Medicine / Orthopaedics
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The rotator cuff, to tear, or not to tear?

April 14, 2007

Matthew Vasey, MD



The rotator cuff muscle is actually composed of four individual muscles, three of which connect to a single point on the humerus, or arm bone and one muscle that is attached alone to the humerus. The names of the muscles are the supraspinatus, infraspinatus, teres minor and the subscapularis which for all practical purposes outside of medicine are irrelavent. Many patients will errantly, refer to this group of muscles as their "rotary cup", or "rotation device".

The important thing to know about the rotator cuff is how it can be damaged. In most cases, the cuff is injured by repetitive overhead motions such as throwing a ball, lifting weights, hitting a volleyball, giving excessive amounts of hi-5's to your friends or even activities as seemingly trivial as reaching into overhead kitchen cabinets. Seventy years of rotator cuff stress from reaching over your head in the kitchen can really add up.

The vast majority of rotator cuff tears involve the supraspinatus muscle. That is the muscle found just below the bone you feel when you touch the top of your shoulder. The combination of the ball of the "ball-and-socket" joint which in actuality, not a ball at all, but rather a hard bone compressing up against the undersurface of the bone above can serve to shred the soft muscle of the rotator cuff.

Should you find that your shoulder is giving you pain and your range-of-motion is not what it used to be, a visit to the doctor is warranted. There are a range of imaging and diagnostic techniques that can be used by your doctor to find out if you have a rotator cuff problem. Importantly, not all tears of the rotator cuff require surgical treatment. If surgery is recommended, there are safe and effective treatments available.

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