What is the Rotator Cuff?

/ Embody Health Centre/
A man in pain stretching his shoulder

The rotator cuff is a term used to describe four muscles and their tendons that aid in supporting the shoulder joint. The shoulder is a ball in socket joint, in which the round head of the humerus, attaches into the glenoid cavity of the scapula (termed the glenohumeral joint). These four muscles arise from the scapula and connect to the head of the humerus, forming a ‘cuff’ around the glenohumeral joint. The four rotator cuff muscles are called the supraspinatus, infraspinatus, subscapularis and teres minor.

These rotator cuff muscles are essential in almost every movement of the shoulder. Their role is to stabilize the shoulder by keeping the head of the humerus within the glenoid cavity. Due to their high function, injuries can commonly occur, resulting in shoulder pain, reduced mobility, impaired functional abilities and can impact quality of life. Injuries of the rotator cuff can occur at any age, and causes can include: repetitive overuse (such as volleyball, pitching or repetitive lifting), and secondary to trauma (such as a fall). The incidence of rotator cuff injury increases with age due to degenerative changes that occur in the muscles and their tendons.

Common symptoms of a rotator cuff injury:

  • Pain in the shoulder and may refer to the upper arm

  • Reduced range of motion of the shoulder, with or without pain

  • Muscle weakness

  • Impaired functional abilities, such as difficulties with lifting, raising arm over head, reaching, driving and/or putting a shirt or jacket on.

Common injuries of the rotator cuff:

  • Rotator cuff tendinitis: acute inflammation of the tendon

  • Rotator cuff tendinopathy: chronic irritation of the tendon

  • Rotator cuff tears: can be a partial-thickness tear or full-thickness tear of the muscle or tendon

  • Bursitis: inflammation of the bursa (small fluid sacs) that pads the space between the rotator cuff tendons and the shoulder.

  • Shoulder impingement syndrome: a structural narrowing of the subacromial space due altered biomechanics of the shoulder complex. The acromion then rubs onto the tendons, causing irritation and pain.

If you’re experiencing any pain and/or limitations in mobility and function of your shoulder, it is important to have your injury assessed to prevent further damage and aid in healing. Physiotherapists are trained in assessing and treating dysfunctions of the shoulder. An assessment would involve taking a thorough medical history, discussing the mechanism of injury, and current/previous physical activities and occupations. A physical exam would also be performed, examining mobility of the neck, shoulder, upper back and shoulder blade, strength testing, palpation of various muscles and tendons, and special tests are used to determine a diagnosis of the injury.

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