What's the rotator cuff?

Do you know what the rotator cuff is? Do you know it’s not just one thing? Have you ever been told that you’ve hurt (or torn) your rotator cuff?

Despite being discussed as a single structure, there are actually four different muscles that make up the rotator cuff. These muscles travel from different parts of your shoulder blade and attach on the ball of your arm bone (humerus). You may have heard their names before – supraspinatus, infraspinatus, subscapularis, and teres minor. Although these names are fun, no need to become caught up in their differences just yet!

We talk about the ‘rotator cuff’ as one because these muscles work so closely together. It’s their job to help you lift your arm, rotate it when throwing, or reaching behind/across your body; and it’s also their job to assist with stability at the shoulder joint when you reach, lift, throw, push through your arms… or really anything that involves movement at the shoulder!

These muscles are extremely active much of the time – in life, work, exercise, fun, you name it! Because of this, it’s super common to have overuse injuries here. In fact, this is most often how we see a rotator cuff injury develop. There are some instances when a traumatic event leads to an injury; and sometimes these require more invasive treatment. However, most of the time, repetitive motions, certain movement patterns or biomechanics, and time in general can contribute to developing a rotator cuff injury. We often diagnose this as shoulder impingement, although more accurately should be called a rotator cuff tendinopathy.

A surprising bit of info here is how common these ‘injuries’ are! 1/3 of adults over 30 years old will have abnormal findings on an MRI… and that number jumps to 2/3 over the age of 70! Even more, 2/3 of people will have abnormal findings on an MRI even after a surgically repaired rotator cuff. With these stats, does it mean that all of these people need to see a physician or physical therapist? Not necessarily! An MRI detecting an ‘abnormality’ is not an absolute that that person will have pain or dysfunction. We need to assess their function, strength, and ability to do the tasks they need to in their life before making that decision! Many people go through life without issue, even if an MRI would argue otherwise. So, what about those people who do have problems? Shoulder issues are really common, right?

In the absence of a significantly traumatic event, rotator cuff related pain responds very well to conservative interventions. Physical therapy is one of the first treatment options. Interventions include pain management, regaining shoulder mobility, strengthening the four rotator cuff muscles (as well as other muscles of the shoulder), and improving dynamic stability and neuromuscular control - all so those muscles can provide stability through all that life throws at you!

So, if you find yourself with shoulder pain, don’t go running to your physician, to get an MRI, or a cortisone injection just yet! Of course, there is a time and place for these, but we can often save time and money by identifying the root cause of that shoulder pain and providing it with exactly what it needs.

Shoulders are so important for a high quality life! Be sure to give yours the TLC they deserve, and to be proactive about keeping them healthy for the long haul!
Check out some of our favorites for the shoulder on our Youtube Channel.

If you find yourself having a hard time returning to the activities that matter, or your shoulder pain seems to be lingering around, seeking care from a professional can lead to a specific plan for what YOU need. I recommend setting aside 30 minutes to give us a call and figure out exactly what may be causing your pain and how you can resolve it.

We’re always here to talk and answer questions along the way. Cheers!
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Dr. Elle Carlson