, and Teres Minor. The rotator cuff is a structure composed of tendons that, with associated muscles, holds the ball at the top of the humerus in the glenoid socket and provides mobility and strength to the shoulder joint. Two filmy sac-like structures called bursae permit smooth gliding between bone, muscle, and tendon. They cushion and protect the rotator cuff from the bony arch of the acromion.

What causes Rotator Cuff problems?

The most common cause of rotator cuff problems is shoulder impingement, in which there is a narrowing of the gap between a portion of the shoulder blade known as the acromion and the top of the upper arm bone. This causes increased friction and gradually damages the rotator cuff, causing it to tear or wear down.

Treating Rotator Cuff Injuries

Rotator cuff tears often require surgical treatment. There are several surgical options, and different factors may influence which procedure is best for you. If you need rotator cuff repair surgery, you may want to discuss the surgery with your doctor.

• Control your pain . Over-the-counter medicines or prescription medication is given to help to relieve pain. In addition, cryotherapy can help to decrease the pain and local swelling. Avoid activities that can worsen your pain - particularly overhead activities, repetitive motions, and heavy lifting. Do not put your arm in one position for a long time - keep it mobile. Your physician may give you a steroid injection into your shoulder area to also help improve the pain. Most orthopedic surgeons recommend that you get no more than one or two of these a year, as they do have the potential to weaken your tendons (every person is different, however - you should check with your doctor).
• Regain motion . It is critical to regain the motion lost as a consequence of having this tear of the cuff muscle/tendon. Strengthen the other muscles of the rotator cuff that are not torn. These muscles can help to compensate for the torn muscle. Because their are 4 muscles in the rotator cuff, and usually only one is torn, sometimes strengthening the others is all you need to return to pain-free function. Sometimes, if all this fails to relieve your pain, rotator cuff repair surgery might be needed to re-attach the torn tendon. There are lots of pros and cons to surgery, and different people need surgery for different reasons - be sure to discuss this with your doctor. The bottom line is that not everyone with a rotator cuff tear needs surgery to feel better.