The Rotator Cuff

The Rotator Cuff

The shoulder is the most mobile joint in the body and relies heavily on muscles for both movement and stability. The Rotator Cuff (RC) is a group of deep muscles that originate from the both the front and back of the scapula and attach onto the head of the humerus: Supraspinatus, Rotator Cuff MusclesInfraspinatus, Teres Minor and Subscapularis.

The Role of the Rotator Cuff

The RC has two major roles: to provide dynamic stabilisation to the shoulder as you move your arm in all directions and to oppose the force of the deltoid muscle as it tries to elevate the humeral head in the shoulder joint as you lift your arm overhead.  The RC muscles recruit at different times , both actively as movers and then as stabilisers, through your active ranges in different directions. Although the RC muscles are separate structures, their tendons are not. They merge prior to inserting into the head of humerus to form a common and continuous tendon before attached to the humeral head at the front of your shoulder. 

Injury to the Rotator Cuff

Injury to the RC can occur in a number of ways: acute injury (direct blow or fall, muscle strain, etc), Frozen Shoulderchronic , e.g deconditioning of RC over time, or a combination of the two. It is important to be thoroughly assessed to rule out any other pain-sensitive structures or pathologies, e.g. nerve involvement, referred pain from neck/upper back, bursae, biceps tendon, and so on.

The RC often gets forgotten about in weight training, especially for upper body and shoulder work. Range of movement exercises for internal and external rotation of the shoulder and thoracic spine as well as exercises targeting stability and endurance of the RC should be incorporated in a warm-up or as part of a shoulder programme.

Rotator cuff injury is not to be confused with frozen shoulder (see previous blog post here). They have some similar presentation characteristics but are not the same clinical conditions.

For some exercises to get you started see our earlier blog post here. If you have any other queries regarding your shoulder, please contact your chartered physiotherapist.

References:

Lewis, J. Rotator cuff related shoulder pain: assessment, management and uncertainties. Manual Therapy, 2016; 23:57-68.

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Áine Tunney MISCP

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