What is the Rotator Cuff?
The rotator cuff is formed by the tendons of four muscles: supraspinatus, infraspinatus, teres minor and subscapularis. This group of muscles and their tendons stabilize the shoulder joint and provides the majority of its motion. The shoulder is not meant to be a large weight bearing joint. Instead, it is meant to give us the ability of motion (reaching, eating, caring for ourselves and family, etc).
What causes a Rotator Cuff Disorder?
Repetitive motion and overuse of the shoulder can cause irritation of the rotator cuff tendons as they insert onto the bone of the upper arm (the humeral head). Too much strain on the tendon can cause small tearing, and the body begins the repair process. The rotator cuff is an area of poor blood supply which means that it is more susceptible to degeneration when compared to other parts of the body. The cycle of tear and repair, is common among many of the musculoskeletal problems that we face as we get older.
How is it diagnosed?
A thorough history and physical examination can identify a rotator cuff problem. Given the severity and persistence of symptoms, advanced imaging may be required to determine if a full thickness tear has occurred in the rotator cuff. A new full thickness tear will require an evaluation by an orthopedic surgeon.
How is it treated?
Initial treatment includes controlling pain and inflammation. This can be achieved with activity modification, medications, stretching, and steroid injections. Later, treatment will focus on strengthening of the rotator cuff tendon to prevent further tears. When treatment options have failed and surgical treatment is not recommended, regenerative medicine is a safe alternative.