The rotator cuff is a group of four muscles and their respective tendons. The origin of each muscle is on the scapula, shoulder blade, and the insertion is on the humuerus. The four muscle-tendon units are the subscapularis, the supraspinatus, the infraspinatus and the teres minor. These muscles are required for normal motion and strength of the upper extremity and are mandatory of forceful rotation, i.e. rotator cuff. Pathology is not uncommon for the rotator cuff because of overuse, micro trauma, or macro trauma, tear. Rotator cuff tendonitis, tendon inflammation, is a common condition for people with upper extremity intense jobs or throwing athletes. Tendonitis is more common for patients in their 40’s and above but can occur and any age. Rotator cuff tears are relatively uncommon in patients under 40 unless associated with major trauma, lifting, throwing, etc.
Prevention of rotator cuff tendonitis is based on a healthy program of stretching and strengthening. Once pain occurs, anti-inflammatory medication, activity modification, physical therapy (home or formal) and under certain conditions an injection of corticosteroids may be helpful and necessary to regain function. However, if the pain is persistent, severe and associated with weakness a rotator cuff tear is possible. Magnetic resonance imaging (MRI) is a diagnostic non-invasive test to evaluate the rotator cuff and other structures in the shoulder such as the biceps muscle and tendon, the ligamentous structures and other soft tissue and bony elements. If the rotator cuff tendon is/are torn then repair may be indicated. The technologic advances of arthroscopy, minimally invasive surgery facilitated by an arthroscope and small incisions, allows repair of almost all rotator cuff tears without large incisions. Arthroscopic treatment of the rotator cuff tears creates less pain, shorter rehabilitation and a more complete return to pre-injury activities. If you have shoulder pain or weakness, see your local orthopedic surgeon.
William Beach, MD, Richmond, Va. from IWLF May Newsletter
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