We’ve all heard about the rotator cuff and have an idea that it’s something to do with the shoulder but what exactly is it and why is it so commonly injured?  Hopefully we can enlighten you in this weeks post.

You’re right the rotator cuff has something to do with the shoulder.  In fact the four muscles that make up the rotator cuff are responsible for providing most of the stability to the shoulder joint.  The shoulder, regarded as a lax and loose joint, sacrifices stability in favour of movement.  We can move our shoulders through an impressive range of motion in three planes, but consequently the shoulder articulation or bony interaction is inherently unstable.  This is where the rotator cuff comes in.  Since the shoulder joint per se is rather unstable, the responsibility of making sure it remains intact lies with the rotator cuff.  The four muscles of the rotator cuff act to “suck” the head of the humerus (upper arm bone) into the glenoid cavity – making up the shoulder joint.  These muscles work hard during all shoulder movements to make sure the shoulder joint remains stable and intact.

The supraspinatus, infraspinatus, subscapularis and teres minor are the muscles that make up the rotator cuff.  All of these muscles are prone to injury due to the pressure that they are placed under while stabilising the shoulder.  Particularly, bowlers, golfers and tennis players are susceptible to injury of these structures.  Diagnosis of the specifically affected muscle, tendon or musculotendinous unit is possible with careful examination by a skilled chartered physiotherapist.  Each of the rotator cuff muscles, as well as providing support to the shoulder joint, assist with particular shoulder movements.  These can be assessed in order to determine the precise rotator cuff muscle that has been injured.

Once this is determined treatment can be tailored specifically to the injured muscle and is far more effective.  Treatment for rotator cuff strains or tendonitis is carried out by a chartered physiotherapist and should consist of manual therapy and exercise rehabilitation.  If a ruptured or torn rotator cuff is suspected an MRI and an orthopaedic surgeon’s opinion is sought.

In general, tears or ruptures of the rotator cuff tend to occur acutely and the onset can be isolated to a particular fall or trauma.  Strains and rotator cuff tendonitis are more often chronic in onset as a result of overuse.