Rotator Cuff

What is the rotator cuff?

The rotator cuff is a group of muscles and tendons around your shoulder joint.

There’s one rotator cuff surrounding each of your shoulders. It connects your shoulder blade (scapula) to your upper arm bone (humerus). You use your rotator cuff to raise your arm overhead and to rotate your arm toward and away from your body.

Rotator cuff injuries are common, especially among athletes. Visit a healthcare provider if you’re experiencing shoulder pain, arm weakness or can’t move your shoulder without pain.

What does the rotator cuff do?

Your rotator cuff keeps your shoulder and upper arm stable when you move and use them. You can probably guess based on its name, but it helps you turn and rotate your shoulder.

The muscles and tendons in your rotator cuff surround your shoulder joint and hold the bones together. Your shoulder is a ball-and-socket joint. The ball-shaped upper end of your humerus (its head) fits into a socket in your scapula — sort of like a golf ball sitting on a tee.

Where is the rotator cuff?

The rotator cuff sits in a small space between your humerus and the upper part of your shoulder blade. It surrounds your shoulder and covers the head of your humerus.

What is the rotator cuff anatomy?

The rotator cuff is made of four shoulder muscles:

• The supraspinatus lets you rotate and lift your arm. It stretches from the top of your scapula to the upper end of your humerus (its head).
• The subscapularis lets you hold your arm outstretched, away from your body. It attaches to the middle of your scapula and stretches to the lower part of your humeral head.
• The infraspinatus helps you rotate your arm. It reaches from the bottom of your scapula and connects to your humerus behind the supraspinatus.
• The teres minor also helps you turn and rotate your arm. It attaches to the outside edge of your scapula and attaches to your humerus beneath the infraspinatus.

Tendons connect the muscles in your rotator cuff to the bones around them. Tendons are like levers that move your bones as your muscles contract and expand. When you contract (squeeze) muscles in your rotator cuff, tendons pull the attached bones to move your shoulder and upper arm.

What are common rotator cuff injuries?

Rotator cuff injuries are common because you use them so often for so many activities throughout your day. Injuries can happen suddenly or build up over time. Rotator cuff damage is a common sports injury.

The most common rotator cuff injuries include:

• Overuse syndrome.
• Shoulder impingement syndrome (rotator cuff tendinitis).
• Rotator cuff tears.
• Shoulder sprains.
• Swimmer’s shoulder.

How do I know if I tore my rotator cuff?

Rotator cuff tears cause shoulder pain. You may feel a dull ache deep within your shoulder, or the pain may feel sharp and stabbing. Sudden tears from traumas cause immediate, intense shoulder pain and arm weakness.

Visit a healthcare provider if you’re experiencing shoulder pain that doesn’t get better in a few days. Go to the emergency room if you can’t move your shoulder or experience trauma.

Which tests do providers use to diagnose injuries?

A healthcare provider will diagnose a rotator cuff injury with a physical exam and some imaging tests. They’ll examine your shoulder and ask about your symptoms. Tell them when you first noticed pain, and if any activities make your symptoms feel better or worse.

You might need a few tests, including:

• Shoulder X-ray.
• Magnetic resonance imaging (MRI).
• Ultrasound.

What are common treatments for rotator cuff injuries?

Which treatments you’ll need depends on which injury you have and its severity. Your provider will suggest treatments to relieve pain and help your rotator cuff heal, including:

• Rest and avoiding the physical activity that caused the injury.
• Icing your shoulder. Your provider will tell you how often (and for how long) you should ice your shoulder. Wrap ice packs in a thin towel to avoid putting them directly on your skin.
• Over-the-counter NSAIDs (nonsteroidal anti-inflammatory drugs) or acetaminophen relieve pain and reduce inflammation. Don’t take pain relievers for more than 10 days in a row without talking to your provider.
• Physical therapy can strengthen your shoulder muscles and help you regain your mobility, especially after an injury. A physical therapist will give you rotator cuff exercises to increase your strength and flexibility.
• Your provider may give you cortisone shots (steroid injections) — doses of corticosteroids (prescription anti-inflammatory medications) injected into your rotator cuff.
• You may need surgery to repair serious injuries or if other, nonsurgical treatments don’t relieve your symptoms after a few months. Your provider or surgeon will tell you which type of surgery you’ll need and what to expect.

How can I prevent rotator cuff injuries?

The best way to prevent rotator cuff injuries is to avoid overusing your shoulders:

• Stop exercise or physical activities as soon as you feel pain. Never “play through the pain” if your shoulder hurts during or after physical activity.
• Warm up and cool down before and after training or working out.
• Wear the right equipment for all sports and physical work.
• Follow a diet and physical activity plan that’s healthy for you.
• Visit a healthcare provider as soon as you notice pain or other symptoms.

Can a rotator cuff heal on its own?

Rest and avoiding physical activities can help your rotator cuff heal, but you should always get injuries examined and diagnosed by a healthcare provider. Don’t ignore symptoms like pain, weakness or a reduced range of motion (how far you can move your shoulder).

Continuing to use your shoulder or putting more stress on your rotator cuff can make minor injuries worse.