The rotator cuff is a set of 4 tendons that insert contiguously into the head of the humerus:
- the subscapularis
- the supraspinatus
- the infraspinatus
- the teres minor
Between the subscapularis and supraspinatus there is a space occupied by another tendon, the long portion of the biceps (PLB), so it is often considered part of the rotator cuff, although it is inserted within the shoulder joint itself.
Like almost every structure in the body, the rotator cuff has several functions:
- It contributes to the mobility of the shoulder, especially rotation (hence its name).
- It centers the humeral head during movement
- It is an important secondary stabilizer
Rotator cuff injuries and causes
Cuff injury encompasses a wide spectrum of conditions, from tendonitis to a complete retracted tear. This can be caused by trauma, but most patients report a degenerative disorder or a work or leisure overload.
These usually have in common a maintained use of the arm above the shoulder, so it is frequent among painters, electricians, tennis players, javelin throwers…
Symptoms vary depending on some factors such as:
- Origin of the injury
- Musculature of the patient
- Use of the arm
Traumatology specialists indicate that there is usually a deep pain in the anterior and lateral aspect of the shoulder, with irradiation towards the elbow and a decrease in its mobility, which may even be associated with a striking muscle weakness.
Treatment of rotator cuff injury
Due to the variability of lesions and symptoms, the treatment is not unique, but has to be adapted to each patient. Roughly speaking, it can be divided into:
- Surgical treatments: these treatments have advanced greatly in recent years. We have moved from open surgery to arthroscopic techniques with regional nerve blocks, which greatly improve postoperative pain control and patient comfort. Basically, an attempt is made to reconstruct the patient’s normal anatomy, mainly by sewing the ruptured tendon back to the bone.
- Non-surgical treatments: include oral anti-inflammatory drugs, rehabilitation (multiple techniques) and infiltrations.