Rotator Cuff Injuries

What is the rotator cuff?

The rotator cuff is the group of four tendons that surround the shoulder joint and connect the muscles of the upper shoulder to the bones. Working together as a unit, they help to stabilise the shoulder, particularly during rotating movements. The individual tendons of the rotator cuff are the supraspinatus, infraspinatus, teres minor and subscapularis. The commonest tendon to tear is the supraspinatus, while the tendon least commonly torn is the subscapularis.

What are rotator cuff injuries?

The three most common conditions that can affect the rotator cuff are tendonitis, impingement and tears.

Rotator cuff tendonitis occurs when the tendons become inflamed due to irritation. This most often happens due to the overuse of repetitive movements. In some cases calcium can be deposited in the rotator cuff, leading to calcific tendonitis. Treatment for tendonitis includes rest, painkillers, anti-inflammatories and physiotherapy. In some severe cases, keyhole surgery may be needed. Rotator cuff impingement is the pinching or rubbing of any of the four rotator cuff tendons against the top of the shoulder blade. This condition and treatment for it are described in greater detail in the section on subacromial impingement.

A rotator cuff tear is an injury to one of the four rotator cuff tendons.

Why do rotator cuff tears happen?

One (or less commonly, more) of your rotator cuff tendons may be torn as a result of a traumatic event, such as a fall on an outstretched arm. A tear may suddenly occur when you try to lift or catch a heavy object. It can also happen due to overuse, such as too much repetition, especially after a period of inactivity. Tears can be age related and can be put down to some extent to wear and tear. If you suffer from subacromial impingement, you may also be more likely to experience a tear in one of your rotator cuff tendons.

How common are they?

Rotator cuff injuries and inflammation are one of the most common causes of shoulder pain. Rotator cuff tears are more common in people above the age of forty although they can occur in younger people. Tears in younger people are usually caused by an accident. In older people, tears are most commonly caused by impingement. Tears of the tendons are common in the "normal" population and it has been shown that as many as 30% of all 60 year olds may have a tear of the tendon. However treatment is only necessary if it is causing symptoms such as pain or weakness.