Shoulder Injuries (Rotator Cuff Injuries)

The rotator cuff or rotor cuff is the group of muscles and their tendons that act to stabilize the shoulder. The four muscles of the rotator cuff, along with the teres major and the deltoid, make up the six scapulohumeral (those that connect to the humerus and scapula and act on the glenohumeral joint) muscles of the human body.

Rotator cuff tears are tears of one or more of the four tendons of the rotator cuff muscles. A rotator cuff injury can include any type of irritation or damage to the rotator cuff muscles or tendons. Rotator cuff tears are among the most common conditions affecting the shoulder.

The tendons of the rotator cuff, not the muscles, are most commonly torn. Of the four tendons, the supraspinatus is most frequently torn as it passes below the acromion; the tear usually occurs at its point of insertion onto the humeral head at the greater tuberosity.

Patients suspected of having a rotator cuff tear are divided into two treatment groups initially: Each patient is initially a candidate for either operative or non-operative treatment, however patients are re-evaluated throughout the course of treatment and may move from one group to the other based on their clinical response and findings on repeated examination.

Since many patients with partial tears and some even with complete tears can respond to non-operative management, generally conservative care is offered first. If a significant trauma such as a shoulder dislocation, or fracture, or high energy force is known to have been followed by complete to near complete loss of rotator cuff- mediated motion and strength, then an operative work-up is initiated with plans to proceed to surgery for repair, if confirmatory.

Depending on the patients status there can be non-operative treatment or invasive treatment.