The rotator cuff tendons stabilize the shoulder joint and help initiate movement. The rotator cuff is comprised of a series of tendons that attach to the top of the humerus bone in the shoulder. On the other side, those tendons are attached to the rotator cuff muscles: the subscapularis, the supraspinatus, the infraspinatus, and the teres minor. These muscles do the work of the rotator cuff, allowing the shoulder joint to move with a great degree of flexibility while keeping it stable. Partly because of the dual role of the rotator cuff, it is a common source of injury and pain in the shoulder.
The anatomy of the shoulder allows it great flexibility in motion but also makes it susceptible to injury. The rotator cuff is at risk for injury during both repetitive motions during work or sports, such as reaching above one’s head, and traumatic events, such as falls and car accidents. Lifting or moving an object while the arms are outstretched also places a significant amount of tension on the rotator cuff and can lead the muscles and tendons to tear. Injury or damage to the rotator cuff is frequently the reason for shoulder and arm pain with activity and at night. In some cases, severe injury can lead to weakness in the arm and difficulty with motion at the shoulder.
A mild rotator cuff injury can be treated with anti-inflammatory medication, corticosteroid injections, and physical therapy to reduce inflammation and improve range of motion. Exercise keeps the joint flexible and improves the condition of the supporting muscles and tendons while the injury is healing. If the tear is large or non-surgical treatments fail to improve symptoms, surgery may be recommended. Arthroscopic shoulder surgery can be performed to reattach or repair the damaged rotator cuff tendons. Mini-open or conventional open surgery may be needed in some cases. No matter what treatment methods are used, physical or occupational therapy is necessary to keep the shoulder joint mobile and to maximize the chance for a full recovery.
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